Settlement and final order

Nurses Recovery

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To make a long story short, my previous employer accused me of stealing dilaudid, which i did not do. There were some issues with documenting pain scores, administering a dose of dilaudid to someone on a PCA (It was ordered and other nurses had done it as well), and forgetting to waste one time. There was not enough evidence to charge me with diversion so BON came up with 3 charges related to the documentation and pain medicine administration and wasting. My question is, whether or not I decide to agree to the settlement, will my current employer keep me around with a punishment from the board on my record? Does anyone have experience with this? I have worked at this hospital since September and NEED to keep my job to support my family. If there is any possibility of getting these charges dropped, I may tell my attorney I want to go for it because i don't want this black mark on my record. I feel like I am being made an example of and it is not fair. I didn't do anything that almost every other nurse on my floor did too. Any advice is appreciated.

All states have slightly different nurse practice acts... but generally punishments are: public reprimand... which can include things like a fine and CEU's... I believe that is what you have been offered. The CEU's and fine aren't a big deal... but having that show up on your license is because that makes getting a job much harder. It's the lowest form of discipline but it is still discipline. Next is probation... which also is public on your license and this will involve a few years worth of requirements, usually random drug tests, 12 step meetings, quarterly reports from your manager, etc. The terms can vary depending on the state and depending on what the offense was. Almost always there are Work restrictions... like no home health, no night shifts, no overtime, no working with narcotics, etc. Suspension means you cannot work as a nurse while on suspension. Usually when it is over you start on probation. These are all public on your license and never goes away. I would imagine you have a better chance of your current job keeping you on with a public reprimand vs probation, since probation is worse and usually involves a lot of work restrictions. A public reprimand doesn't involve work restrictions (that i have seen). There is no guarantee that they would keep you on, even with just the reprimand. I do think that helps if you have been there over 90 days. Getting a new job would be easier with just a public reprimand than being on probation but it is still a public mark and would still make job hunting difficult.

Now, many states have an alternative to discipline for addicts or people needing mental health monitoring but they are all different in the requirements. Unfortunately I have not heard of any alternative to discipline for simple charting errors, which isn't fair. But many will include people who aren't addicts but have a need for mental health monitoring/stress or whatever. In my state someone in your situation would have gotten off easier by admitting to taking the dilaudid and signing up for the alternative to discipline program, which again isn't fair. (You would have had to sign up right away to qualify in my state but they are all different in what they require). All the states handle these programs differently and some states have requirements that are difficult... like a lot of work restrictions and expenses. Usually the payoff is no mark on your license though.

Thanks for the reply. Also, they are saying I put someone's psychosocial welfare at risk by administering dilaudid to someone on a PCA...it was ordered and on the MAR and the pt requested the extra dose because it was a higher dose that controlled their pain better and they weren't currently using their PCA...is this not ok?? Other nurses had been doing it for weeks for this pt.

Well where I used to work when I worked on a medical floor if the pt was ON a PCA they weren't supposed to get separate IVP doses but you're saying the PT wasn't currently on a PCA at the time? Either way... if nothing bad happened with the patient it seems rediculous that this would be something they would discipline you for but I have seen some stupid things people were disciplined for. They may not have had a lawyer though and you do so I'm hoping your lawyer can give you some direction as to where to go from here. I would also think that if the other nurses were doing it too that should be taken into consideration. Are they going to discipline all of them? And pharmacy too for profiling it? What does your lawyer say?

The pt was on a PCA, however, she never pushed the button. Also, these extra doses of dilaudid were on the MAR for or that had a lot of pain and were typically a larger dose than the PCA dose, so this pt preferred to get a larger dose every 2 hours, vs a small dose every ten min. There is no order to not give it when on a PCA or anything. Also, the only reason all of this got brought up is because pharmacy flagged me for giving more dilaudid than the other nurses that month...that led to an investigation, which led to them believing I diverted, looking into my charting and deciding they had evidence of this stuff instead of the diversion, when I wouldn't admit to anything I didn't do. No other nurses are in trouble...my lawyer believes they think I diverted but can't prove it so they will punish me this way then...still waiting to hewr from her today, as I haven't gotten to discuss this settlement agreement with her.

I don't know. I'm starting to believe someone had it out for me. All I hope is that I can keep my current job.

Specializes in Medical Telemetry, SICU.

Well for my hospital the right practice would have been to alert the provider that they had two separate routes for pain control. Usually if you have the PCA that should be your only source for short acting pain control. I have seen them on a long acting pain medication with the PCA but that's it. But doctors change their minds all the time..

Specializes in Med/surg/ortho.

So you have to pay a fine and do some hours of education but then it's done. I'm assuming that's all your punishment was? You have no idea how worse it could be lol.

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