Termination

resumecpr · May 10, 2010

That's interesting! One of the EMT-B's got fired for starting an IV on a patient in the back of an ambulance....a patient that really needed the IV I might add...because it was out of her scope of practice for that shift. (She was in school for EMT-I and was skilled in IV initiation, so could start IV's when she was in clinicals). She also lost her license. Make sure you check the hospital policy about scope of practice etc. Some places allow RN's to intubate patients and insert central lines if they have been checked off. But to be honest, the hospital was right to terminate you. What happened to the physician who was "mentoring" you while you were suturing? Best of luck in med school!

RN1982 · May 10, 2010

All I can say is, there is nothing you can do to get your job back. Next time be aware of what you can and cannot do.

SummerGarden, BSN, MSN, RN · May 10, 2010

so, i am actually an er technician and was recently terminated for suturing a patient. i was under the supervision of the md, but still terminated for practising outside of my job scope. i actually wasn't aware of the possibility of me getting fired over it, and simply took it as something new to learn. i have seen all over the internet that many er technicians are able to do basic sutures, but not able to find out much information beyond that. the job scope set in place at my former hospital was very ambiguous and i am currently trying to get my job back.

there are nurses in my facility who have practiced outside of their scope related to intubations and other emergency procedures because they are close friends with the doc that was observing them. when i first started i was encouraged to do a few things outside of my scope. however, i politely refused. i cannot afford to trust anyone for any reason when it comes to my license. i understand that the policy was ambiguous but you must always be cautious when practicing in health care.

i think the best thing for you to do at this time is to talk to a lawyer about any loopholes that will allow you to get your job back. no one on here will be of much help. hopefully, you will not lose your license over this... gl! btw, congrats on medical school admission!!!!

what happened to the physician who was "mentoring" you while you were suturing?

probably nothing!!! it is not the physician's responsibility to protect the license of someone else. i know that those that delegate procedures must ensure that it is properly delagated, but realistically, the person carrying the license is the one who is responsible to know and work within his/her own scope or practice. i do not know the scope of everyone to whom i delegate.. so i ask them first if i am unsure then i document to cover me. the doctor probably did the same.

ukstudent · May 10, 2010

When you started working there, did they have a check of list of all the things you were meant to do? This is normal, your preceptor would have signed stuff off as you demonstrated them. On this list was there anything about suturing? If not, then you were NOT ALLOWED to do it.

You say that you have heard that in some places ED techs are permitted to suture, I would be very surprised if this was true. ED tech, and I was one, do not have the knowledge or training to do this. You said yourself that you took a one semester course. Military medics yes, ED techs no.

The other point you need to think about is the patient. Did the patient that you used in order to learn about suturing told before hand that someone not trained in suturing was going to be trying it out for the first time. And after being told (I really doubt they were told), did they give permission for you to do this. This is called getting informed consent, the patient need to be informed about ALL relevant information.

In this day and age of lawsuits, can you think what would happen if the patient had any problems. Infection, nerve damage, scaring, that they were not happy about and wanted to sue. It's an automatic win for the patient if the person on the stand saying everything was done to standard was you.

roser13, ASN, RN · May 10, 2010

Simply out of curiosity, why do you ask this question on allnurses.com?

Truly, I'm interested in how you think nurses could help in your situation?

fungez · May 10, 2010

I worked in a clinic where I witnessed CNAs flushing central lines. I was shocked by this as in my hospital only RNs could touch central lines, but when I called BON they said, while it wasn't recommended, it wasn't illegal because the CNA was under the physician's license. So you might want to investigate that.

Was this the only error you've made? Are you, for the most part, a good employee (be honest). If you get a lawyer you might be able to get your job back, but if you're a bad employee they'll figure out something else to fire you for. You'll have to decide if it's worth it to you to go through the hassle or simply to move on. Good luck.

NurseLoveJoy88, ASN, RN · May 10, 2010

I think this is appropiate for allnurses. com, just for the simple act that others can learn from the OP.

netglow, ASN, RN · May 10, 2010

OP asks because we excel at working things out for those that post. SDN( if you've visited), does not offer what we do by a long shot.

As I've told so many techs/nursing student friends... sure it's fun when a doc wants to show you stuff. You do learn a lot!!! But they are not at all aware of your scope. They are only aware of their scope, and how things were done when they were in residency. There was no malicious intent to get you in trouble. It's either that that doc wanted to let you learn, or just didn't feel like doing it. No kidding, they don't really think any more about it. Having said that, you would be very lucky these days if that doc spoke up for you. Your only choice is to approach him/her directly about what happened and see if they want to help you. Many just won't tho, these days. Good luck.

Trauma Columnist · May 10, 2010

Doubt you can do anything at this point.

Chalk it up to a learning experience and go on would be my advice.

Next time, please be fully aware of what you can and can't do in the ER. You don't want to ruin your career prior to it getting started.

FutureERDoc · May 10, 2010

The reason why I think that nurses could help, or at least have advice is simply because of the fact that nurses run hospitals. The doctor did speak up and so did the medical director, both saying that they didn't think that I should be terminated.

In my time in the ER I have witnessed many nurses practice outside their scope, including intubations, sutures; etc. But, they never get fired, merely suspended. And most of the time suspension begins on the the next day and includes days off.

The termination as of now stands, but I have to undergo a peer review evaluation as the next step to possibly getting my job back. This panel will be made up of other technicians and nurses, and human resources says that if they rule in favor of me that I will be reinstated. I am allowed to bring others to speak on my behalf, which I think could be my saving grace.

steelcityrn, RN · May 10, 2010

What would make a emergency room physician allow someone to practice on a patient? Im sure the payer is paying for emergency room care and use of the physician. Why and how could that person allow this? This hospital could probably be sued for this.