Weird meeting with manager

[amzyRN]

I work in a busy ER and am constantly giving pain medications. We have an error-prone system where it's easy to pull a narcotic on the wrong patient and administer it to a different patient. This has happened numerous times to people on my unit. They are also very particular about timing of narcotic medications, if you are over 15 minutes late in giving the med, they write you up. My last ER job, narcotics couldn't be pulled without a physician order being verified and you couldn't override narcotic meds. This made it easy to avoid these stupid errors. There was one incident where I forgot to chart a narcotic. The patient was writhing in pain and I gave the med and probably forgot to scan it. I feel bad about these things and feel like an idiot. Not only that I was interrogated by my manager who in the course of the meeting the way she spoke to me made me feel like she thought I was stealing medications, which no one has ever accused me of. I have never every stolen anything in my life.

Not only do I feel like an idiot but now feel so weird, like they think I'm a narc diverter at work and don't trust me. I also worry if I make another mistake I will be fired. I have never ever given narcs so much at this hospital and the system they have makes it easier to pull the meds on the wrong patient. I might make a mistake again because of the frequency of giving the meds. I will try very hard to be careful, but now I feel so bad about my job, nursing in general, like the hard work I do is unrecognized and the mistakes are all that stands out.

[Ellie G]

Obviously you should chart all of your medications but particularly narcotics. I don't know what your system is but the nurse coming after you could give a dose not realizing that you had already done it. You should never rush when giving a narcotic. Take your time and make sure you get it right. Don't you chart pain scale before and after?

[3ringnursing, BSN]

I don't have to tell you to be extra vigilant and watch your step. There is no room for additional errors - another misstep will not be tolerated. That's just the way it is with narcotics - very black and white.

My advice is to leave that hospital tout sweet - it's likely a facility wide issue and you cannot afford even one more transgression associated with your name.

Forget losing your job - your nursing license, and very livelihood could be at stake. Nothing would suck more than facing disciplinary action against your nursing licence.

I spent 3 years in a diversion option program (I belonged there) at the very beginning of my nursing career, which involved an intense amount of hoop jumping. I thought nursing school was all consuming - it had nothing on the diversion option program (but let me take a moment to say when I finally calmed down that I was 9 kinds of grateful to be offered this option). Due to my past experience I can tell you that to erroneously spend time in a diversion option program in order to be able to continue to practice nursing would stink.

Protect yourself now. Please.

[HikingNinja, BSN, MSN, DNP, RN, APRN, NP]

Fellow ER nurse here.

Do you have a union? If so, you can bring up these issues with a union rep?

Even using procedural pyxis, i've always either written the pts name & MRN # down, rolled the computer over, or sometimes simply gone back to the computer to look at the name again if I've forgotten. I'm sorry, similar names should not be an issue. It's hard to imagine this in a busy ER, but slow down. If you cannot give pain medication in

All in all though, your best bet is to seek employment elsewhere. Places like this are notorious for throwing any nurse they can under the bus if a sentinel event occurs. They will whip out a policy you've never seen, and they've never even followed, to lay blame on you. Firing you at best, reporting you to the BON at worst. Get out while you still have a license.