Should this RN be fired for giving med to housekeeper to give to patient?

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by Nurse Beth Nurse Beth, MSN (Columnist) Educator Columnist Innovator Expert Nurse

Specializes in Med Surg, Tele, ICU, Ortho. Has 30 years experience.

Dear Nurse Beth,

I have been a nurse for 29 years. Started out as LPN for 15 years, and then graduated from RN school in 2005. I should have known better....but this is what happened. I work in a small nursing home with less than 100 residents. I am very close to the residents and other staff members.

We all help each other out anytime we can....no matter what area you work in. I was cart nurse for the day, when our housekeeper, that I know well, stated that one of our residents needed something for nausea. Like I said, I should have known better, but due to trying to get things done, change a colostomy bag, etc, I put the pill in a cup and asked if she would take to the resident. The resident is alert and oriented, knew the medication was coming, and was within my eyesight (less than 30 feet away).

The housekeeper stated that she would and walked off in the other direction. I started walking that way, and "Susan" in logistics came to me with the med and stated that the housekeeper gave her the meds and she did not know what to do with them. Again, like I said, I know that was wrong....I took the meds, and threw them away. I had not documented that they were given. Next, I took new meds to her and charted that I gave them.

Next thing I know, I am called into the DON office and was terminated. She asked about the med situation and I told her the truth and informed that I knew that it was wrong and it would not happen again. I have never been written up and also was just asked to become supervisor for the 3-11 shift the week prior. I have ALWAYS worked over when they asked and have given this place all that I have. It just so happened, that 1 hour prior, to this incident, I informed the ADON that I would be unable to accept the position due to that fact that I have 2 children in elementary school, and middle school. I am also a single mother and my 9 year old is a newly diagnosed Type 1 diabetic.

Needless to say, I was already stressed to the bone, and now I have been FIRED because of this mistake. I am not saying that it was a small mistake or that it was not bad, but dang....termination? Really? I have reported several CNA's that were actually caught being verbally and physically abusive to residents and they still walk in and out of that place everyday. I really loved my job and my residents. I have come to a point where I do not even want to be a nurse anymore. I would appreciate any and all advice that you have to offer. Thank you for taking the time to read this.

Dear Terminated,

What you're going through is devastating, and I'm so sorry.

To me, the DON could have suspended you or given you a warning instead of firing you, but in all kindness, you don't really have a justifiable defense, and it was a reckless decision.

As a nurse trying to do several things at one time, there is a lot of pressure to take shortcuts, but the results can jeopardize patient safety. It wasn't only giving the med to the housekeeper, it's not checking patient ID, and there's also the matter of documenting a med you didn't give if the housekeeper had given it.

It's natural to feel angry about what you see as unfairness with the CNAs, and it's healing to let it go. Instead, reflect on what led up to your decision. 

The only way through an error like this is to accept it, acknowledge your responsibility, forgive yourself, and then put it in your rearview mirror so you can move forward.

Very best wishes,

Nurse Beth

JKL33

6,370 Posts

To the nurse in this scenario,

I, too, am sorry to hear of this situation. Taking everything that nursing is into consideration (let's face it, it isn't easy work) I wish we would be a little less harsh with some things. But in the end it's so hard to say that something is okay just this once...or "don't let it happen again." Still, I would favor a final warning or something similar for your circumstance. I'm sorry you were terminated.

Since nursing presents so very many  "opportunities" (temptations) to compromise or diverge from what we were taught, I've had plenty of occasions to think about whether I need to operate as strictly as I do. And my consensus is that YES, I do. One thing that has helped me stay on track is recognizing the numerous decisions that are made without nurses' input which then lead to situations where we might be tempted to make a bad compromise; the classic example being staffing: We might think of shortcuts or compromises because there just aren't enough hands available to care for patients the way we wish we could. But that is not a situation you or I caused, and we are not obligated to make unsafe or unwise compromises in order to try to fix the problem. Patients are relying on us not to give in and compromise their care.

I 100% agree with @Nurse Beth's reply, especially that you must forgive yourself. Do it ASAP. One decision such as this one does not make a bad person. Also, don't let anger or a sense of injustice get the best of you either. Process it and move on; don't let it destroy you. We all have to take life as it comes; that's all we can do. I wish you well in moving forward ~

CommunityRNBSN

CommunityRNBSN, BSN, RN

Specializes in Community health. Has 4 years experience. 854 Posts

This sucks. The good news is— I speak from very recent experience— the job market is HOT. There are so many jobs available for both LPNs and RNs right now, you will not have trouble finding one. When the interviewer asks why you left your last job you can say “I unfortunately made a med error— not involving a controlled substance— and believe me that I learned my lesson.”  I know you’re having such a tough time at the moment but this really isn’t the end of the world. Hang in there.