So what would you do?

Karynica, RN · Jun 9, 2008

if you didn't work the 8th, then anyone can look at the schedule and tell you didn't give it. If they try to blame you, explain to them they need to look at the schedule. Had this happen before. DON didn't even look at the schedule to see who worked. Wow, what a great idea to check the schedule before blaming someone!

I have at times signed a MAR for the next day and didn't catch it, but the nurse who worked that day should have caught it. Can't they count the meds?

Sometimes you have to lead management by the nose

Jolie, BSN · Jun 9, 2008

Since you signed the MAR without noting that the med was held, you must have given the Coumadin. If you accidentally signed the MAR for the 8th, instead of the 7th, I would assume that you did inded give it on the 7th, a day on which it should have been held.

medsurgrnco, BSN, RN · Jun 9, 2008

I'd look at my documentation to determine facts - was Coumadin given and was there an error in documenting the day it was given.

TazziRN, RN · Jun 9, 2008

Whether or not you worked on the 8th is not the issue. You signed it as given, so you must have given it. The issue is that it was supposed to be held until the 8th, so if you worked on the 7th and gave it, the pt got a dose he wasn't supposed to get.

Karynica, RN · Jun 9, 2008

Again...has anyone counted the number of coumadin left?? That would be a smart thing to do..

When we hold a med, we always took the medication out of the cart, or wherever it was kept until the person was back on the med.

If she/he didn't work on the 8th, how could he/she have given the med on the 8th??????

morte, LPN, LVN · Jun 9, 2008

hmmm i thought all places went by the "no hold" meds rule...either it is given or dcd.....and reordered later?

BradleyRN · Jun 9, 2008

How are you suppose to know to hold it if it doesnt say that on the MAR? When i worked long term care, the MAR was for 30 days. If a dose was to be held, then each day would say HOLD in the place where you initial it. Whoever noted the order was the one responsible for this med error, so i doubt they will write you up for it.

morte, LPN, LVN · Jun 9, 2008

How are you suppose to know to hold it if it doesnt say that on the MAR? When i worked long term care, the MAR was for 30 days. If a dose was to be held, then each day would say HOLD in the place where you initial it. Whoever noted the order was the one responsible for this med error, so i doubt they will write you up for it.

but she signed it off in the wrong day.......there lies the issue......if they followed the policy that i mentioned this COULDNT happen

smstar1996 · Jun 9, 2008

okay I worked on the rehab unit last night, I do not work this floor often. Anyway, I recieved a call from the supervisor asking me if a gave so and so a coumadin last night, I can't recall.... I had 16 patients. Well so and so coumadin was supposed to be held untill the 8th (today) and I worked The seventh and I quess I initialed in the MARS for the 8th. So if they come to me with a "write up" should I dispute it d/t the fact I worked the 7th so there is no way I could of given it on the 8th? Write ups go in your file...so what would you say or do?

I'm not asking wif you think it was given or not, my question is what would you say or do should you be confronted with write up? I will sign a write up if I know in fact I did something wrong.... no denying it. However, I can't say for sure if I gave it or not d/t the patient load I had that night. I may have I may not have..... but I should I dispute if/any write up d/t lack of proof being 1. initialed was the 8th, I worked the 7th ( how can I be sure that someone didn't just through my simple little initials in (hint there are some shadey nurses like that on that floor) and 2. They could of went back to the PT med drawer and looked to see if there was a coum pill missing since it was a brand new dose, but they didn't. So with that said, would you just sign it, knowing it goes in your file or dispute it? Thanks

TazziRN, RN · Jun 9, 2008

I'm not asking wif you think it was given or not, my question is what would you say or do should you be confronted with write up? I will sign a write up if I know in fact I did something wrong.... no denying it. However, I can't say for sure if I gave it or not d/t the patient load I had that night. I may have I may not have..... but I should I dispute if/any write up d/t lack of proof being 1. initialed was the 8th, I worked the 7th ( how can I be sure that someone didn't just through my simple little initials in (hint there are some shadey nurses like that on that floor) and 2. They could of went back to the PT med drawer and looked to see if there was a coum pill missing since it was a brand new dose, but they didn't. So with that said, would you just sign it, knowing it goes in your file or dispute it? Thanks

If you signed it off, whether or not it was on the wrong day, then you must have given it. If you signed it off by mistake while giving the other meds but held the Coumadin, were the other meds also signed off on the 8th? And if you didn't give it but signed it off by mistake, wrong date or not, then it's a documentation issue and another whole can of worms.

I don't think you have a legitimate fight on your hands. There are several things wrong here that can be pinned on you: a hold med given anyway and documented wrong, or a med not given but signed off as given.

smstar1996 · Jun 9, 2008

Again...has anyone counted the number of coumadin left?? That would be a smart thing to do..
When we hold a med, we always took the medication out of the cart, or wherever it was kept until the person was back on the med.
If she/he didn't work on the 8th, how could he/she have given the med on the 8th??????

Exactly!........ I don't think anyone counted the drug to see if there was a pill missing. I haven't been to work since, so I will find out Weds if there will be a write up. I just don't think I should sign a write up d/t the fact that there was not enough evidence to prove I gave it.....and honestly I don't know If I did or did't d/t the work load I had that day. Thanks.