Who is responsible in this situation?

[Amanda026]

I work at a longterm care home and have been working with cytotoxic medications and crushing them while possibly inhaling them while pregnant. I had a miscarriage in October. The medication on the strip pack was not labeled as cytotoxic and did not state cytotoxic on the package. Our home did not train staff until after I had my miscarriage. The pharmacy just recently started labeling the packaging now and stating not to crush. Is this my fault for not knowing as a nurse not to crush these medications even though our MAR stated to do so, or is this the home and pharmacies mistake. What should I do? Cytotoxins are very very dangerous for pregnant women, and anyone for that matter.

[Jolie, BSN]

I am sorry for your loss. Have you been able to determine that exposure to this medication caused the termination of your pregnancy? Have other possible causes of miscarriage been ruled out?

[Sam J.]

*Not for the faint of heart: An un-PC reply follows.

1/3 or more of human pregnancies self-abort. A majority of those are from women that didn't even know they were pregnant. This is Natural Selection.

For an educated nurse to imply that her lack of knowledge about the risks of a medication may have caused her own 'miscarriage', brings up another, more real issue- would that nurse have given the same med to a known or suspected, pregnant patient? If yes, we have a pressing educational situation to resolve.

And can I imagine the loss of a child, at any stage, or for any reason? No. I can't. Hell, no.

[Been there,done that, ASN, RN]

My heart hurts for you and the loss of your baby.

I can see where you need answers. Especially now that your facility has changed policy after your loss.

In your position , you give many, many meds.

In my hospital position, I pushed a lot of pills.. no where near the amount you were responsible for.

I not only appreciated, but counted on the MARS warnings.

No legal advice can be given here, of course. But .. please seek legal counsel.

[ktwlpn, LPN]

[quote=Sam J.;7737849

For an educated nurse to imply that her lack of knowledge about the risks of a medication may have caused her own 'miscarriage', brings up another, more real issue- would that nurse have given the same med to a known or suspected, pregnant patient? If yes, we have a pressing educational situation to resolve.

I doubt it-she said it was Avodart-that's for treating BPH. The presence of a prostate rules out a pregnancy.No pressing educational situation to resolve except for basic med administration which is so important,especially in LTC where you have outrageously long med passes.

ALWAYS take the time to know what meds you are passing-for the resident's safety and yours. Take that extra minute and look them up when you can. Our electronic medical record makes this very easy is, prior to obtaining that system we had a reference book on every med cart.

Having been through this type of loss I realize the poster is going through the stages of grief and will blame herself for sometime.

OP-in many cases it is impossible to ever know what caused your miscarriage, it's so very hard to accept but you must forgive yourself and the system that may have led to this. Mourning the loss of your baby will lead you to healing and peace, please don't get stuck in a complicated grieving pattern by focusing on blame or cause.I'm sorry

[sallyrnrrt, ADN, RN]

i am sorry for your loss, AND KTWLPN, rocks, very good advice !

[kakamegamama]

OP--So sorry for your loss.....and, miscarriages are often because there is already something wrong with the baby that would make extra-uterine life/continuance of pregnancy not possible. I get the sense that you are feeling the need to blame yourself or someone for your loss....no need. Peace to you and comfort....

[ktwlpn, LPN]

and I'll add that when a friend, family member or co-worker suffers a loss like this they truly shouldn't hear any of the following

" it's for the best", "you'll have another" or " something was probably wrong with it". It is hard to know what to say-for help you can go to a miscarriage support web site and read up on it, especially if this happens to someone very close to you. An offhand remark can hurt a friend so very deeply for a long time. Recognize this is the death of a child and respond accordingly.That's the best thing you can do.You don't say anything to her that you wouldn't say to a friend who lost a child to cancer or trauma.

[heron, ASN, RN]

While this doesn't apply to the OP, be aware that attorneys have been known to troll the board looking for ammunition.

OP, I can't imagine what it's like to lose a child - I'm so sorry.

[Here.I.Stand, BSN, RN]

Hugs, OP. I'm very sorry for your loss. There's probably nothing you could have done...these things happen. I know your heart must be broken, but it's not your fault any more than the next woman is at fault for a miscarriage.

Maybe it would be a good idea though, for your peace of mind and actual safety, to get a list of NIOSH drugs (you can Google it) and keep for reference. My hospital has a policy that nurses NOT crush them--either they send elixirs, or if that's not available then the pharmacy crushes them under the hood before sending them. If this is not something your facility is willing to implement, then at least you know what drugs are considered hazardous, someone else can handle them if able, or if nothing else you can double-glove and mask while handling them.

[BlueLightRN]

If you are not familiar with a med and whether or not it can be crushed you should research it. That being said, I'm sorry for your loss. I don't think anyone is "responsible" but at the end of the day, the only person who really cares about protecting you is yourself and you have to do so, no one else is going to worry about you when you're doing a med pass.