I had a patient that choked after taking her pills the other night. Happened around 2200. I was there standing in front of her while she was taking her pills. I left the room after she drank her water. A minute after that, a heard a moan in the room and went back. Saw patient holding her throat. Asked her if she was choking, she nodded yes. I did the Heimlich and she started coughing. I rejoiced after doing the Heimlich as I never had done it after I had my BLS certification. Little did I know, it is a severe case that is reportable to nurse supervisor, admin on-call, MD, and the state.
My mistake: Didn't told my nurse supervisor about it right after the incident happened. Though she overheard it when I was giving report to the incoming shift. She told me to make an IDT about it and make an IR. Admin on-call wasn't informed since nobody in my shift nor the incoming shift knew that she needs to be notified about it. Family wasn't made aware because of the time though I forgot to pass it on to the incoming shift. MD was made aware thru fax but forgot to document it on my nurse's notes.
Now, I feel like I'll be totally grilled today when I come in to work. My clinical directors would be there. And only God knows what's gonna happen. I did my very best to give care to my patients, but right now, I just don't know what to think about myself. I am new to LTC and had 6 weeks of orientation. I am on my last month of my introductory period. Should I ask them for more training? I've been having lots of mistakes in the past few days because of improper documentation, unfinished admission papers and little things. Can I get fired from being written up?
Please share me your thoughts. I'm feeling so down right now.
Yes, you can be fired for being written up, but your managers really do have great deal of latitude( in my experience) as to how to address discipline issues. It sounds like you are still kind of new. Your management has a responsbility to make sure you have an opportunity to learn protocols of who needs to be notified and when. If they are writing you up for failing to document what they say needs to be documented, have they taught you these things in orietation? It does little good to write a nurse up for not doing something she didn't know needed to be done.
In any case, main reason I wanted to respond is that you said you are down and worried about the incident. Want to point out that whatever mistakes you made in notification and documentation, you did a very good job. You identified the threat to the resident. You initiated the appropriate clinical response thereby ensuring the continued health and welfare of your client. KUDOS! Yeah, documentation is important, but any nurse will tell you that I would rather screw up on the administrative aspect of my job than to have failed to have rendered appropriate care. I mean, what if you for whatever reason you were unable to save the lady but had meticulous documentation and notified all the right people:eek:. Count your blessings, chalk it up to a learning experience and celebrate the outcome you have is better than it might have been.
No one learns to be a good nurse without making a mistake. If your management fires you for that, you are probably at the wrong job.:redpinkhe
Specializes in OB, Peds, Med Surg and Geriatric Nsg.
If they are writing you up for failing to document what they say needs to be documented, have they taught you these things in orietation? It does little good to write a nurse up for not doing something she didn't know needed to be done.
Nope. Not at all. Even my nurse supervisor didn't exactly knew what to do. She just told me to make an IDT form and fill out an IR. No administrative calls, notify MD and family. I'm good with following orders to safeguard my patients as well as my nursing license. I only did what I was told to do. Within my 6 weeks of orientation, I was behind the med cart all the time which is a quarter of the job that needs to be done as a staff there. I felt like I was fed to the lions on my first day. I truly believed that I needed more time but my preceptor didn't see that. I told my staff coordinator that I'm not ready and she told me that they are understaffed and needs a staff nurse to fill the position. She told me not to worry as the staff would be there and that I should ask questions. Guess what? My 'not enough orientation' backfired and it took an incident for them to realize that. I hope they would put me back on orientation which I could already see that the FT nurses wouldn't be happy about as they would be short-staffed in most days.
Specializes in Gerontology, Med surg, Home Health.
I've been called tough and even I wouldn't fire someone for doing what you did, or didn't do. We'd write an incident report and call the family and the doctor and ask for a chest xray, but I wouldn't report it to the DPH unless the resident died.
Specializes in OB, Peds, Med Surg and Geriatric Nsg.
I see. Then probably the day shift nurse supervisor was exaggerating everything. I dunno. I don't wanna blame it on her for the emotional stress she caused me, but I do hope she sees that she almost drove me crazy that I might lose my job.
misschiatia
83 Posts
Yes, you can be fired for being written up, but your managers really do have great deal of latitude( in my experience) as to how to address discipline issues. It sounds like you are still kind of new. Your management has a responsbility to make sure you have an opportunity to learn protocols of who needs to be notified and when. If they are writing you up for failing to document what they say needs to be documented, have they taught you these things in orietation? It does little good to write a nurse up for not doing something she didn't know needed to be done.
In any case, main reason I wanted to respond is that you said you are down and worried about the incident. Want to point out that whatever mistakes you made in notification and documentation, you did a very good job. You identified the threat to the resident. You initiated the appropriate clinical response thereby ensuring the continued health and welfare of your client. KUDOS!
Yeah, documentation is important, but any nurse will tell you that I would rather screw up on the administrative aspect of my job than to have failed to have rendered appropriate care. I mean, what if you for whatever reason you were unable to save the lady but had meticulous documentation and notified all the right people:eek:. Count your blessings, chalk it up to a learning experience and celebrate the outcome you have is better than it might have been.
No one learns to be a good nurse without making a mistake. If your management fires you for that, you are probably at the wrong job.:redpinkhe