terminated- feeling like a failure

[sunshine539]

I was recently terminated from a nursing job for a charting error. to make a long story short I went back into a chart the day after to fix something in my charting in a patients chart. I deleted a piece of charting because i said i did something without actually doing it and wanted to make my charting correct. unfortunately in retrospect my company brought it to my attention that this is a breach in HIPAA thus terminated my employment.

This has been particularly hard for me to face as i am one of those people who is a perfectionist and always plays by the book. I have about 2 years of nursing experience (1 year night shift on a step down unit -was a zombie and bullied by a nurse, now 1 year office nursing/ambulatory surgery) and am now so frustrated and so upset with myself. All i can do is sit here and cry because I am so mad at myself. I just feel like i have a bitter taste in my mouth about nursing now. I used to be this young intelligent nurse so excited for my career to begin and had such high prospects.

I feel that I have lost all my confidence and feeling like a failure. Who will hire me now?

Any suggestions from people in similar situations and how to move on? should i quit nursing or keep looking for a better fit?

[Mavrick, BSN, RN]

I don't think deleting an entry is the same as use white out to a paper chart. That info would still be recoverable if the chart was audited or subpeonaed. Knowing that, I would think deleting the entry is appropriate. There's usually a place to state why something is being deleted.

No, no no no no no no no.

There is a way to edit or amend an entry. Perfectly legit.

[Postpartum RN]

I agree. In electronic charting, you can never "delete" something permanently after you have filed it. I work for 2 places, so I know how different EMRs can be. At one place I would simply go in and edit my note, meaning delete the sentence or whatever I wanted to remove and add any other info. After I file it, this note turns a different color than the usual, which shows it was edited after it was initially filed.

At my other place, I actually have to go in and "amend" a note and it looks different. Either way, there is a trace of what you changed. It's not at all as taking "white out to paper".

In the electronic form this is the proper way to do it, it would be as if I took a pen and crossed out a line of my charting and initialed it---which is the right way to do it on paper.

OP, mourn your loss and then pick yourself up and move on. It's completely normal to beat yourself up over a mistake or two. Just know that you will be a better nurse after going through this experience, you have learned something. Everyone makes mistakes at one point or another. Please, don't give up!

[joanna73, BSN, RN]

@ KRVRN, perhaps you may want to review your nursing standards. Deleting a piece of charting is not acceptable practice. This is a legal document.

[Been there,done that, ASN, RN]

pangea reunited- there is a bit more of the story. to make a long story short i was being trained in the surgical center and i had made a potentially bad medication error that did not hurt a patient. I did not communicate this error with management until prompted (even thought i had with the preceptor) and mgt had put up red flags after this, despite my urging that i had learned from the situation.

I understand that this is my fault, my errors. and i am very thankful that they have not reported my charting error(that i know of).Just having a hard time picking myself up when i thought i was doing the correct thing by making my charting correct.

Im just so scared no one will want me now- little experience, being fired, mistakes made

If you were being precepted in the surgical center,and informed your preceptor ... what is the preceptor's position in this?

[LadyFree28, BSN, LPN, RN]

If you were being precepted in the surgical center,and informed your preceptor ... what is the preceptor's position in this?

This.

What was your interactions with the perception during all of this?

[hppygr8ful, ASN, RN, EMT-I]

I haven't been in a situation as yours, while I don't feel the way you do - I can only begin to imagine and I'm sure you are feeling awful. I'm so sorry this has happened. :HUGS:

The question is not SHOULD you quit nursing, it ought to be: Do YOU want to quit nursing?

Answer this once you've cried and mourned over your job loss. Answer this once you are back on your feet.

Your next employer you will hire you, that's who! =)

Be positive, you will be hired again if you so wish.

There are nurses out there that have done some really really messed up stuff, and somehow they're still allowed to nurse.

Learn from this and move forward.

On the scale of career ending mistakes this is a minor one. Take a deep breath tune up your resume

and get back out there.

Hppy

[BuckyBadgerRN, ASN, RN]

Maybe I don't know as much about HIPAA as I once believed. How is this a HIPAA violation? Falsified charting/documentation, yes. A violation?

[BuckyBadgerRN, ASN, RN]

Ugh. The other shoe. WHY must we always dig for the other shoe. Anyhoo, it sounds like you were on their radar, OP. Maybe they were looking for ANY reason...

pangea reunited- there is a bit more of the story. to make a long story short i was being trained in the surgical center and i had made a potentially bad medication error that did not hurt a patient. I did not communicate this error with management until prompted (even thought i had with the preceptor) and mgt had put up red flags after this, despite my urging that i had learned from the situation.

I understand that this is my fault, my errors. and i am very thankful that they have not reported my charting error(that i know of).Just having a hard time picking myself up when i thought i was doing the correct thing by making my charting correct.

Im just so scared no one will want me now- little experience, being fired, mistakes made

[xoemmylouox, ASN, RN]

EMR's are different. The EMR we use allows us to amend the note, but not delete things. The amended part is added to the end of the "document" or notation. I'm surprised any EMR allows you to "delete" things after 24hrs. Our notes get locked and require permission from our IT dept to get corrected.

I seriously doubt this will be the end to you nursing career. We all make mistakes. I'm not sure if the documentation you deleted was related to the medication error or not. If so I am not suprised you were fired. Trying to cover up mistakes always makes the situation worse. If not then you were already seen as a target and they were prob. just waiting for the next mistake to happen.

[MadelaineT]

Sunshine520, my interpretation of your entries is that the med error occurred prior to and was separate from the charting issue. Is that correct?

At any rate, med errors or near-med errors are inevitable given the load nurses carry and the stresses we face. Making one med error or one charting error should be grounds for a warning or disciplinary action, not grounds for termination. It sounds like the place you were working was harsh, and someday, I hope you can feel relieved you got out of there when you did. In an ideal world—and our health care system is so far from ideal it's appalling—errors such as yours would be used as learning tools for everyone. I had a nurse manager who pined for the old days when nurses could safely admit to an error, which would then result in all of the nurses talking about why it happened and how it could be prevented in the future.

As for the charting issue, at my hospital we are able to delete electronic entries, and it isn't an illegal action. Computers, computer software, nurses, and doctors are not infallible; duplicate charting, clicking on the wrong med, and erroneous MD orders abound. In deleting or amending an entry in the electronic record, be it an assessment item or med administration, nothing is "hidden". You go through a few steps, one of which is a typed explanation for the deletion or amendment, and it stays on the record for all to see.

I'm sorry for what you're going through. I'm also sorry some of the commenters here have shown such an un-nurselike lack of empathy, but that's the reality of nursing, as you well now from your earlier experience. Take some time off to heal, and then get back to it!

[hppygr8ful, ASN, RN, EMT-I]

Maybe I don't know as much about HIPAA as I once believed. How is this a HIPAA violation? Falsified charting/documentation, yes. A violation?

It is a HIPAA violation to access any patient record that you are not assigned to in a care capacity. IE Clocking out and continuing to chart is violation because since you are technically not working your legal access to the chart is void.

Hppy

[Kiki1970]

Medical records are a legal document. Any changes made (in writing), are to be done with a SINGLE line drawn through it, initials and date above or beside it. It's 101 in biz and medicine that deleting anything is a no no!! It leaves things wide open. What if there was a law suit? Think about it...