Terminated. Pursue a Lawsuit?

[ERgirlynurse]

So I work in an ER. I am pretty new to nursing. I was called in to HR to explain why I had overridden Benadryl multiple times and not given it. Also a handful of times I did not waste excess narcotics appropriately. I explained my thought process on having the Benadryl in case I needed it and that the issues with waste were due to no one being around to waste with. I acknowledged I was wrong and was willing to do any education/disciplinary things they wanted. This was agreed upon at the time. After having meetings canceled and no phone calls for weeks they finally called me back in. They put me on unpaid leave. Essentially said I was lying. No drug testing or talking to my direct supervisor. I have another better job so I resigned that day. 4 days later they terminated me for performance issues.

So my question is that many friends have recommended I talk to a lawyer. Should I? Or should I just let it go and move on? Please help!

[NotAllWhoWandeRN, ASN, RN]

Where I work the Pyxis always pops up with the prompt asking if I'm administering the full amount for any controlled substance and you hit the "yes" or "no" button. If no is selected then before we can pull the med we have to have another nurse co-sign in the Pyxis as witness. Is this unique to my facility or something most facilities have implemented? If it's an IV med I will pull it up and waste it right then and there. If it's a pill then I administer it right away and then immediately find the nurse who witnessed in the Pyxis and waste it in the sharps with her watching. If for some strange reason I cannot find the same nurse I will find another witness and we will both let the original witness know. Unfortunately I can't open pills until they've been scanned since opening them makes the barcode unreadable.

I once pulled a med the patient requested and then the patient changed her mind. I was having a hard time returning it since it was documented that I had already wasted half. Nobody knew what to do, I was new, and I didn't want to walk around with a vial of dilaudid in my pocket. I went straight to my manager, who was also unsure how to return it, but it was decided we would document in the Pyxis and waste the entire vial together. I later found out there was a way to return it, but it was complicated and it's rarely done. You can't get sloppy with wasting since it's for your protection. Just like the summer I was a camp counselor: nobody was allowed to be alone with a camper- it was to protect the camper, counselor (from false allegations), and the camp.

As with other things, I don't believe it is kosher to document waste in anticipation of doing it in the future. I don't document waste unless it's being wasted (or has already been) at the time of documentation. I also don't like drawing up meds away from the bedside beforehand for a witness. My first hospital job trained me that you prepare meds for administration within view of the pt who will be getting it. That also reduces the risk of med error due to unmarked syringes of medication.

My current job has these terrible vial-access not-quite-needle things that leave a spike in the vial, so I worry the med is going to seep out in my pocket. It's done ok so far, though.

[Sage611]

May I say that many of the posters heretofore have not missed the opportunity to offer words of derision but little advice to this nurse. Thirty years and not much changes.

This is precisely why the expression "nurses eat their young" was coined so long ago. In the course of a nursing career there will not be one of you who will escape being accused of malfeasance whether real or imagined;whether from a disoriented patient or a disgruntled family member or, even, worse yet, a desperate substance addicted colleague. In this business no one is immune. Without knowing all the facts, I would advise this nurse to forego a lawsuit, it's futile, and move on. Anyway, you have probably signed an arbitration agreement with your employer and even if you are dead to rights as they say, very few employees short of Jesus Christ ever prevail. Just understand that in a situation like this many are quick to condemn but most disappear when you need a friend. Angels of mercy are few and far between these days,unfortunately.

So nice to see kindness on this board. I have read all the responses, have filed away all the precautions, ethical considerations, and proper protocol as a hopeful nursing student. So, thank you, OP for a lesson at your expense. I am truly sorry you find yourself in this predicament and hope you'll come out of this wiser and unscathed. I agree that helpful advice, even gentler delivery, should have been shown you...not the venom and derision.

[Nursemiriben, LPN, EMT-P]

Am I the only one that is only more than slightly suspicious about pocketing benadryl and not wasting narcs?!?

[LadyFree28, BSN, LPN, RN]

As with other things, I don't believe it is kosher to document waste in anticipation of doing it in the future. I don't document waste unless it's being wasted (or has already been) at the time of documentation. I also don't like drawing up meds away from the bedside beforehand for a witness. My first hospital job trained me that you prepare meds for administration within view of the pt who will be getting it. That also reduces the risk of med error due to unmarked syringes of medication.

.

We have to make an immediate waste per policy, or we can get written up; we witness waste for accuracy of what we are going to give, label and draw up the medication, and then prepare for administration by scanning, administering, and then wasting the remainder; as long as we label the spring during the preparation, less likely a med error, at least my facility has found.

[DiscGolfNurse, BSN]

Also, ALL narcotics, including pills, needs to be wasted down a drain - either a sink or a toilet.

Is this unique to your facility? At my facility we have a witness to waste excess (usually IV form but also pills into a designated blue sharps container with a foot lever that opens the lid and closes the lid. I'm just curious if it varies from facility to facility or if this is a practice we should be following. I was told medications shouldn't be dumped down a drain because of the of water run off issues (do medications get filtered out of water that goes down the drain?)

[NotAllWhoWandeRN, ASN, RN]

We have to make an immediate waste per policy, or we can get written up; we witness waste for accuracy of what we are going to give, label and draw up the medication, and then prepare for administration by scanning, administering, and then wasting the remainder; as long as we label the spring during the preparation, less likely a med error, at least my facility has found.

That makes sense, and when done properly sounds like it would reduce the risk of diverting waste. I haven't worked anywhere that provided a means to label the new syringe, though.

[tyvin, BSN, RN]

Apparently taking large quantiles of Imdoium AD is now the new or newer way to get high. I just can't keep up with all this crap. SMH

Addicts turning to anti-diarrhea medication Imodium A-D to get high - CBS News

You people crack me up. If you would have taken this a step further, you would have found out that imodium doesn't work on the central nervous system (that's really oversimplifying it), or else they would't be able to keep the stuff on the shelves at any store anywhere. It can help with withdrawal to ease symptoms along with other stuff, but it won't get you high anymore than the air we breathe.

The blood brain barrier conception adds to it plus words like first pass, P-gp, M6,G...and on and on and on. Addicts have been trying forever to get imodium into their systems to get them high, but have been unsuccessful. I'm talking the hard core ones. There are multiple threads on the issue from years ago since no one has succeeded. Some say they have, but it's most likely all the extra meds to make the imodium get into the system and wishful thinking that even caused a little buzz.

The addicts turn to the imodium to lessen their withdrawal symptom...it's a trick as old as the hills and according to most addicts I talk to it works. 10 to 15 2mg pills is what one person took when getting sick from withdrawal; they had a light habit IMO. This does not make them high according to them.

https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=5&cad=rja&uact=8&ved=0ahUKEwjSwqC81ejMAhVs8IMKHSIqAbkQFghAMAQ&url=http%3A%2F%2Fopiateaddictionsupport.com%2Fhow-to-use-loperamide-for-opiate-withdrawal%2F&usg=AFQjCNGyGofysYV-PwzviSwYhk4gRCo90A&sig2=kDL9YOvPGRcrmYOIw0HqdA&bvm=bv.122448493,d.amc

The make-up of this forum has changed drastically.

[Jensmom7, BSN, RN]

The make-up of this forum has changed drastically.

Yeah, well it's been opened up to Facebook now, so...

[Guest219794]

1. Your tastes I find creepy.

2. With heartless logic like that, what the devil are you a nurse for! You're lawyer material. We need more of those by the way.

3. When it comes to mea culpa, I take my cue from Wall Street-haven't heard sorry yet. Have you? They LOVE responsibility.

1- FWIW, my response has nothing to do with eating the young. I was just amused at that old mantra being invoked in this case. I would have had the same reaction if the OP was Clara Barton.

2- Good call, I actually had a respectable LSAT, changed my mind.

I can't tie a tie, and scrubs are ever so comfy.

3- I am so sorry, I am missing the Wall Street thing.

BTW- The OP, who has had ample opportunity to clarify and explain, is long gone.

We will never know how her lawsuit against the big mean hospital plays out.

[LadyFree28, BSN, LPN, RN]

Also, ALL narcotics, including pills, needs to be wasted down a drain - either a sink or a toilet.

Is this unique to your facility? At my facility we have a witness to waste excess (usually IV form but also pills into a designated blue sharps container with a foot lever that opens the lid and closes the lid. I'm just curious if it varies from facility to facility or if this is a practice we should be following. I was told medications shouldn't be dumped down a drain because of the of water run off issues (do medications get filtered out of water that goes down the drain?)

We have a blue container for meds.

[Altra, BSN, RN]

Am I the only one that is only more than slightly suspicious about pocketing benadryl and not wasting narcs?!?

No, definitely not.

[bgxyrnf, MSN, RN]

I find it ridiculous to say that there is "no one around" in an ER to waste with. You definitely need to review your nurse practice act. Some things are NOT negotiable in nursing.

In my case, we actually were in this situation because these were single-nurse EDs. It was a little sketchy but the procedure was to label each waste and then document all the wastes at shift change. The ED nurses even had access to the pharmacy.

To your point, though, in a 'real' ED, you simply find someone to waste... period.

One undocumented waste, ok... nobody's perfect. But multiples? Um, big problem.

And a "newish" nurse? Holy cow, what were you thinking? As a newbie, I was a "dot every i and cross every t" kind of guy.

Seriously, what are nursing schools putting out? People who are upset that they're terminated for multiple tardies? People upset at being canned for repeated drug overrides or undocumented wastes? The people who've been around for a long time have a little (tiny) bit of lattitude and a 'presumption of innocence' based on years of reliability. But a newbie? Sheesh.