Tired of impaired nurses

lamazeteacher · Oct 23, 2007

You're lucky that your license wasn't suspended, Sallie! Sick or nor, common practise or not, taking medications away from the facility where you work, is inexcusable. I've never left work without checking all my pockets, etc. You'd have to be unconscious and unable to drive home to have overlooked that.

Giving medications at the wrong time, is also wrong, especially early, when an earlier dose may still have been in affect, with the new dose doubling the dose ordered.

It seems that leaving your last employer was very good for your career, as you haven't had good examples to follow. New computerized medication dispensing machines will not allow early provision of a medication to a patient, but some innovative staff members may get around that, despite knowing it's not OK.

Reactions to being fired, are called SARAH - Shock, anger, revenge to resolution, acceptance, hope. I hope you will come out wiser, and more responsible, and have as guilt-free a career as possible.

So stop feeling sorry for yourself and consider the experience a necessary one for your development into a model Nurse. Take care, I mean no harm.

cmo421 · Oct 23, 2007

You're lucky that your license wasn't suspended, Sallie! Sick or nor, common practise or not, taking medications away from the facility where you work, is inexcusable. I've never left work without checking all my pockets, etc. You'd have to be unconscious and unable to drive home to have overlooked that.
Giving medications at the wrong time, is also wrong, especially early, when an earlier dose may still have been in affect, with the new dose doubling the dose ordered.
It seems that leaving your last employer was very good for your career, as you haven't had good examples to follow. New computerized medication dispensing machines will not allow early provision of a medication to a patient, but some innovative staff members may get around that, despite knowing it's not OK.
Reactions to being fired, are called SARAH - Shock, anger, revenge to resolution, acceptance, hope. I hope you will come out wiser, and more responsible, and have as guilt-free a career as possible.
So stop feeling sorry for yourself and consider the experience a necessary one for your development into a model Nurse. Take care, I mean no harm.

I would like to take a survey of nurses,especially critical care,,,How many have gone home and found the vial of extra ativan,etc,,,,in ur pocket. Come on people,even though I think there more to the story,meds have been forgotton in pockets for years. We had a girl who was going through a bad divorce,her husband reported her for having a vial of haldol at home. When questioned by the powers that be,she had it in her pocket,forgotton to discard it, and was taking it back to work next shift. They understood and no big deal. When narcotics are taken,well thats different. Due to history of drug abuse,they would have to be leary. But she took them back,,,

As for being a model nurse,,,,,I would love to see that one. We are human,we will make mistakes,we will forget. So busy we r,pockets full of whatever,it happens.

As for the SARAH thing,good advice.Never heard that before. When listening to my kids explain why something happened ,I always remember,the more they protest,more explanation I get, the more leary I get about the validity of their explanation. Good luck, and I agree,learn and move on,,,,,thats what life is about!

lamazeteacher · Oct 23, 2007

I'm beginning to see why there are as many medication errors (including those taken away from the facility) as there seem to be. If you weren't taught at your Nursing School, to be responsible about that, and you're exposed to Nurses who see fatigue as an excuse for less than good practise, you will always have a reason for misdeeds.

There are "model" Nurses out there. I've worked with them. They have their hearts and souls (as well as their self esteem) in their work, and treat their patients as they'd want to be treated.

It's a very simple thing to always pat your pockets before getting your purses or other things like car keys, to take home.

I'd sure hate to see the day again, when administrative Nurses, as they did half a century ago, checked each Nurse's pockets, uniforms, and hands before they came on or left duty. That was for appearance, now it seems, it would be for disappearance. It makes me so sad to think that any Nurse would think it "common practise" to walk away with meds or anything that doesn't belong to her/him. Have we sunk to Sari Gamp's level? Check her history out, it reveals how the slippery slide can occur

cmo421 · Oct 23, 2007

I'm beginning to see why there are as many medication errors (including those taken away from the facility) as there seem to be. If you weren't taught at your Nursing School, to be responsible about that, and you're exposed to Nurses who see fatigue as an excuse for less than good practise, you will always have a reason for misdeeds.
There are "model" Nurses out there. I've worked with them. They have their hearts and souls (as well as their self esteem) in their work, and treat their patients as they'd want to be treated.
It's a very simple thing to always pat your pockets before getting your purses or other things like car keys, to take home.
I'd sure hate to see the day again, when administrative Nurses, as they did half a century ago, checked each Nurse's pockets, uniforms, and hands before they came on or left duty. That was for appearance, now it seems, it would be for disappearance. It makes me so sad to think that any Nurse would think it "common practise" to walk away with meds or anything that doesn't belong to her/him. Have we sunk to Sari Gamp's level? Check her history out, it reveals how the slippery slide can occur

Excuse my sun glasses, but ur halo burns so brightly. I forgot a level of nurses, the perfect one. Sorry,next time I will remember.

I have been a registered nurse,and a damn great one for 28 yrs. I 've worked hard,been ethical ,honest,and stoic in my responsibilities as a nurse.I have never had a complaint, a BON issue or lost a job.My skills are wanted,I am a valued employee. People are not perfect,they forget,they get busy,they have a crisis.

You have never been so tired at work that walking is difficult,normal duties seem unending? Well congradulations to u. A perfect nurse with a perfect life!

I am sorry,but condecending feedback gets my irish up..When u put urself in a humans hands,u may get mistakes. There is no perfect human.

I am not saying misuse of drugs is appropriate, I am saying mistakes happen.

MustangSallie1997 · Oct 24, 2007

LAMAZETEACHER,

Oh if we could all be so perfect.......NEVER is a strong word, and to say you have never done something, well anyway. And as far as me doubling a dose THAT NEVER HAPPENED !! We are talking about giving a dose from 14-19 min. before the dose was "due", and just another bit of info....we did use hand held computerized machines to scan patients ID bands and the meds before we gave them......THEY ALLOWED YOU TO GIVE THE PRN MED UP TO 30 MIN. BEFORE THE NEXT DOSE WAS DUE !!! Did I make a careless mistake ?? YES, and I take responsibility for it, I have paid with the loss of 9 months salary for it, I have paid with my husband working 2 jobs and not being home for our daughters 1st birthday, I in no way feel sorry for myself, and if you felt as horrible as I did when I left that hospital that day, maybe you might be human enough to understand how it could have happened.

And to even emply that I dont have my heart and soul into my job or that I dont treat my patients the way they desirve to be treated is WAY OUT OF LINE !! And I dont believe that I ever stated that I made it common practice to walk away with meds or anything else that didnt belong to me !!!!!

If you mean no harm by your posting, I would hate to read what you would post for someone that you really didnt agree with. I am HUMAN, and guess what, you are too !! I have paid the price for the mistake I made, the mistake I do own up to. I have held it together all of these months, and now I finally have a chance to move on to another job, one of which I am so excited about !! I know that I will be a better nurse for what I have been through, and I sure hope you never make a human mistake !!!

lamazeteacher · Oct 24, 2007

Excuse my sun glasses, but ur halo burns so brightly. I forgot a level of nurses, the perfect one. Sorry,next time I will remember.
I have been a registered nurse,and a damn great one for 28 yrs. I 've worked hard,been ethical ,honest,and stoic in my responsibilities as a nurse.I have never had a complaint, a BON issue or lost a job.My skills are wanted,I am a valued employee. People are not perfect,they forget,they get busy,they have a crisis.
You have never been so tired at work that walking is difficult,normal duties seem unending? Well congradulations to u. A perfect nurse with a perfect life!
I am sorry,but condecending feedback gets my irish up..When u put urself in a humans hands,u may get mistakes. There is no perfect human.
I am not saying misuse of drugs is appropriate, I am saying mistakes happen.

During my 47 year career, I have worked many double and once, a triple shift on OB, when it was raining babies. My feet occasionally felt glued to the floor, but I would never leave without checking my pockets.... Usually after a Lamaze class I taught 4 evenings a week, I was asked to stay the night shift when the unit was busy, and if the morning looked that way too, with many discharges I'd stay until the evening shift came on.

The difference between us is, I think, generational. My "training" was at a hospital where old fashioned discipline occurred for errors, and I felt I was privileged to "serve". Graduate nurses watched over me, when instructors didn't, and we were discouraged from putting anything in the one pocket we had, under our aprons. Granted, there were fewer medications, but you haven't lived, untill you squeeze a "mustard plaster" between 2 sticks, with a colleague.

When I came to the U.S.A. in 1963 from Canada, I realized that I'd had a very special education, and my skills were appreciated. I've been an Inservice Coordinartor, Infection Control Nurse, (implementing "Universal" precautions when they were first implemented), an Employee Health Nurse (seeing that role as the employees' advocate), and Director of Nursing early in my career.

Maintaining good communication with the Nurses with whom I work has been very satisfying. I've met their needs as much as possible, treating them like family and shared my attitude about Nursing, as well as other topics. My door was always open, and I've had the pleasure of knowing excellent Nurses, who worked selflessly at times, and rarely showed disregard for the principles they'd been taught. If that's perfect, then I'm guilty as charged, despite some small unintended "errors". My cap actually was shaped as a round mortar board-type thing, which I was happy to put aside, when it became outdated. However, high standards of care are never outdated.

cmo421 · Oct 24, 2007

During my 47 year career, I have worked many double and once, a triple shift on OB, when it was raining babies. My feet occasionally felt glued to the floor, but I would never leave without checking my pockets.... Usually after a Lamaze class I taught 4 evenings a week, I was asked to stay the night shift when the unit was busy, and if the morning looked that way too, with many discharges I'd stay until the evening shift came on.
The difference between us is, I think, generational. My "training" was at a hospital where old fashioned discipline occurred for errors, and I felt I was privileged to "serve". Graduate nurses watched over me, when instructors didn't, and we were discouraged from putting anything in the one pocket we had, under our aprons. Granted, there were fewer medications, but you haven't lived, untill you squeeze a "mustard plaster" between 2 sticks, with a colleague.
When I came to the U.S.A. in 1963 from Canada, I realized that I'd had a very special education, and my skills were appreciated. I've been an Inservice Coordinartor, Infection Control Nurse, (implementing "Universal" precautions when they were first implemented), an Employee Health Nurse (seeing that role as the employees' advocate), and Director of Nursing early in my career.
Maintaining good communication with the Nurses with whom I work has been very satisfying. I've met their needs as much as possible, treating them like family and shared my attitude about Nursing, as well as other topics. My door was always open, and I've had the pleasure of knowing excellent Nurses, who worked selflessly at times, and rarely showed disregard for the principles they'd been taught. If that's perfect, then I'm guilty as charged, despite some small unintended "errors". My cap actually was shaped as a round mortar board-type thing, which I was happy to put aside, when it became outdated. However, high standards of care are never outdated.

I do not think this is a tit for tat issue. I am sure that u have worked hard and done well. But saying that others have not practiced well or have the same work ethics that u feel u have is wrong. Most nurses, I want to believe, have a high standard of care. People are people. Things happen, I am glad that they have not happened to u or to me. But if we continue to berate each other, our profession will continue to spiral downwood. Educators today,I am sure press the same standards that u and I were privy too.I also know that there are exceptions to every rule.

The "I would never","It would never be me" ,or "look at them,they should have know better" , ideal has ta go. One never knows what is down the line for them. We need to practice defensivly in many areas unfortunately, we need to protect our licence, we need to support our peers. Many will fall or stumble,we have to at least attempt to believe that they made an honest mistake and help them back on their feet.

I could ramble on and on, maybe I am nieve in ways,but I believe!

Have a great day!

FireStarterRN, BSN, RN · Oct 24, 2007

The current thinking is to take a non-punitive attitude towards errors in order to create an atmosphere in healthcare where we can objectively analyse the root causes contributing to mistakes. Most of the time there are several contributing factors.

MustangSallie1997 · Oct 24, 2007

You are so right jlsrn, there were many factors that worked against me that day. The main one I feel is that I got lax, I lost respect for the percocet because we give it out like candy. It was easy to forget exactly what the medication was and the respect that the medication needed. I know that it would not have happend if I had not been ill, I had always done an excellent job, I went above and beyond the call on a regular basis and the copy of my employee file that I have shows for it. To imply that I don't have high standards as a healthcare professional is unfair just because I made a mistake. If I had an abuse problem, most people would look at this differently, most not all, it would be looked at like I had a "problem" not that I made a careless nursing error. I am thankful everyday that this has been the most serious thing I have ever done, it has been a good wake up call for me, but it IS NOT the sum total of who I am as a nurse, and what I stand for.

Lamazeteacher, it is great that you have been so fortunate in your carreer to "NEVER" do something, I dont think the majority of nurses can say that, but that does not make them bad, careless, or of low standards. I feel that it is because of your "I am a superior nurse to you" attidude that causes people to start threads about nurses eating their young, and question if they want to continue in school or in their career. I do not feel there is anyproblem with holding yourself, and others, to a high standard, we should but we are human. Unfortunately we are in a career that does not have tolerance for human error so we must ALWAYS watch our back, and I failed MYSELF, NO ONE ELSE. I did not harm any patients, despite what you may think, I did not divert narcotics from my employer for my use or anyone elses.

To be honest, I am getting tired of defending myself here. I made a mistake, I am paying for it, I HAVE LEARNED FROM IT, and I will grow and be better for it. I came to Allnurses.com because it was such a supportive place, I felt comfortable talking about my experience and getting feedback, it was not until now that I ever felt personally attacked. Lamazeteacher, I have read some of your other posts, I respect your experience but you are not perfect, none of us are ! You seem to be very good at telling others your opinion of what they should do, maybe you should go to work at your states BON so you can make sure that low standard, and careless nurses like myself never get to practice again, or better yet, forget about the legal nurse consultant thing and just become judge and jury. You would think that in your nearly 50 year career, and hats off that is impressive, you would have learned how TO WALK A MILE !!!

lamazeteacher · Oct 24, 2007

I haven't been objective about errors occurring, and believe it is important to reinforce learning with an appropriate consequence.

9 months' suspension seems excessive, in the above situation for a Nurse who seems to have appreciated the value of completing her work, i.e. signing the MAP. I'm so glad that Sallie has another job. The one she had was not serving her well.

It would be great if committees like " Standards and Ethics" could be revived, as assigning QA/QI to a separate department isn't working as well as was intended. I've found the latter very politically motivated and full of "paper pushing". There isn't something examining the response after issues are resolved, for all involved and then change whatever wasn't effective. We do learn from mistakes, and it's a pity that the Nurse who made the error often leaves that employer, due to the need to leave it behind. Maybe someone going for a thesis for her/his advanced practise degree could take that one on.

Many years ago, "Standards and Ethics" committees composed of Staff Nurses, as well as supervisors, examined common Nursing issues, and decided what action should be taken (to prevent harm happening), for specific events, while not in the heat of the reaction to deviation(s) to standards. A lot of mutual understanding resulted from those committees, and overreaction when mistakes occurred, was averted. It did take more time than was available, and fell into the pile of good ideas that no longer exist.

However, it didn't prevent an ICU Nurse who had the habit of using her hands when talking, from stabbing a pregnant Nurse walking by - in the abdomen. She had an unsheathed IV needle (pre "needleless" equipment)in her hand from a patient whose IV was DC'd. No one thought his test would be HIV Ab +, but it was. That was a "needlestick follow-up" I'll never forget, nor will those who were there. The Nurse affected tested negative throughout the 6 month time she was monitored, and her husband took the "safer sex" talk I gave them, with some chagrin and just one threat to sue which wasn't done. The expressive Nurse stayed on, and became Assistant Director at that hospital. Advances in safe practise occur due to incidents such as that!

Everyone learns, and behavior changes occur, when adverse events happen. In the issue we're currently writing about, happily no patient suffered because of it. The Nurse has suffered, and I appreciate her pain and sacrifice. One day, Sallie, when you're relating it to someone, you'll not feel the "sting", recognizing the positive change you've made.

lamazeteacher · Oct 24, 2007

Sallie, you sound like you have the "grit" and conscience to contunue being a superb Nurse. This experience has enhanced your career, and perhaps was the push you needed to leave a situation that tolerated "lax" performance - until it came under the virtual microscope. I think 9 months suspension was excessive, though. You may have been scapegoated for all the other medication errors that went on in that place.

It would be great if there was some reference book that reflected objectively reached protocols for abberance, with fitting consequences.

Most administrative Nurses go "by the seat of their pants". I didn't realize how "superior" and snotty my message was. Thank you for pointing that out. I have made mistakes, too. I am not perfect, and I've learned from my mistakes - most of which have to do with "shooting my mouth off". I lost one job as an Employee Health Nurse because I refused to sign off a PA who found it "inconvenient" to have a drug test, as the policy was that all employees have them when they began their work. Administration didn't agree with me. The PA stayed, I left. I don't think I would change the decision I made, knowing the consequences. However, it still rankles, many years later.

This website is supportive mostly, but may be less useful if it indulges "pity parties". The thread was about "impaired" Nurses, and your illness impaired your decision making skills. You've recovered, found a better job, and need to move on in a positive way.

If my response helped you ventilate your concerns, in an effort to resolve them it was good. Since I've had to make my opinions known most of the time during my career, it was a knee-jerk reaction for me to share one here. The feedback you and others gave was good for me.

MustangSallie1997 · Oct 25, 2007

Lamazeteacher i thank you for your knowledge and input. I do want to make on thing clear though, I was not suspended by the BON. This happened back in April, I lost my job, and I have just now been able to find employment. Understandably, no one wants to hire a RN who is under investigation. All of this will be over tomorrow some time after the BON's monthly meeting. I too am very excited that I have a new job, and you are right to a degree, after 10 years with the same employer I was in the same spot I was when I walked through those doors as a wide eyed new grad, only difference was the years of experience and graduate school under my belt.

Well I am going to go for now, today is my wedding ann. and I am going to put the kids to bed and enjoy what is left of it. I know I will not sleep well tonight knowing what will be going on tomorrow, but I will be glad for it to be over.......goodnight, and god bless.