Am I in trouble?

  1. HI Fellow Nurses,
    I started in a state ran psych facility about 2 and half months ago... I was hired for what I was told was going to be a staff nurse position...well guess what when the head rn isnt in you (me the staff RN) automatically is in charge of running the unit and also doing the head rn work that is due that day (rn weekly notes etc) and they pay you like a $1 more an hour for charge pay, while the head nurse doing the same job is making 5 or 6 $ more an hour.... it rubs me the wrong way.... now I am in a predicament now that during a psych emergency i was running as charge nurse, my med nurse was on break and i had to handle the suicide attempt alone... I paged the psych alarm, called on call dr and than went to med room to draw up the geodon 20 and ativan 2mg IM that we all know can take a few mins to draw up..... iwas doing this while the patient was in manual hold.... I was under the impression that the IM was a stnading order as that is what is given to the PT EVERY single time there is an emergency with her (borderline emergency quite frequently).... so I administered the shot, than dr came in room and gave verbal order to give what i had just given, I was like "ooops I just gave it" well the Dr was like next time you need an order first.. and kinda shrugged off as no big deal... well a week later i get called in the office (this is now after working a solid week as charge nurse some of the nights)and am told I can no longer do my nursing duties in the facility untill this is investigated.... I will find out what they will do by the end of the week... but so much for making a honest mistake a learning oppurtunity instead of a punishment... i am stuck at work working as an aid having all my co workers asking why i am not nursing etc... it humilating.... and I need the job because its a state job and ive been with the sTAte for 15+ years (but was in a different agency as an aid) and need the insurance cause I have MS.. sorry for the rant... just have really stessed as i just started this job and am closing on a house next week
    John
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    About johnsavv

    Joined: Nov '05; Posts: 11; Likes: 3

    13 Comments

  3. by   TsavarenaRN
    The only thing I could guess based on what you have written would be a med error due to lack of order for med given. This is usually (and this is based just on MY personal experience) handled by a meeting where you get written up, counseled/educated, and an opportunity to disclose your personal statement of what occured and why.
    Always check your MAR, I know it's hard and time consuming especially usually being responsible for 30+ patients and sometimes over the entire freaking hospital. Also considering drawing up Ativan is like sucking cold molasses through a coffee straw, even with a 16g needle. And believe me, I want every drop of it in that syringe that I am supposed to have during those situations. But you can never assume anything.
    It really shouldn't take them that long to investigate the situation, but state hospitals can be weird sometimes.
    Be honest, make sure you documented everything, but if they fire you over something like that it would be pretty severe (but not unheard of) punishment. Even if they do not treat it as an opportunity for education and as a mistake that I am sure you have learned from, you will.
    Sorry for what happened, and goodluck getting the situation straightened out. :redpinkhe
  4. by   Thunderwolf
    I definitely think this was a learning experience.

    The lesson...do not administer any meds without a written/verbal order...even in an emergency...none.

    End of lesson.


    Hugs
  5. by   Leahr
    I have done this and called the doc after.....
  6. by   johnsavv
    Thanks to all the replies... this is what they did to me.... They told me and handed me with my Union Delegate a written warning that would be placed in my file.... I thought that was the extent of it.... lesson learned done with... but no, when I ask does this mean I can go back to my nursing duties.... to which they replied no not yet because they were not sure if the error was going to be reported to the board of health..... I was disgusted by this that they would even consider taking it to that level and to do that to a new nurse/employee and not make it a positive.... I think that if this is the way this place is ran I may be best off going back to my old agency and taking the demotion back to being a aid (this is a group home with adults with disabilities, worked as an aid there for 15+ years, and this was suppose to be a promotion....) before any further/worse action is taken against me.... I think it is sad for the patients to loose a good nurse such as myself who is in the profession cause I TRULY love NURSING and helping others.... As much as I complained while working part time in the evenings in an acute rehab was back breaking hard work at least I felt valued and respected at this facility.... So the game plan I think is I am going to see if they will change me from per diem at the rehab place back to part time..... All these stressors going on and in the mean time of all this im closing on my first home next week.... Talk about having MIGRAINES..... I need to go and try to take care of myself... sorry for the ramble but needed to get some of this off my chest... they waited till middle of the shift to tell me this and at that point my migraine got so much worse I went home sick before I told off the charge nurse who is responsible mainly for the way things have gone down.... I will suck it up and go in there tomorrow and do the MHA's work as asked and try to stay positive..... wish me all luck and for this migraine to go away....
  7. by   meluhn
    johnsavy,
    I am so sorry to hear of your predicament. It must be very stressful to have to deal with all this and it is not good for your health at all. Since the state does have such great free benefits, I would ride it out and see how it plays out. If you quit just on principal and because you are insulted, you lose those free benefits, not to mention all the time you have in with them and probably a nice pension when you retire. It is a good thing that you kept your foot in the door at the acute rehab. I work in one too and I know how physically demanding it is. Also, not good for your health.
    What happens if they do report it to the board of health? Does that mean you loose your job? Are they paying you as a nurse while you work as a cna? If it doesn't work out for you at least you have plan B. I hate to see this happening to a fellow nurse. It is such a slap in the face when we work so hard. :icon_hug:
    Good luck to you, keep us posted. Congrats on the new house.
  8. by   haistar77
    I am in similar situation. I am a new nurse, just graduated from school. last friday, that was the last night of my orientation, I forget to give one of my patient 6 am medication, I reported my mistake to the managment people. I feel very sorry and guilty for my patient, and I don't know what they are going to do with me, I am very scared that I will lose my liscence because of that medication error
  9. by   johnsavv
    Haistar, I doubt you will be in any kind of 'big' trouble over a small error like that, it happens unfortunately all the time.... I think that med errors should be made a learning opportunity not a punitive occurrence. I wish you the best of luck and out of curiosity what med did you forget? I got bad news today myself, I got into work today only to be told that I did not make my working test period and they were sending me back to the state agency I came from (a demotion) and they also said they are not sure yet if they are going to report this to the nursing board or not... does it have any relevance the error was not reported by the dr (who I may add is the head of the clinical services there) untill 8 days after the fact in which time they still let me practice and be in charge? I feel awfull over this whole thing, got migraine and am thankful though I had a plan b....
  10. by   haistar77
    thank you for your kindwords johnsavv, I forgot librium, that is a big medication. I feel awful too. several weeks ago, I was in daytime orientation, one patient complained he didn't receive 6 am medication, so I checked the MAR, I found out the night nurse did not sign on the MAR, I guessed the nurse gave the 6 am medication but forgot to sign, I told this to my preceptor, my preceptor felt the same way because nurses on the unit forget to sign all the time. then the patient complained to the doctor. the doctor asked me about the missed medication in the morning meeting, my preceptor said we would check if the medication been taken out from the armicell. we found out the nurse didn't give the 6 am medication, my preceptor asked me to give the miss does. that was the end of the stroy. I did not know the night nurse got writen up, and the nurse educator filled out the incident report for him. the night nurse thought I had big mouth, reported his mistake to the manager. In fact, I don't know we have to fill out incident report for miss does. this time he found I made a mistake, he wanted to take revenge on me, he filled out the forms, passed it through the manager's office door. then other nurse told him, if he reported me, my preceptor would also get in trouble since I was still in orientation. they called the security and opened the manager's office, took the incident report back. when I came back to work on tuesday night, they told me the whole stroy, said they covered me. but I decided to report my mistake to the management people. I want to be honest. I agree with you, we are humans, we do make mistakes, the most imporntant thing is we learn from that, and not make the same error again. I don't blame any one report my mistake to the manager, I am responsible for every mistake I make. if I do something wrong, please tell me face to face or report it to the manager, but don't do this little dirty things behind my back. I am going back to work tonight, I feel like I am going to have heart attack. the relation with your colleagues is even more difficult than taking care of my patients.
  11. by   Jules A
    It sucks that the Doc did that, imo. As long as it wasn't something the patient was allergic to our Docs will just do a TORC in situations like this especially since you are a long time employee. Definitely hang in there because state benefits for people with MS are very important. Wish you well.
  12. by   Orca
    If the boards of nursing took away the licenses of everyone who has made a medication error, there wouldn't be any of us left.
  13. by   iwanna
    john,
    I am so sorry that your dr. decided to report this, as he ordered what you gave him. But, you thought that it was a standing order. However, I believe in all take downs, you have to notify dr. first before giving anything, unless the pt. has a standing prn order. It would be ashame to see you penalized for honesty. I am sure that there are nurses who wouldn't have told dr. that you just gave him the med. I can remember making a med error while working in psych facility. I accidentally gave a pm drug in the am. I realized it, as I went to sign it off. I reported my error to head nurse and an incident report was filled out. The dr. said no biggie, just hold his pm dose. I did have to go up front to meet with the clinical director, but it was just to come up with plan that it does not happen in the future. Also, they took into consideration that the unit was extremely busy that morning. Not that should have excused my mistake, but just that I needed to be more cautious. I really do not understand aneed to report it to the board! Is it because that it is a state hospital?

    I am wishing you the best.
  14. by   aloevera
    I am so sorry for your situation......that was awful of Doc to report that.....BUT...you did learn a good lesson without harm to anyone....
    Do not give med without verbal/written order under no circumstance.....
    unless you have a standing order........
    now for working as charge for 1.00/hr more......phooey on that !!!!!!!!!!!
    the extra work and responsibility is definately not worth it......
    good luck and I hope this gets taken care of for you........

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