pseudonym87

I’m imploring all of my colleagues to settle down. The OP should feel free to have a forum where she can anonymously ask questions like this. After all, it’s better to be berated online than in person or behind your back my colleagues. OP- here’s my guidance, if in your heart you believe it is your obligation to report to the BON, then do it. Most of us on here believe that would be an overreaction and you could potentially destroy someone’s career and reputation over a small infraction. Whatever you do re this relatively minor infraction, I would personally do it anonymously. Yes you’re a professional but at the end of the day you’re a person in an environment that has its own distinct culture and perhaps people, even management, may “mark” you if they determine you’re a snitch who needs to be removed from the group. here’s a quick story- I once observed a consistent mistake every nurse was making with a specific ICU procedure. This mistake could have led to patient harm. I immediately verified through literature that I was correct and started letting my colleagues know the correct way to do it. My colleagues were so grateful and encouraged me to take it to shared governance so we can make a more formal education plan. I also discussed it with my manager. But she hated this. The fact that an error so flagrant was occurring on her unit and she didn’t catch it but I did threatened her. She came to me and said, “I don’t know what your intentions are but I’ve got my eyes on you.” she made my life a living hell and ultimately I ended up leaving. Ultimately, it’s all about politics, so for your own sake, carefully think about your next steps and the potential repercussions on you and your life. just my 2¢

Personally, I would only report colleagues to the BON in instances of neglect, prescribing without a license, going outside of your scope and actual or potential harm to a patient due to someone’s actions. I would always first report to hospital management in person and recap via email (to protect myself). Then, if the incident was in my opinion so grave, then I would report to the BON. For all other practice issues or minor infractions as the one the OP describes, a verbal conversation with a nurse manager with a follow up via email should suffice. Keep in mind that if she is well liked, her buddies may retaliate against you so sometimes it’s best to report it anonymously through the ethics line or safety hotline.

I had a similar experience in nursing. After 4 years of the nonsense, it felt like I was constantly in a battle to simply get the resources we needed to care for our patients. I quit 1.5 years ago and I haven’t looked back ever since. Every now and then I’ll miss the patient care aspect, but that feeling lasts for about 30 seconds and I come back to this thread to remind me why I left.

In my previous comments I had more sympathy for the nurse. I’m fact I assumed that there was some sort of short staffing issue that may have led to this. But after reading the legal documents and the nurses own confession, she clearly was grossly negligent. Vanderbilt had the policies in place that I would have expected- the only two modifications I would ask the hospital to make is to add a computer for medication scanning purposes and to revisit their policy on nurses administering medications outside of their unit, I.e. during Transport or at CT / pet / MRI. Perhaps it more appropriate to have the radiology nurses designated to administer all medications in these areas and prohibit nurses from administering meds outside of their areas.

The beautiful thing about nursing is that there is a plethora of opportunities away from the bedside. Nursing is a beautiful profession, but at some point, some of us, need to step away from the bedside. Dont start hating the nursing profession. Continue to love it. Take your skills and experience that you have gained over the last 6 years and enter the medical device or pharmaceutical industry as a clinical specialist, educator, account manager, etc. Believe me, the nurses are highly sought out in the medical device industry. I was having similar challenges as you and entered the medical device industry and couldn’t be happier. Be proud of your nursing career and make a change that will not only capitalize your experience but will improve your quality of life and earning potential.

First, I want to address the fact that you’re making valid points regarding the mistreatment of nurses by management and physicians. I’ve experienced it and dealt with it and is one of the contributing factors as to why I left the bedside. The other, and major contributing factor, is the lack of minimum nurse patient ratios. Everyday I felt like there was a situation where if it were taken to court, either myself or one of my nursing colleagues could have been held responsible and usually it was associated with short staffing or unsafe ratios. I think it’s great that you love your patients and are willing to do what it takes to promote positive patient outcomes. Documentation, although not obviously critical to your day to day activities as it relates to the current admission, is extremely critical when another dose of medication is ordered or another practitioner needs to make a decision based on documentation. So although management stresses documentation because of the legal implications of not documenting accurately, it can in fact contribute to outcomes in a negative way. The most concerning statement, however, is your comment regarding potentially overdosing on your meds or someone else’s. I understand that you’re most likely making a joke, but in my opinion, in our line of work where we have open access to controlled substances, jokes like that are not professional. With that said, even if there is an ounce of truth in that statement, I would highly suggest that you reach out to your hospital’s Employee Assistance Program (EAP) or seek out help from a qualified mental health professional. Believe it or not, despite the challenges in nursing, about 50% of nurses never face the mental anguish that you are describing. Therefore, I think it’s essential for you to reach out for help. Feel free to private message me and I have no problem connecting you with the right resources. You seem like you’re experiencing the textbook definition of burn out. This is not your fault but is a symptom of moral distress. More medical errors are made when nurses are experiencing burn out. So my concerns are for you and your patients. Please seek the help that you need and reevaluate whether or not the bedside is the safest place for you right now. Maybe you just need a break, or a different hospital or specialty, but you definitely need to do something ASAP before you hurt yourself or your patients. Best of luck! (Btw, I meant it when I said you can private message me if you want.)

I'm not a school nurse, but after reading the consistency among all of you in your responses, it makes me really glad to see you advocating for the students and not allowing your position to be used in unethical manners! You guys rock!

vec was removed from Pyxis at 1459, code was called at 1529. During this 30 minute period is when the vec was administered.

Beautiful said! @MunroRn

How does it not make sense? It's proven in the literature that organ with blame-culture yield to under reporting of incidents.

Susie I agree with you. I'm not concerned with the consequences of being fired on the individual nurse. Instead, I'm more concerned with other nurses being afraid to speak up or document incidents if they see punivitive solutions to medication errors. We should want to promote a just culture. That will prevent future deaths and will protect the right of every patient to remain free from harm while under our care. Oh and yes, while I do have an agenda it's not a personal one. I believe that we can be better a profession and that starts by accepting, to err is human. I understand that she ignored basic safety rights. She needs to be written up, suspended without pay, etc etc. Termination, however, will lead to a lot of messes being brushed under the rug.

Unfortunately, to err is human. That's a fact of life. We can either use this as a lesson to make sure this never happens again or we can be vultures and breed a culture that promotes keeping secrets instead of reporting yourself. If we want sentinel events like this to happen again, then remain punitive in how we handle medication errors.

I see the point you're making and I agree with you. When someone comes to work impaired or diverts drugs even once, this person's license is subject to revocation. Usually, however, the Board of Nursing allows second chances. You should read your boards quarterly report on disciplinary actions and the fact is most of the actions are consent orders, administrative fees, suspensions, remediation, and/or completion of a supervised program. The Board of Nursings take their job as protectors of the public seriously and they also don't take license revocation lightly (and neither should we). The Board of nursing will generally provide due-process to the nurse. Unfortunately, some people on this blog apparently don't believe in due process. I believe in accountability. If you look at my first post you would have seen that I wrote the nurse is at fault as is the system, the pharmacist, the doctor, etc. all at fault and all contributed to varying degrees. All should be held accountable- policies and processes need to be changed and all involved parties including the nurse should get remediation. The nurse should be suspended by the BON, required to take classes in patient safety, medication safety, and the nurse practice again and also complete a probationary period with restrictions on IV-push medications.

I agree. Absolutely gross negligence. The entire person needs to be assessed- her work performance evaluations, previous incidents, etc. Using The Whole Person method, she can be appropriately disciplined and absent any evidence pointing to a PATTERN of gross negligence or misconduct, remediate and reintegrate the nurse.

Texas law further explains violations of the NPA as Providing information which was false, deceptive, or misleading in connection with the practice of nursing; By adjudicating action against a nurse without having all of the information a Board of Nursinf would request, you are being deceptive and are therefore in violation of the NPA. Other states has vague statutes that provide broad powers to regulate every aspect of a nurses life. With that said, it's still a violation. Now, just to clarify, I have no connection to any of the involved parties at vanderbilt. The solution of firing someone and revoking a license should occur after it has been proven that a pattern of behaviors have led the board to believe, that it is in the best interest of the public for someone to no longer be allowed to practice. This one incident, although a horrible outcome, is not a pattern. Why can the hospital provide a corrective plan and be allowed to stay in business but the nurse can't be placed on a PIP? The reason why I am even concerned with the nurse is because I care about our profession. Yes we must keep the public safe. We also must hold ourselves accountable but in a way that doesn't create a blame culture and promotes a just culture. We're professionals. And just to address your rude assumptions- I'm lucky to have never been put in a situation where one of my patients were harmed because of my actions. We're all human. I, however, as a supporter of nurses, supporter of unions, and former union delegate would fight for this nurse because I promise you she didn't walk into work saying, "I want to hurt someone today." She's not a criminal- she made a series of stupid mistakes and she should be held accountable and placed on a PIP.