Need Advice on Accused Medication Error

[Shannon Dull Dunlevy]

So, here is the situation. I started a DuoNeb treatment on my patient WITH my professor/instructor. Once the treatment was started we left the room and documented the treatment. I checked in on patient about 7 minutes and and everything was fine. At around 15 minutes I checked on the patient and noticed that someone had taken the face mask off the patient and turned the nebulizer machine off. When my instructor came back I reported that someone had turned the machine off. My instructor went into the room alone and reported to me that she had re-initiated treatment because there was still some DuoNeb in the reservoir. I was written up as having made a medical error because I did not personally take it upon myself to start the treatment again. My rationale behind not starting the treatment by myself is:

I wasn't sure who stopped the treatment in the first place. It could have been my instructor for all I knew.

I wasn't sure WHY the treatment was stopped. The patient may have been observed having adverse reactions for all I knew.

I do not feel that I as a student, working under another's license, should make the clinical judgement to restart the treatment on my own accord.

What do you all think is the best move here. I have a remediation meeting in a couple days.

I feel like the persons who made the medication error was #1, the person prematurely stopped the treatment and didn't document or notify anyone, and #2, my instructor who restarted treatment without knowing who stopped it in the first place and why.

[Tenebrae, BSN, RN]

On 12/3/2019 at 12:03 AM, Shannon Dull Dunlevy said:

This was a different patient. There were 4 of us trying to "help". The facility nurse (the patient's nurse) told me to stop, and document as refusal and try again when the patient was calm. So....that's what I did, and it worked.

And thats exactly what i would do.

Any one who says you would be fired for not getting a pulse ox is fully of crap IMO

I've found particularly in aged care, but other areas of nursing as well its helpful if you can always be thinking "what will I do with this information?" "will this information change the treatment for this patient"

I had a scenario where the charge nurse obtained an order for QID BGL and act rapid administration. Sound reasonable right?

In reality the patient was moving into end of life stage, and amoung other things not eating. The patient was NFR and comfort cares only so we would not have been starting IV dex or inserting an NG tube. In the end I refused to do the QID finger sticks and documented "BGLS not obtained, as patient appears to be in the end of life stage, oral intake minimal" and checked with the GP the next day who removed both orders

[ArmyRntoMD, BSN, RN]

Your instructor is a moron. What is SAFER? Holding a treatment temporarily for clarification or just doing it without checking? But, the key to passing nursing school is playing the stupid game. I just always played dumb and when the instructor told me something I acted like it was absolute fact.

I had an instructor yell at me and act like I was a moron in front of a patient and then 10 minutes later say yeah you didn’t do anything wrong.

[Kooky Korky, BSN, RN]

On 12/4/2019 at 1:00 PM, thenewspirit said:

Communication is a top cause of medication errors and you have just illustrated this in practice.

Your professor is not trying to write you up to mess with you.

Swallow your pride, listen to your instructor and if you cant learn from being written up for something that is not completely 100% true - look for a different job.

What you should have done is stayed with the patient from the beginning to the end of the Duoneb. Once you left and came back, someone could have washed/flushed out the nebulizer mask and the remaining "medication" you saw inside was left over. Someone could have spit inside the nebulizer chamber for all you know. Who turned off the mask? Maybe another patient. Maybe the cleaning person. Probably it was an aide. If you can learn from this and understand the dynamics of workplace groups.

Her professor is the one who told her to leave the pt and go chart the treatment.

It's hard to swallow pride when it's the unfairness of the whole thing that is the problem. And the mess was caused by her so-called professor.

[Patriotssuck]

I can’t believe people are telling you to suck it up to let your instructor save face. This is her fault, not yours, especially as a first semester student. Don’t tuck your tail between your legs and back down on this. I would take it up with her boss and beyond. If someone is going to trash my reputation, and destroy my schooling/future career, it’ll be me and no one else. It sure won’t be someone willing to throw me as a student under a bus because the instructor is incapable of her doing her job correctly. She failed as a nurse and she failed as an instructor, period. She should be written up, not you.

[heythatsmybike]

I don't know if anyone has mentioned this, but given that it was a sore situation for you I would probably change your handle from your name on here and remove your photo.

[Shannon Dull Dunlevy]

3 hours ago, heythatsmybike said:

I don't know if anyone has mentioned this, but given that it was a sore situation for you I would probably change your handle from your name on here and remove your photo.

Thank you. Good idea.