I posted this on another thread that wasn't really correct...I hope I can get some feedback from this thread. I've been an RN for22 years, and until now have never violated the rule of altering a document by "writing over" existing writing. Well, I did it this week...I'm aghast and shocked that to do such a thing would ever cross my mind!! It was on 2 injections that I gave over the past 2 months (1 every 4 weeks). I saw that I had written I had given half of the dose ordered by the Dr., and without thinking I wrote over my own handwriting to reflect the full dose. The next day I was terminated for doing this. Some background; I hated the job I was at, and was overwhelmed and unsupported by anyone I worked with. Anything I did was never enough, and never correct in their eyes. I had a total hysterectomy this past April and went back to work in June. I went thru instant menopause with the surgery, and am not able to use HRT. I realized that my thoughts and emotions weren't like they used to be, and the daily anxiety of simply going to work put me into a near panic. No harm came to the patient, but I was clearly wrong in what I did. I can't even explain why in the world I would do such a thing. Please give me feedback on the possible repurcussions of this action. My husband told me he was glad I was out of that place, but I'm worried sick about my license. I've never done anything like this before!! Please help me assess what I need to do. Thanks in advance.
Specializes in Med/Surg, ER, L&D, ICU, OR, Educator.
Originally posted by sjoe
Catastrophizing
Great word!:)
I agree that if you actually gave the full dose, but mistakenly charted giving only half the dose, and are making a correction so the record reflects more accurately what was done...this seems minor indeed. Perhaps a new entry to clarify would have been more correct, but what's done is done! Listen to Barbara...she gave you some great advise!
I thank all of you for your advice and feedback. It is true I'm almost irrationally emotional about this because I have never even THOUGHT of doing such a thing in the past 22 years!! Why now?? This is the whole picture; this particular patient was basically non-compliant with any sort of treatment. He's a homeless man, who openly told the agency I worked for that he wasn't going to take any oral meds because he wanted to continue to drink his liquor. He did accept the 2 injections, which were depot meds, one shot every 4 weeks. When I gave him the injections, I'm sure I read the DO to administer the IM. When recording the shots, I think what I did is look at the previously recorded IM on the MAR, which was half of the dose ordered, (the med had been increased by the time I was giving them). I was told by my nursing supervisor that I had actually filled out an incident report in the past month that he got only the smaller dose. Have I confused everyone yet? She rightfully confronted me during the meeting about which action was true; had I given only half and "fradulentely" changed the MAR, or had I given the correct dose and incorrectly filled out an incident report? I thougt I had given the full amount, but I didn"t intend to be fradulent. For some bizarre reason, I reasoned that since it was my writing, I could change it!! I'll tell you what my mindset was at the time I did the act; I had been experiencing increasing hostility and thinly veiled verbal abuse over the last month from the people I worked directly with. I was becoming less competent in my work as my anxiety level increased. I was forgetting things constantly, or assume I had done something that I hadn't. The nursing supervisor is a wonderful supervisor and nurse. I respected her greatly, but she was not around me in the day to day activities of my job. I went to her several times with concerns and problems I was having, and she was supportive, but nothing changed in my work environment. By the time this incident happened, I was convinced they were going to fire me, and was seriously considering turning in my resignation before I got to the point of complete emotional collapse. Obviously, being fired happened first. The irony is, the people I worked with are convinced that they are such a "nice" group to be with. That's another thread in itself. As far as legal advice; I appreciate all points of view. I'm aware all of the states have different standards and expectations. Michigan may be very different from Fla. By the way, just because the man was homeless didn't mean I didn't care about the possible effect on him; I did. What set me off emotionally is to think I would do something as a nurse that may harm someone! I'm sure my emotions are whacked out because of the instant menopause... that too is another thread!!
I totally agree with Barb, even tho I am in OZ, and our policies may be different , you are being too hard on yourself !
Sounds to me as if you were due out of there anyhow !
Certainly would not have been a ": termination" issue where I work, an " incedent form" would have been filled in by you , and at the most , the NUM would have slapped your wrist !
Relax, and learn from the mistake , you will never do it again! I bet
Thank you for your support. Going thru instant menopause is indeed hell!! I had no idea it would make me so whacky!! One of the nurses I worked with called me last Monday to see how I was (this was 3 days after the incident). I told her that I think I unconsiously set myself up to be fired because I hated the job so much, and yet I felt an obligation to several people to stay there. ( I know it sounds crazy, but that's how I felt!). She told me one of the Drs. came up to her afterward and asked what had happened...when she told him I had been fired and what had happened, he told her that he would have "stuck up" for me, and felt getting fired over something that didn't harm the client was unfair. But who said life was fair? My ex-colleague was very supportive of me, and said "I know you're a good nurse....you know you are too.." I felt so relieved that she had called me. I still don't trust the agency to not report me...they are one of those places that seem to enjoy making life hell for those they decide are unworthy of their company. Again, thank you for your kind words and encouragement and prayers.
something not quite right here. I could understand if you had altered the dose from a full one to a half one but the other way around?. Are you sure your telling the whole problem or is there something else that may have happened before?
You'll have to read my original post. It explains the whole situation. Something that happened before?? Before what??
The whole thing is such a senseless act on my part...my own medical Dr. said he thinks I was either in the midst of a panic attack, or was having a "psychotic fugue"!! That's a pretty strong statement! This person has been my Dr. for 12 years, and he knows all of my medical problems. He told me he has seen panic related behaviors from other of his aging patients, and that several of them have reported the same sense of derealization at those times they were having a panic attack.
What you are having is not a panic attack it is the result of bullying. Reading between the lines this is what you were experiencing at work. Admittedly you are having other issues such as menopause but this only makes you more sensitive to the effects of the bullying.
Self-fullfilling prophesy. This is where you act as people expect you to act. It is an extremely powerful force that only the very self contained can stand against. It is well known in educational psychology.
If your colleagues had started to nit pick on you looking for a mistake then you will make one - simple as that. As to why they are behaving that way - there are so many reasons but it usually comes down to they want to feel better about themselves and so they suck out the ego of those around them - ego vampires. The most dangerous are those who "do it for your own good"
This is a very insightful post. I was indeed being bullied in the most subtle and underhanded manner. There was a definite lack of respect for nursing in general, and me in particular. I worked with 4 social workers, all much younger than me. They used humor in a demeaning way, directed at anyone they looked down on.The supervisor too was 30 years old, and all of them acted like a bunch of high-school kids. It was a very unprofessional atmosphere. By the way. When I was interviewed for the job, what they told me I would be doing and what I actually wound up doing was two different things. I would never had taken the job if they had told me the real-deal!! I do think I was having panic attacks...chest pain, SOB, diaphoresis, dizziness..it was awful. Thanks for your insight.
What BarbPick adivsed you seems to be the best. First, calm down! When you try to justify what you did it does tend to sound a little manic, not to offend you. Yes, writing over is never correct in nursing documentation, however, as long as you gave what was ordered correctly and no harm came to your patient, relax. Whether the Board was informed or not is a concern, however, if they were, don't worry, you'll be notified in writing by them and they will call you before the Board to explain what you did. They are out to protect the consumer from those RN's who practice unsafely. As long as your practice is safe, what you did regarding the paperwork, although against the rules of documentation, is the only thing you are guilty of. Please try and get your personal life in order (or at least in a better state) before you try to tackle the stress of a new job! Your mental and physical health is definitely more important! May see a counselor, talk to someone who is unbaised, consider medication if necessary....whatever it takes to get your life in order, then consider your new career options.
ceecel.dee, MSN, RN
869 Posts
Great word!:)
I agree that if you actually gave the full dose, but mistakenly charted giving only half the dose, and are making a correction so the record reflects more accurately what was done...this seems minor indeed. Perhaps a new entry to clarify would have been more correct, but what's done is done! Listen to Barbara...she gave you some great advise!