Upcoming peer review

linearthinker, DNP, RN · Oct 1, 2011

OK, this is really weird, b/c I answered this post already and my response is gone. My response was, with all due respect, I'd fire you. There is no excuse for those egregious errors IMO.

However, my advice in this situation is to go into the meeting requesting to be sent to some kind of medication administration class and volunteer for drug screening.

Good luck.

APN Under Construction · Oct 2, 2011

1. already volunteered for drug screen, boss said not necessary. diversion not a concern (she's right about this). 2. I have alrady been in touch with our educator and got the necessary education on handling narcotics... since that edu, not problems (and never will be...)

linearthinker, DNP, RN · Oct 2, 2011

Well it sounds as though yo have it in hand then. Your OP, which you deleted after getting a response you apparently did not like, was begging, HELP! OMG HELP ME, WHAT DO I DO?!?!?!?!

So, seeing as how the situation is so well under control, I am confused why you posted then.

And speaking only for myself, I rather resent it when I take the time to respond and petulant posters delete material because they don't like what they are hearing. I was telling you the truth. With the record you posted of multiple major med errors, documentation errors and narcotic, um, issues, I would have to fire you. I was giving you the only advice I could think of that might save your job under the circumstances. I'm sorry it was not pleasing to you.

Good luck.

APN Under Construction · Oct 2, 2011

Linearthinker, I really appreciate your responses, which have been helpful. Your opinion helped me appreciate my boss more. It also helped me realize that I things could have been worse, like I could have had you for a boss and I could have got fired! At this time, I received written warning. Job is intact. I was just freaking about how to handle upcoming peer review committee; what's the most important thing to say or never say... etc

some of my posts were deleted by administrators. Turned out I had given out too much info on the situation. I wanted for readers to understand exactly what the situation was. All the same I agree with the administrators.

Enough for the bashing.... lets talk peer review, which infact was the reason for posting, not what anyone would have done if they were the boss :-)

linearthinker, DNP, RN · Oct 2, 2011

I see. I recall that there was another thread that seems to have disappeared. However, it appears that you are the one who edited the OP in this thread and I remain perplexed as to why you would delete the entire post if the concern was strictly privacy. I don't recall content that included identifying information but I suppose it is irrelevant now. Enough on the matter.

So, do you still need advice on the peer review committee meeting?

APN Under Construction · Oct 2, 2011

I edited my post after hearing moderator's opinion on posting too much info on the case, blow by blow info on this, even though no pt id info was on it. However, I just don't want to extend this problem into confidentiality matter, incase anyone familiar with the issue comes accross. There are 2 issues here (1. i did not know that Klonopin and Lyrica were controlled since I rarely have given them 2. Not aware that I was being timed on narcotics. I thought as long as I don't go home with them they shouldn't be any problems). I know this sounds stupid, but that's what happened. I haven't ever had any other disciplinary action before,...

Yes, I'll take any advice on dos and donts when in peer review. I had contacted attorney in case I need one, who's wanting $5000 to go to peer review meeting with me, (even though they will not be allowed into the meeting, but I can request a recess to consult with him/her). Errors were reported to peer review as minor errors....

linearthinker, DNP, RN · Oct 3, 2011

OK, fair enough.

If you have already been over the details with your supervisor and an acceptable plan of correction has been agreed upon, I don't see any reason to retain legal representation for a peer review.

I am suddenly afraid with all the edits I under a big misunderstanding: Is this a BON peer review? If so, my god yes, you had better have an attorney in the next room.

APN Under Construction · Oct 3, 2011

So far, the matter has not been reported the BON. This is a Nursing peer review committee (NPRC) established by our facility (each facility is required to have one in place to review minor incidents, rather than report to BON.) In the letter, I am informed that the committee's purpose is to recommend whether or not a patient was exposed, or is likely to be exposed, unnecessarily to the risk of harm. The committee can report the issue to BON if they think it's necessary. In the letter, I received a copy of report which states the incident is treated as minor, no concern for chemical influence, and has not been reported to BON ...

Errors mostly involve handling controlled. 2 are unaccounted for, but none others are missing. Patient safely issue is that I did not use scanner for pt id majority of the time. I previosly worked in a hospital that had no scanning so I didn't think it'd be a nightmare not to scan. Computer feature states "scan armband. Alternatively, click next to verify manually." I have ALWAYS, even when I'm using scanner, used at least pt name and date of birth before giving meds or anything...as required by JCAHO...

linearthinker, DNP, RN · Oct 3, 2011

OK, then no, I would not retain legal counsel for this meeting. Your supervisor has already ruled on the issue. Be forthright. Do not make excuses or shift blame. Just share what you have learned and your plan of correction.

If it gets referred to the BON, I'd get legal advice.

APN Under Construction · Oct 3, 2011

I really appreciate your opinion Linearthinker... I pray this fire gets put out at this meeting and doesn't go to BON. I'll keep your recommendations in mind. One thing I know is that this ain't happening again

rn/writer, RN · Oct 3, 2011

This may be nothing more than a formality. Your manager has spoken with you. The educator showed you the error of your ways. You've been receptive to correction and have followed the new game plan. The facility peer review requirement might be something they have put in place to keep managers from sweeping things under the carpet and to make sure that correct action is taken when it's warranted.

I don't know what more they can ask you to do.

I would advise you get yourself a professional liability policy as soon as this is over. They won't cover you for this (and they will ask you if you have anything pending, so wait till this is resolved), but you'll have protection from here on out. For about $110 a year (less than ten bucks a month!) you'll have access to an attorney who is familiar with nursing matters. The yearly premium costs less than one hour of attorney services if you have to pay on your own.

Present a positive outlook. Tell the peer review committee that you are thankful that you were straightened out about what you were doing wrong and given a second chance. Be ready to tell them what you are doing now to keep from repeating your mistakes (returning turned down meds immediately, scanning armbands, wasting in a timely manner, etc.).

Keep your head in the game. Don't become so focused on this that you get distracted.

I'm rooting for you.