Medication Charting Errors

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by Magnoliaflowers Magnoliaflowers (New) New

charting-error-investigation.jpg.df0327fca71538f2b4edbcc1fb325812.jpg

I’ve been an LPN for since 1995. Mostly clinics. Last year I went on the floor at a facility that uses CPSI. Shortly out of my 90 days I was terminated for charting errors. AM sliding scale insulin and one serious accusation involving oxycodone 5 mg.  

I got my letter from State yesterday. I’m being investigated and have to now jump through hoops to prove myself. I don’t mind them investigating, but since my termination, it’s 10 instances of not charting insulin, one inhaler “ not pulled on camera” ( more likely than not was at bedside as was the usual place to be found) and the narcotic. Now I’m reasonably sure I charted the insulin. However my prior DON has stated it was well known that CPSI had a glitch that sometimes did not retain the insulin dose charted and was well known to management. I got two days of orientation on this system and often questions went unanswered. The narcotic was pulled, crushed and water added for a peg patient. I was never counseled. Never made aware of any errors except three insulin issues. All the doses of insulin were at shift change.

At the termination meeting, I was told three insulins and the narcotic. I asked when I could take my drug screen, that I was prepared right then and was told they weren’t going to test me which is against policy. I was also made aware that this DON ( new, first job as DON) knew a week before that I would be terminated but she needed me to fill the schedule until her friends could be trained. I was not escorted to my locker or off the property, both of which are against policy. I went straight to a physicians office and paid for a full panel witnessed drug screen. It was negative of course.

Now, I have to be seen by a state approved psychiatrist to determine if I’m "addicted or have and addiction" to alcohol, prescription or elicit drugs. I’ve 10 days to comply. I’m 56 and this is all I know.

I’m currently working in an office of a tiny hospital in infection control and employee health. I stand to loose everything I’ve worked for all my life. I’m literally numb. I’m from the paper charting era. Computer charting has been a learning curve for me. My old DON told me she’d recommended they replace CPSI with a better system and they didn’t want to spend the money.

I also found out last night that as of yesterday, since the end of April, six nurses and one Doctor are gone. The Doctor was terminated also for writing a script for his stepdaughter for Xanax. Three nurses fired for various reasons (not including myself) and two left because they saw the writing on the wall. 

Is there anything I should include in my letter other than a copy of my drug screen to attest to my honesty and lack of knowledge of these errors? I was not given access to any proof of claims.

thank y’all for at least listening. 

Been there,done that, ASN, RN

Has 33 years experience. 6,854 Posts

"my prior DON has stated it was well known that CPSI had a glitch that sometimes did not retain the insulin dose charted and was well known to management. " I would be in contact with the other nurses and see if you could get more information regarding the system error. 

Did you forget to chart the oxy?

Have you contacted a lawyer, do you have malpractice insurance?

LovingLife123

LovingLife123

1,557 Posts

Honestly, I’d be concerned more about the charting errors.  I mean it’s not even just one type of drug.  It’s insulin, an inhaler, and a narc.  So while I fully believing a charting error can happen, you have multiple which seems to be the issue here.

I personally would be trying to get to the bottom of the charting problem.  

Have never worked at a place that used EMRs before?  It’s not new to nursing.  If this was all new to you, I would have been double and triple checking my med administration.

I’m sympathetic to your struggle with the system, but that’s also why you have yo be vigilant.  Any time I think there can even be a question to my med admin I document and then report to the appropriate people.  You. Always. Have. To. CYA.

Nurse Pompom

95 Posts

On 7/30/2022 at 7:27 AM, Magnoliaflowers said:

I’ve been an LPN for since 1995. Mostly clinics. Last year I went on the floor at a facility that uses CPSI. Shortly out of my 90 days I was terminated for charting errors. AM sliding scale insulin and one serious accusation involving oxycodone 5 mg.  I got my letter from State yesterday. I’m being investigated and have to now jump through hoops to prove myself. I don’t mind them investigating, but since my termination, it’s 10 instances of not charting insulin, one inhaler “ not pulled on camera” ( more likely than not was at bedside as was the usual place to be found) and the narcotic. Now I’m reasonably sure I charted the insulin. However my prior DON has stated it was well known that CPSI had a glitch that sometimes did not retain the insulin dose charted and was well known to management. I got two days of orientation on this system and often questions went unanswered. The narcotic was pulled, crushed and water added for a peg patient. I was never counseled. Never mad aware of any errors except three insulin issues. All the doses of insulin were at shift change. At the termination meeting I was tole three insulins and the narcotic. I asked when I could take my drug screen, that I was prepared right then and was told they weren’t going to test me which is against policy. I was also made aware that this DON ( new, first job as DON) knew a week before that I would be terminated but she needed me to fill the schedule until her friends friend could be trained. I was not escorted to my locker or off the property, both of which are against policy. I went straight to a physicians office and paid for a full panel witnessed drug screen. It was negative of course. Now I have to be seen by a state approved psychiatrist to determine if I’m “ addicted or have and addiction “ to alcohol, prescription or elicit drugs. I’ve 10 days to comply. I’m 56 and this is all I know. I’m currently working in an office of a tiny hospital in infection control and employee health. I stand to loose everything I’ve worked for all my life. I’m literally numb. I’m from the paper charting era. Computer charting has been a learning curve for me. My old DON told me she’d recommended they replace CPSI with a better system and they didn’t want to spend the money. 
I also found out last night that as of yesterday, since the end of April, six nurses and one Doctor are gone. The Doctor was terminated also for writing a script for his stepdaughter for Xanax. Three nurses fired for various reasons ( not including myself) and two left because they saw the writing on the wall. 
Is there anything I should include in my letter other than a copy of my drug screen to attest to my honesty and lack of knowledge of these errors? I was not given access to any proof of claims. 
thank y’all for at least listening. 

Go consult a lawyer asap. don't send anything IN WRITING to these people. don't admit anything. Talk to a lawyer, like yesterday.  

traumaRUs

traumaRUs, MSN, APRN, CNS

Specializes in Nephrology, Cardiology, ER, ICU. Has 30 years experience. 164 Articles; 21,155 Posts

Please consult with an administrative law attorney in your state that has experience with your BON.