LadysSolo 8,283 Views
Joined: Dec 17, '06;
Posts: 426 (73% Liked)
; Likes: 1,136
I worked in a long term intensive care facility in Folsom Ca. Back in 2005. I had an Intensive care patient who needed dialysis and not received it for a week. She was ventilated, had been coded that day for cardiac arrest and a potassium of 9.6. She had been there 6 months, comatose, non-responsive, and vegetated. Family did not want her transferred, and she was a full code. I Walked into this diaster for night shift. None of monitoring equipment was working where she vomited on it earlier, and there was no replacement. Called Dr all night. She was on high dose levophed, and Dr would not treat hyperkalemia, had one dose kaexylate. By 0600 her t waves tented really high and vtach was starting. I placed her on the external pacemaker as I was using crash cart for the monitor. Dr Was in before I could call him and left her on pacemaker. It was in the policy that I could apply it. She was pronounced at 1pm, way after I went home. They fired me! They pulled the policy regarding pacemaker. Stated that I should have done compressions and "it would have all been over sooner." I reported them to state for not treating hyperkalemia, to coroner, to Joint commission, to head of company. This had happened to other patients, but I was not involved. They were escorted out by the police (manager and nurse director) and fired. As retaliation, I was reported to the board for "not doing compressions" and called incompetent. I had an attorney. My license was revoked, but I was allowed to work another job, put on probation for 3years. I had to be monitored quarterly like a criminal! I had been a registered nurse for 25 years at that time. I had worked intensive care for 7 years at that time and in acute care. I had malpractice insurance through nurses association. They did nothing !
It's probably easier to start out with a leg up. But it's also possible to start at the rear of the pack and still come out ahead or at least farther up front than dead last.
Work hard, live frugally, budget everything, say no to just about everything, pay yourself first.
work extra hours, work 2 and 3 jobs. Hold Rent Parties. Learn to fish. Get cheap cuts of meat, and day old produce and bread, 2nd hand clothes, use food pantries. Sew for others, walk pets, run errands for others, just do everything you can possibly do to make a buck.
Stop feelihg sorry for yourself.
I'm so sorry you're going through this, the whole situation sounds absurd. I echo others above that you may be better off in the long run finding a new job if this is how your institution operates.
In the future, if you're ever called to the carpet for any reason, you should get comfortable speaking up for yourself a bit more (I know you are relatively new and were blindsided). You do not have to agree to meet with HR alone about an issue like this, you should insist on talking to your manager about it first (or whoever is covering them if they're on vacation), and having them or someone from nursing leadership/management present at any meeting. You should also insist on seeing exactly what written policy you have violated, as well as insist on seeing where in the employee handbook it states that this was a fireable offense. Even if we call this an "error," which to me it was not, there should be some sort of 3 or 4 step process for warnings/mediation before you just get canned, particularly if you've never had a write-up of any kind in the past. If they're going to fire you, they need to be able to back up the rationale. Otherwise, get an attorney.
I have to put my 2 cents worth in again. When I read some of the nutty things employers/managers do, I wonder why on earth anybody would want to be a nurse. I wonder why pharmacy doesn't ever get in trouble over some of these medication issues, such as meds that won't scan. With everything, its ALWAYS THE NURSE. I have never heard of a pharmacist getting suspended.
On the sub topic of CNAs working under your license, they do work under our license, but that doesn't mean that every single thing they do is under our license.
The things you direct them to do are under your license. And there are things they can't do unless it is under your direction.
For example in psych, a tech restrains a patient only under the direction of the RN. If you have techs who are restraining patients willy nilly, you'd better take care of that because that is happening under your license.
If you direct a cna to feed a patient who is npo, that would be under your license. You are responsible for stuff like that.
Your license doesn't hold you responsible for cna work ethic. But it is an issue that concerns you.
I mentioned an incident like this to a supervisor , once. I was ordered to put it in writing. Then , I was 100% THROWN UNDER A BUS. Long story but suffice to say it was an environment where the slackers were lauded and ethical workers were taken for granted / never promoted. Other nurses had their cars keyed , and false accusations made against another who reported sleeping staff members.
I no longer work there and I do NOT miss it. Oh, and yes " management " knew and most things were common knowledge. But " nothing was ever done ". I gave up and made the change by taking myself out of the sick equation
This is problematic because it has gone on for so long.
You've been complicit with this behavior for years. For this reason I think its fair that you warn the sleeping beauties that you're not gonna let it slide any more.
Don't just blindside them with write ups. Make sure they all know that you will be changing the standard. Then write up PRN.
Sometimes the ones you think you want to be a part of aren't all they're cracked up to be
I don't get the "dream employer" thing. I have yet to hear of someone working at XYZ BigNameHospital and been impressed by it. That would not even figure in for me.
I don't subscribe to the notion of dream employers because most treat their workers like crap.
I do believe in the money though.
Thank you. Many other nurses have said the same. I feel the need to disagree. Doing this may have possibly ended with what the administration is currently alleging. That I attempted to forge documentation regarding my error. Since i reported myself regarding the incident immediately, there was no way for me to falsify any records. I followed administrators directions to bring vial back to center.
35 years in practice and still believing honesty is best practice.
Update! I talked with my manager, who went into the patients record and saw that the nurse had put the order in and administered the dose a few minutes after the incident. She thanked me for letting her know and for not giving the med without an order, and said that this nurse is very experienced and knowledgeable but this wasn't the first time something like this had occurred with her.
Thanks all for the advice and support, this has definitely been a nerve wracking but valuable learning experience for me.
You did the right thing. It would be one thing (but still risky) if you had a longstanding relationship with a coworker and totally trusted her. But you're new and still proving yourself and she's not regularly on your unit and you didn't know her from Adam. Way too many red flags and I wouldn't have touched that with a barge pole.
Bringing her patient a beverage or an extra blanket? Sure. Administering morphine without an order? No.
I am an RN case manager for a Home Health company. LPNs make up a large portion of my team. Those women make me look good everyday. It's one thing to tell a client you are going to provide them with services. When the LPNs go in and blow them out of the water with their care, commitment and professionalism it humbles me beyond measure. These are not "just" LPNs. They are nurses. They are amazing nurses practicing at the top of their licenses and making the team work for the benefit of the patient.
Thanks Davey. But what are those appropriate outside agencies? And the write-up really just pissed me off more than anything. My DON said if I'm not comfortable bringing in a pt without talking to doc, that's fine. But the administrative people are the ones insisting we do this. They say the doctor's wife (she owns the hospital) complains when the doctor doesn't get enough sleep. So administration doesn't want him called. Either way, I'm sticking to my guns.
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