Medication Charting Errors

[Magnoliaflowers]

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]

"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]

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]

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, MSN, APRN]

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