This can't be right...

Altra, BSN, RN · Sep 20, 2010

No, your license is not in jeopardy for your conversation with the PA-C. Sheesh.

Your termination, however, ... you're going to have to think about how much time & effort you're willing to put into fighting it. Is it retaliation, pure & simple? Most likely. And that may seem to be ethically wrong, but it's not necessarily illegal.

I'm sorry this happened to you. I wish you luck.

Edited to add: There are a lot of details not contained in your post, and I'm not suggesting that you fill in all the details completely. But the possibilities and implications of the DON's actions are troubling. How long had this been going on? Were nurses giving meds according to the altered orders with the knowledge that they were not prescribed by a provider with prescriptive authority? Are the orders on paper or electronic? Is this an issue of cost -- formulary meds vs. non-formulary meds, and if so, what are the facility's administrative policies regarding this? Is this an issue of possible intended diversion of someone's preferred narcotic? Many unanswered questions -- and a likely nasty can of worms. I cannot imagine the PA-C and ultimately the medical director letting this slide though, and that is the reason that the DON has flipped out now that he/she has been held accountable.

LACA, BSN, LPN, RN · Sep 20, 2010

My thoughts are::do you really want to go back to that environment??? It's only going to get worse if you go against her and get your job back, unless she loses her job over the incident, which is unlikely. You would probably be better off looking elsewhere....

neophyte · Sep 20, 2010

Hmmmm. I'm trying to give as few details as possible.

There is a retalatory aspect to this... Somebody "killed the messenger," and that was me, now I'm out of work over this. It makes me sick. From the time the DON got caught, it was a week before I was fired. I had a stellar track record until then though. The order was not a cost based desicion, the DON decided on her own that the initial narcotics ordered were "too strong, for the patient."

Flying ICU RN · Sep 20, 2010

To what benefit if not punitive? For significant loss of say for example, retirement benefits after long term employment, yes.

To bring a civil action for wrongful termination, costs a minimum of $350.00 / hr, depending on your location.

If you really want to try to pluck her quills a bit, write a detailed letter to this persons corporate office.

I only talked to one person about this so far, and they said my license might be in jeapardy. What?!?

Only if you fulfilled an unlawful order by a unlicensed provider. In which case, take pause and think it through.

ukstudent · Sep 20, 2010

1. Apply for unemployment. When they try to deny it bring up the retaliation.

2. Call your State BON and give them a detailed account of what happened.

3. Look for a new job, because that one is never coming back.

diligent-trooper · Sep 20, 2010

I would file a grievance complaint with the hospital to whom, or the department in which handles such actions. I would also get in contact with that P.A. This sounds like an issue with your DON, and I believe you should have not lost your job. It appears very trivial. :crying2: Good Luck!

Vikingkitten · Sep 20, 2010

I wouldn't add much to what has been said before; all good advice here. Something to remember too is that here in Colorado it's an "at will" state. No one needs a reasonn to let you go. At all times, CYA and good luck, you sound like the conscientious employee everyone wants, except your former employer.

Just my $.02.

OgopogoLPN, LPN, RN · Sep 20, 2010

So, I've worked in LTC in Colorado for a while now, but have just been hit with a doozy!
My new D.O.N. decided that she was going to cancel orders for one narcotic and write orders for a completely different one. When the P.A. showed up and asked who cancelled his orders, I had to refer him to her. He complained to her about the need for her to follow his orders (not the other way around) for about 20 minutes but did not report the incident. Later, she started treating me like I was the one who turned her into him. Well, I did, but not because I wanted to!!! Within a week all my hard work at the home was for naught. I was fired for insubordination (I could barely look her in the eye, so it was partly my fault).
I'm not going to take this lying down. No way!!!
Who do I report her to though? The state surveyors that come to the home, the board of nursing? I only talked to one person about this so far, and they said my license might be in jeapardy. What?!?
Any help is much appreciated.

My bold. How does not being able to look her in the eyes count as insubordination and being partly your fault??

Anyways, the situation sucks and I hope you get some resolution!!!!

Altra, BSN, RN · Sep 20, 2010

I would file a grievance complaint with the hospital to whom, or the department in which handles such actions. I would also get in contact with that P.A. This sounds like an issue with your DON, and I believe you should have not lost your job. It appears very trivial. Good Luck!

OP works in an LTC - nursing home. Sometimes these are business units of a corporation, sometimes they are independent businesses.

If OP's LTC is part of a chain, she could contact the corporate office and possibly seek their assistance. But if this is an independent business, there is literally nowhere else to go in the organization. The only option then is EEOC/DOL/other legal action on the part of the OP, at his/her own time and expense.

Regardless ... based on the details provided by the OP this is, IMO, either an issue with underlying intent to divert narcotics, or a severe lack of judgement/knowledge on the part of the DON that resulted in her believing she could rightfully change physician orders.

And then there's the issue of whether or not the nurses in this LTC were giving meds per the altered orders with the knowledge that they were not written by someone licensed to prescribe.

Peetz, BSN · Sep 20, 2010

Leave and don't look back. The DON will hang herself sooner or later, just don't be around to catch any spatter when she goes down for writing RX without a license. It seems like the DON has a complex about doing things her way and not the right way, changing the rx instead of calling the PA to explain why she felt the drug was to strong, and having it changed the proper way. If she has done it once she will do it again, if she breaks one rule, she will break another, one will bite her in the backside.

j621d · Sep 20, 2010

My new D.O.N. decided that she was going to cancel orders for one narcotic and write orders for a completely different one. When the P.A. showed up and asked who cancelled his orders, I had to refer him to her. He complained to her about the need for her to follow his orders (not the other way around) for about 20 minutes but did not report the incident.

Under whose authority did she write orders? I have not worked in LTC, but I would think you still need a physician's order and signature. The PA works under the physician, and can write orders, but the DON? Am I missing something? Shouldn't she be the one in trouble?