Medication

[Akam]

I am LPN working in nursing home. I gave Nystatin cream to one of my tech cna to apply to bottom of the resident. But he mistakenly applied it orally. I did an incident report, nursing note, inform the physician and risk management. The management of the nursing want to report me to the state and terminate my employment. Need some advice.

[Rose_Queen, BSN, MSN, RN]

Welcome to allnurses, @Akam! Your post has been moved to the Patient Medications forum for more relevant replies.

[brownbook]

If the CNA lacked the skills, knowledge, or training to administer medications you'd be at fault. Is the CNA allowed/trained to pass meds? All these new training/skills for CNA's, MA's, PCT's confuse me.

If the CNA is trained to pass meds I can't understand how it's your fault.

Med errors are NOT reasons the State Board of Nursing takes away a license.

You did all the right things. You notified the appropriate people, made an incident report, etc.

For any error in any type of care facility no one should be blamed or threatened. The staff should be assisted to walk through the steps of who, what, where, why, etc. the error happened. Then training or changes in protocol can be put in place to prevent it happening again.

Whatever happens look for a new job. Where you're currently working is barbaric.

[TriciaJ, RN]

The Board may sanction you for inappropriate delegation if the CNA did not have any qualifications to administer meds. But it would be a long shot for your license to be threatened.

This termination smacks of a blessing in disguise. When you're enjoying your next job you might feel very grateful not to be in this one.

[Akam]

Thanks for all your advise

[Just me.]

The employers response sound a little extreme.

It seems straight forward, that you tell someone apply this cream to the patient's...I may have asked myself. Was there a barrier in the communication, language? And as was already pointed out, was this a job that should have been delegated?

The only other thing I would have done is call Poison Control.

[gemivrn, BSN, RN]

Hi Akam,

Terminating you is up to them, but reporting you to the state will be a bit too harsh, it wasn't that big of a deal error, compare to what happened to one of my co-RN staff at my workplace, he used to be LPN actually he started as a CNA too then got an LPN course then decided to take an RN exam and was able to pass the test, he consider a senior RN in my unit, one morning he and the other nurse split the floor ( 6 or 7 patient each) in the morning medication pass he mistakenly gave 6-7 kinds of medications to the wrong patient, he said they're almost similar looking older ladies, they like to sit together at the same table for a meal, he asked the name of the wrong pt and she replied to him only then he realized that he supposed to give the meds to the other patient in the opposite table! the medications were all for CHF lisinopril, potassium chl. etc. he ended up putting the patient in alert charting for 24hrs for CHF s/s, such as elevation or sudden drop of BP, HR greater than 100/less than 50 etc, SOB, all kinds of sudden changes LOC and all that, but then since he is considered "senior nurse" (and the management favor him) they didn't do anything (as far as I know) so it's kinda unfair for new staff to make error, its another reason that's why I'm a bit disappointed too but anyway, your case is somewhat nothing compare to the mistake the senior nurse committed in my workplace. so take heart look for another job somewhere and treat it as a learning experience. Good luck.

[Akam]

Thanks a lot for taking your time to respond me . This reply make me feel better.