The other day I received a call from my DNS and she terminated me over the phone about a mistake I made the day before. I worked at the skilled nursing facility for 1 1/2 years as a relief nurse. I have been written up once within a few months of employment. Since then I have made mistakes, discussed it with the DNS and did not have any further write ups. The other day I had a total of 9 skilled patient load, which was nothing abnormal and was consistently busy-- and somewhat stressful. In room 36 there were two patients, one by the window (36W) and one by the door (36D). I got in report that 36W is going to discharge home in 4 days, she was independent in her room, alert and oriented, cooperative, ect. The patient was 7 days post op for a CABG where they used the femoral artery (can't think of the specific name), the patient had a dressing on her inner thigh that appeared to be clean, dry and intact. 36D had a fall at home, broke her hip and had surgery. She also had cellulitis on the affected leg and her dressing was saturated with clear sero-sang drainage to the point that it went through to her sheets. While changing her dressing I noticed redness around her staples as well, also markings from a sharpie demonstrating the area of redness- which was still within its proximity. I had an order remove staples and I promptly went to 36W and discussed the procedure with the patient, removed the dressing and the incision appeared intact and I removed the staples (some staples has some skin growing around it) and applied steri strips. Based on my assessment I thought that I was in the right, fulfilling my nursing duties and the patient was satisfied. The following day I received a call from the DNS stating that I had removed the staples from the wrong patient! My heart sunk. She explained that because of the risk she was terminating my position. Not to minimize the risk I caused to the patient, but I tried to explain my nursing assessment, however she did not seem consider or listen. I asked if the patient was ok, and she did not know, and stated that all she knew was that the surgeon was called. She did not have any other information. She also explained that being a relief nurse I need to triple check my steps-- and I explained that I am accountable for not referring back to the order and to which patient I was to remove the staples. I understand that there is risk to my mistake, such as the incision could dehisce, however I feel that I am competent as a nurse to judge if the staples were ready to be removed. I feel I would question the correct patient's order and may have called for a clarification. I feel that I may have been wrongfully terminated. The DNS did not give me the curtsy to come in and talk about it, it was over the phone, nothing in writing and I feel she is not being a professional advocate or respecting my professional integrity. I called her to schedule a meeting with her and she a agreed to meet with me next week. For my own peace of mind I feel like I need to explain this to her. She did not follow do process and I don't know if what she did was right. I feel she reacted with an emotional response because she learned about the incident probably 2-3 hours prior to calling with the news. What do you guys think????
