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pseudonym87

pseudonym87

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pseudonym87 has 1 years experience.

pseudonym87's Latest Activity

  1. pseudonym87

    CoWorker using a patient's medication

    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.
  2. pseudonym87

    Why Do Nurses Quit?

    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.
  3. pseudonym87

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    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.
  4. pseudonym87

    I'm So Over Nursing. I would rather work at Costco!!

    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.
  5. pseudonym87

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    vec was removed from Pyxis at 1459, code was called at 1529. During this 30 minute period is when the vec was administered.
  6. pseudonym87

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    Beautiful said! @MunroRn
  7. pseudonym87

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    How does it not make sense? It's proven in the literature that organ with blame-culture yield to under reporting of incidents.
  8. pseudonym87

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    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.
  9. pseudonym87

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    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.
  10. pseudonym87

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    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.
  11. pseudonym87

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    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.
  12. pseudonym87

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    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.
  13. pseudonym87

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    Right- but let's say she did the right thing and stayed with the patient, she would have most likely saved the patients life.
  14. pseudonym87

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    Of course I was ICU trained. I was going to take the post-code patient on the unit but the sup called up to start caring for the patient on the floor until patient was able to be given a room (pretty sure I mentioned this in my initial post). I recalled the policy from my previous hospital that you should not transport a patient after a fresh intubation until placement is confirmed with CXR. After this situation, I investigated, and the same policy was in place at this facility as well. The portable x-ray team had not arrived yet, co2 capnography was not used during intubation and I sure as heck wasn't moving that patient unless I was certain that I had a secure airway. Sorry, breath sounds don't cut it and I would say airway trumps cooling measures (I continued caring for this patient finally in the ICU until the end of my shift and cooling was not indicated. Just a few vasoactives, fluids, a-line, central line. There were no delays in care. Your red flags seem to ignore the potential for an unconfirmed airway to lead to respiratory arrest en route. My point is that you have to stand your ground. Maybe this nurse was summoned to the ER urgently and made the stupid decision to save time rather than to be safe. Instead, she should have properly administered the versed and stayed with the patient. She should have stood her ground and not be rushed to the next task. I'd like to know if a supervisor was aware that she was going to administer versed and then rush to the ER. There's something missing in this story.
  15. pseudonym87

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    It's unprofessionalism which also violates the nurse practice act. You have not seen everything the board of nursing will weigh in their determination to take action against her. To think that you can adjudicate on someone's professional licensure based solely on a review of content released to the public without taking account other evidence is unprofessional and this violates the Nurse Practice Act in all states. Of course I take issue with the errors made by the nurse, the physician, the charge nurse, the pharmacy, etc. She ignored basic checks but we need to determine if this is a pattern of behavior or an isolated incident before we revoke her license in the court of public opinion.
  16. pseudonym87

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    How dare you even say that a nurse should lose her license without knowing her, her work ethic, the quality of her work throughout her tenure, and without knowing all of the facts. The CMS report does not address the nurses experience level, whether or not she had received the training and competence to be a Resource Nurse, and does not address other patient situations that may have led to her being rushed. With that said, I've heard of resource nurses providing coverage for a specific unit. I've never heard of a resource nurse for the hospital. Typically, when an RN is providing coverage for a hospital it's usually as a SWAT nurse, IV nurse, etc and the requirement always remains to not move on to the next patient unless you've made sure as a RN you're leaving the patient in a safe situation. The nurse who administered the vec immediately went to the ED to care for another patient. I'm sure someone told her, "after you give the versed, head to the ED, we need you there." So while the nurse is the one who injected the medication, many people and departments dropped the ball here. I'll tell you a story of my own. I was called in to go to work- there was a call out. When I arrived, I was told there was a code and I would be taking care of the post-code patient. The nursing supervisor called and asked me to come to the floor to care for the patient during transport, imaging, etc etc. I had no other patients and even though my charge nurse didn't want me to go to a unit I wasn't trained on, I still went. Essentially, I used the nurses and aides as my gofers while I cared for the now intubated patient in a non-ICU. We were ready for transport- portable vent, monitoring, code meds, ambu bag, everything was ready. But, a CXR to confirm placement was still pending. The doctors, and the nurse supervisor, were pressuring me to go straight to the ICU and we can confirm placement there. Although I was newer to this hospital, I remember from my previous hospital to never transport post intubation until we have a CXR conforming placement. Well, it was my patient so I told the sup and the MD that I'm not going anywhere until we get the CXR and if they want to move the patient, then I need to endorse the patient to another nurse. We waited for the CXR. I guess the point of my relatively uneventful story is that many times, supervisors and docs will pressure us to do things that are not safe- that go against best practice and we always 100% of the time have to stand our ground and respectfully tell them to F off or bring another nurse. To say a nurse should lose her license without even conducting an investigation is unprofessional and quite frankly, goes against the Nurse Practice Act of every state and territory of the USA.
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