I have a problem that I have never seen addressed on here before. I recently graduated and happily accepted a job at my local hospital. Anyhow, a physician on staff decided to do a favor for his patient as the patient had an emergency and had to go out of town. The MD took out a drain in the hospital in a room that was not being occupied with other patients. Upon completion he told the nurses to put a gauze on it. All of us nurses were busy, but as I was the new grad, I was asked by the charge nurse to put the dressing on the patient. I asked if that was o.k. for me to do and I was told yes. I did no irrigation I just placed a gauze with one piece of tape over it (bad move) didn't think there would be a problem since I had no idea about the area.
Here is the problem, the doctor literally did the patient a favor by pulling the drain and asked the patient to come to the room to do this procedure. The patient had not registered and no auth had been recieved. The doctor could have done it in his office, but was tied up at the hospital all day. I was called by the CNO and asked about the situation today, I told them what had happened and then I was told that I was going to be in trouble for the situation and given a warning and that the list of protocals that I broke would be listed on the warning. I am by far not trying to pass the buck, but I have been at this job for 11 days and I was orientating. I am crushed, confused and feel like I was thrown under a bus. I understand that there are protocals, but I am new, did not know and was told by my superiors to do it? I have never worked in this area before in my life. I am sure I will never make that mistake again, but I just feel that me getting in trouble to the extent that it is seems rather harsh, I am scared confused and feel that the charge nurse will not have my back in any situation. I have caught her on more than one occasion blaming me for mistakes and when confronted by me , she told me they were her errors.
I was told that the physician will be in trouble, the charge nurse will be written up but I will have the most reported on me. I have worked so hard for this and I am just reeling with confusion, anxiety and fear...what should I do?
I was told that the MD had called the patient while he was trying to admit and the admitting clerk went and told...and the rest is a nightmare!
YES! And I wish he would have taken the 30 seconds to put the gauze on!! You are so right! No complications, the patient was elated and thankful! It came to the attention by way of CFO, while the pt was downstairs trying to admit/auth. the MD called the pt on his cell phone and told him to meet him upstairs, I was not aware of this until after everything boiled over! The charge nurse precepto was busy as so was I , but she told me to go and put the gauze on, there was a box of 4X4 gauze sitting beside pt, I guess the doc feels he didn't need to put it on, they usually don't in an OR setting.
This is a hard lesson learned and in hindsight I would not have changed anything as I truly was out of the loop, with the phone call, set up etc. The charge went and got the necessary supplies, I was told after all was said and done to dress it, but I am getting in trouble for no documentation etc., I feel she should be as well as she set it up. Now that I have been scolded and will be officially written up next week, I am sure that it will never happen again. But for whatever reason I cannot shake it~ I was out of the loop asked by MD if me or charge could dress it and then told by charge to do it, I even asked, I can do that? she said Yes. All I can say is DAMN.
You should have "sensed' that there was something wrong when you are asked to see a patient that’s not even admitted in the hospital!!
But then again I remember how it feels to be a new grad, grateful to have a job, anxious and exited; and on top of that a new employee jitters. You tend to have no "backbone" for lack of a better term, and do as you are told. trying to fit in.
I bet you were thinking its you charge nurse telling you this, an experienced RN and you assume its ok because its coming from a charge nurse, who has worked there longer then you.
All you can do at this point is learn from this. Always think of yourself first, protect yours elf first, because no one will do it for you. I've heard stories of MD changing orders in charts to make the nurses look bad when the "feaces hit the fan!!"
((Hugs)), you have not lost your job, just be more careful next time, and don't be afraid to question or say no to something that doesn't "seem" right. That gut feeling...all nurses have it, even new grads! You just need to pay attention to it.
Thank you~ and you nailed it, I am trying to fit in and so grateful, the strange thing is that I am very assertive and I did question the charge nurse, I have a backbone,but I do not know the area well enough. I was told that this was o.k. I am just trying to learn the area and have the knowledge to say "Hey that is not right" It was my 7th day actually in the outpatient area. My gut feeling had kicked in (like you said) but was still approved by my charge nurse, being new I said o.k....dangit. I know mistakes will be made, but everytime I think about I get even more upset. If the patient was having trouble with auth and admission, then why did they walk him to outpatient? Why didn't someone call and say we did not get auth, do not treat pt. or even a call to the CNO to stop it...what if...............Grrrrrrrrrrrrrrrrrrrrrrrrrrrrr! All of a sudden the charge is getting a towel for MD and then the feces did hit the fan...YUCK!
So grateful to still have job, you are right. I am just scared now, I was told this information yesterday afternoon, and now have to go to work on Monday to face the music. I was told I would be written up mid week, after the wording is proper on write up...I feel like throwing up. The joys of a hard lesson, I am dress-right-dress so this is even harder for me........poop.
Sounds like you are being made the scapegoat. This SUCKS in a major way. I am infuriated just reading it. Should the MD not be written up also? He/she did the major part of the procedure. Putting a dressing on someone should not warrant all of this ridiculousness. It is because our society is lawsuit happy and god forbid that patient got a scratch on he/she they might sue for while thay were not authorized to be at the hospital.
It is because you are the new kid on the block that you are receiving the blunt end. This story makes me wonder why I went into this profession in the first place. Can people not make an honest mistake anymore?
I was told to definately state a rebuttal, I am curious, I was told by a fellow nurse since when is removing a peg invasive? It is about money since the CFO is the one that reported it, then CNO and CEO involved, so they are all aware of the situation,but I am to be used as a learning tool. I was going to sign and do a detailed rebuttal , but I was also told not to sign ANYTHING...period
Should I sign or not? I was told since when is putting a gauze on a procedure that I did not witness practicing out of my scope? I took a verbal from the MD and the charge ...Sign ot not?
Yes, you are correct. Since the pt. was not technically a patient and the doctor snuck him in, that is where the problem lies. When he came out from behind the curtain he said motioning to us "I need for you to put a dressing on the patient" Since he was generalizing and did not care who put the gauze/bandaid on, I looked at my preceptor/charge nurse and she told me to do it. We were both busy, but since I was new I took her orders and did it. I even questioned her if I could do this, she agreed yes.
So I get a phone call from the CNO the next day informing me that an investigation would be placed on me,charge nurse and the doctor and that I would be written up for: not following Universal protocal, not charting on patient and using nursing judgement. I am beside myself, I can't sleep, my stomach is in knots and I feel betrayed. It is a lesson learned, but I feel like my whole world is crumbling. I am known for doing the right thing being a patient advocate and following protocol. The charge nurse agreed that she rcvd a phone call about pt and even ackowledged the patient entering the room, she even got a towel for the procedure. But I was told that since I put the dry gauze/piece of tape on that I will be written up with the most offenses.
I am highly worried about going back to the unit, because I caught the same nurse pawning on error off on me and when I asked what I had done she would not answer and when I continued to question her she finally admitted that it was her error and had not noted an order. This is drama that I cannot stand, after nursing school I was grateful to get a job and finally work. This was the rainbow I had been looking for, and to get in there and for this to happen I am just sick to my stomach. THe charge is known for avoiding blame, however she did admit to taking the call and the above information. Her excuse was she was just so busy and didn't really know the situation. What she failed to tell the CNO and dept mnger is that she provided the MD with the necessary supplies to do the procedure.
I was told by the CNO that it would be a verbal first warning (although it is written on triplicate)and put in my chart there. I was told that if anyhting similar ever happens it will be grounds for immediate termination. Thank you for your encouragement as I truly do not know what to do at this point. The charge nurse that this is stemming from disscouraged me to go to this dept in the first place, and another nurse in the dept. told me"How are you doing? I hope good since we are known for eating our young in this dept....The rest of the unit tells me that they need a person like me there to boost morale, but I just don't know after this. I am by far a quitter, I just dont want to be tossed under the bus again or know that I am being trained wrong.
All I can say is, What the heck? I have struggled to get here in the worst way, me and my family have gone without. My husband, children and family have been so supportive and now this? I have literally worked as a new grad 10 days on the floor. My heart is heavy and I am stressed, I just feel wronged and so confused. Thank you for your words of wisdom and encouragment....I really appreciate them:confused:
I would have handed the doc some 4X4's gauzes and tape and told him "here you go" and walked away.
I would have handed the doc some 4X4's gauzes and tape and told him "here you go" and walked away.
While I gave you kudos because that's what I would probably do now (or just outright refuse to have anything to do with it - or ask the charge RN why she wasn't the one doing it), I felt I should follow up with this - a new grad probably won't feel comfortable doing that.
EXACTLY!!! It's a tough unit and I am just trying to learn and do right. That is the reason that I wish it was years from now when I know my craft in OR and I can say that , it was my 7th day there...THANK YOU!!! I was told by the charge go ahead, I do not know this unit...yet....It is amazing all of the wisdom you all are putting out here, Thank you!
While I gave you kudos because that's what I would probably do now (or just outright refuse to have anything to do with it - or ask the charge RN why she wasn't the one doing it), I felt I should follow up with this - a new grad probably won't feel comfortable doing that.
You are right, when you are new and grateful to have a job, you don't want to "rock the boat" sorta speak.
I think the OP is being thrown under the bus. And if she is getting written up, her preceptor should too. If she asked her preceptor and was told it was ok to go ahead and dress the incision, then this is something that should also fall on the preceptor. Not trying to ruffle any feathers here.
Also, the charge nurse should have stood up for the OP and told the doc that he is out of protocol. I would be sure to put all of that in the rebuttal to the write up.
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NewGrad70
7 Posts
YES! And I wish he would have taken the 30 seconds to put the gauze on!! You are so right! No complications, the patient was elated and thankful! It came to the attention by way of CFO, while the pt was downstairs trying to admit/auth. the MD called the pt on his cell phone and told him to meet him upstairs, I was not aware of this until after everything boiled over! The charge nurse precepto was busy as so was I , but she told me to go and put the gauze on, there was a box of 4X4 gauze sitting beside pt, I guess the doc feels he didn't need to put it on, they usually don't in an OR setting.
This is a hard lesson learned and in hindsight I would not have changed anything as I truly was out of the loop, with the phone call, set up etc. The charge went and got the necessary supplies, I was told after all was said and done to dress it, but I am getting in trouble for no documentation etc., I feel she should be as well as she set it up. Now that I have been scolded and will be officially written up next week, I am sure that it will never happen again. But for whatever reason I cannot shake it~ I was out of the loop asked by MD if me or charge could dress it and then told by charge to do it, I even asked, I can do that? she said Yes. All I can say is DAMN.