Oncology RN Forced to Resign

[Done]

For my second year of nursing, I was hired to become an Oncology Nurse. It was not my first choice because of the multiple cancer stricken family members I have in my life right now. Eventually, I made peace with it since I needed a job and I thought it was God's way to have me a chance to honor my love ones. I had a great year meeting new co-workers and caring for the patients and meeting their families.

I was not aware of Oncology Nursing's reputation for the highest nacotic meds access and the other reputation of suspected users in Oncology Nursing. I regret to be so limited/hard-headed to only think it as chemotherapy, death & dying.

Now that I am reading allnurses since I had been audited for the lack of documentation for my controlled substance administration, I am shocked to see that the highest suspected narcotic user/diverter is that of: Oncology nurses, that really good nurse, the one with the outgoing personality, and that one that works plenty of shifts, and of course, the one with documentation issues. I am all those!

Because of my strongly moral basis for Oncology, the kind of care I deliver to patients is heart-felt and personal.

Because I come from an artistic background, I tend to be emotional and expressive.

Because I am only a sophomore nurse, I am very optimistic in the wonderful world of nursing the sick.

Because I am a new grad from 2008, I was tangibly affected by the recession that I:

perform with so much enthusiasm against all odds

worked many additional shifts like back-to-back, and extra days. I was positively enforced about this at work as well.

There will be nothing an investigator will find in my background in relation to narcotic diversion or use. It was purely mis-documentation and my self-bought drug test show negative. But I cannot let go of the thoughts that someone out there thinks that I am a possible suspect.

My director is obligated to report my forced resignation to the Board. I hear that there might be times that the director does not do so anymore. Does anybody know what happens if my director truly reports me ?

This is so very upsetting. I was almost suicidal and psychotic the day after I wanted to voluntary admit myself as a 5150; but thanks to family, my faith, and nursing knowledge, I was able to get out of that funk immediately.

I not quite sure what type of response I wish by writing a new thread but I'm just taking advantage of the support this type of community offers.

[TheCommuter, BSN, RN]

My workplace requires that nurses document each instance of narcotic administration in three different places: the MAR, the flow sheet, and a narrative in the nurses notes. Any person who repeatedly fails to document narcotic administration in all three places runs the risk of being investigated and/or reported.

The bottom line is that any caregivers who work after you may sometimes depend on your accurate (or inaccurate) documentation before making their next clinical moves. Omitted documentation of giving narcotics can have gravely serious consequences.

[RHIA, RN]

I'm sorry that this happened to you. I hope that you will accept it as a learning experience and allow yourself to move on in nursing. You seem to be compassionate and I am sure there are many that will benefit from being in your care.

[brandy1017, ASN, RN]

I didn't know oncology nurses had the highest rate of drug diversion! I do know that the hospital watches nurses via the computer ADU and tracks them against how often they dispense drugs and compares it to their fellow nurses and if someone is seen to give out more drugs than the average that can trigger an investigation. It makes a person paranoid to give meds even though they are needed. Sometimes it seems all your patients are asking for drugs around the clock, but other times no one is! Also once they start an investigation on someone who they find suspicious they then track how well they are documenting meds and are they giving meds out to other patients besides their own! A coworker was discovered this way with the computer charting, she had been through several serious illnesses even cancer and had become addicted to pain meds. She was friendly and outgoing and no one suspected.

I don't understand so many things people do and I always say don't they have a conscience. Because if someone is diverting meds then the patients are suffering and in pain, wouldn't your conscience stop you from doing this?

If you are innocent and a drug screen would prove that then why would you resign? I would seek an attorney and fight for my job, but it goes against you that you were sloppy in your documentation.

If a person is addicted they should seek out a doctor to be treated as this is a chemical dependency, physical and not just psychological, your dopamine receptors are all screwed up. They would probably transition you with methadone.

[merlee]

I am somewhat confused - - are you saying that your forced resignation is due only to poor documentation? Weren't you made aware of the issues with your documentation prior to your resignation?

If you aren't diverting meds then simple documentation issues can usually be resolved.

Please get legal representation - preferably from a nurse-lawyer - to help you through this, as well as some counselling for yourself.

Best wishes!

[tothepointeLVN, LVN]

I did not know that oncology nurses were high level diverters either though I've noticed in Hospice with some companies there is no documentation of narcotics other than in the narrative. Had one company I was staffing for instruct me to leave all medications in the house after the patient passed and not destroy them with a witness because they had had "problems" Really so leaving them in the families hands until a field nurse can pick them up is a better solution? The field nurse did come before I left counted the medication ( did not ask me to countersign) and left with them.

[TakeTwoAspirin, MSN, RN, APRN]

The fact that they allowed you to resign is a positive. If they had fired you it would indicate to me that they believed you to be guilty of something other than negligent documentation. You say that you paid for a drug test that you presumably wanted to take to prove somethign to them. The fact that they did not require you to have a drug test indicates to me (based soley on what you are saying in your post) that you were fired for documentation problems rather than them actually believing you were diverting drugs. Having said this, you really do need to learn from this experience and never leave yourself open to this kind of misunderstanding again. You have to be responsible for your own documentation, and as a nurse you had to have some understanding of the importance of properly handling and documenting narcotics - even as a new grad this is pounded into people. I think it is time to lick your wounds, learn from your experiencee, and move on thankful that they allowed you to resign with some dignity.

[Done]

Thank you LPN RHIA. You are very kind. I think that I am and I thought this was surpassing such the non-human elements of nursing.

Re: Forced resignation: I guess I forgot to say that I was forced to resign because management was laying down Termination. Forced resignation was the lesser evil for myself. Yes, they presented the problem documentation to me prior to the decision but of course with not enough time for me but enough time for them, the big guys. My union representative could not win this aspect for me as well.

I continually asked to review the documentations before the HR meeting but was denied. I pushed hard just to review the documentations during the HR meeting. I saw a lawyer previously but a lawyer isn't allowed in this process; but did not successfully work with my union rep. Our hopsital has had a strike last Sept. 22 and the Admin. - Union relationship is sensitive.

Unfortunately, I cannot get myself out of the non-documentations except for my defense that no patient had complained to not received the pain meds or be releived from their pain. I am frustrated because more senior nurses confessed to me the worse narcotic situations they've done but got no attention from management.

I called a nurse-lawyer firm that had even written nursing journals about seeking good legal representation if wrongfully accused assocated with poor documentation. This firm represents the hospital I had problems with.

[Done]

Really take2 ? I hadn't or wasn't able to look at it this way. Thank you.

Have you seen this situation before ?

[brandy1017, ASN, RN]

If the firm represents the hospital then why did they take your case. That would seem to be a conflict of interest!

[mazy]

I really worry sometimes about whether it is a good idea to be posting such specific information about an ongoing investigation on a public forum.

Done, it sounds like you have had a lot going on in your life, both personally and professionally. A hard road to travel for someone just coming into an already difficult profession. I hope that you can find the answers that you need and that you are able to move on from this awful experience.

[tothepointeLVN, LVN]

It doesn't sound like an ongoing investigation. If she was forced to resign then I think the case is considered closed