I worked last Friday and we had a new admit to our skilled unit. Our facility pharmacy was closed so we had to get a few meds from a local pharmacy. One of them was Pepcid 10 mg to be given daily at 2000.
It was a brand new box which I opened to give the first dose on Friday night. I was off the weekend. On Monday night I went to give her 2000 meds including the Pepcid. When I got into the box, only one pill had been popped which would have been the one I gave on Friday night. I checked the MAR--the nurse from the weekend had signed off that she gave it. I checked the nurses notes from the weekend to see if it had been held for any reason and couldn't find anything leaving me to believe that an error was made.
I went ahead and reported it but now I'm feeling guilty. Part of me keeps saying, "Oh, it was just Pepcid, what's the big deal??" This is the first time I've had to report a co-worker for a med error. Would you have done the same? Or--be honest!--have there ever been small errors like that that you have "overlooked"?
Could I please remind all posters that flaming and personal attacks will not be tolerated here. I have removed quite a few posts to ensure that you are complying with the terms of service. There have been quite a few so if you can't find your post I've deleted it, if you wish to discuss it feel free to PM me
You can disagree without being rude or attacking so please can I respectfully request that if you feel the need to comment in a way that would constitute an attack on another member take a deep breath and walk away (figuratively speaking)
I am not a mean nurse, nore do I have temper issues. I am just applauded that someone would report something they HAD NO KNOWLEDGE of. YOU can suspect somone untill cows come home, but you cannot report someone unless you know for that they are committing fraud. You suspicions may be unfounded, but yet innocent person may get into trouble. What is someone( DON) asks her about it, and she panics and gives a wrong answer?? ALL your fault.
I still say what you did was wrong and had no merit
Sarah
She DID have knowledge of a discrepency, it was her RESPONSIBILITY to report that discrepency, and it DID have merit. At the very least, the other nurse involved did not chart the med accurately, so she is not entirely "innocent" even if she somehow obtained the med from another source and gave it.
I get that you may not agree with reporting it, but to escalate it to the level that you did in your previous post, and then say that it would be all the fault of the OP if the other nurse "panics and gives a wrong answer," well, that's what is appalling to me!
An omission is an omission and I will be reporting as such from here on out.
As I do on occasion tend to be somewhat cryptic in my written forum responses, allow me clarify.
My response is not only for your benefit, but to urge caution in this regard to the membership in general. We are professionals, and as such are subject to both slanderous as well as libelous damages incurred as a result of unsubstantiated accusations that may be acted upon by a poorly informed or otherwise motivated administration.
The legal presumption is that medical documentation is factual, to say otherwise is to accuse one of falsification, a serious criminal offense.
Let's say for the sake of argument the nurse (me), as you suspected, had not given the pepcid, but vehemently denies the omission and falsification stating instead that one had been "lying around" and that had been the one given. The administration, not having liked my "shifty eyes" and "snooty attitude" for years, chooses not to believe me, takes action and terminates my employment denying my retirement benefits and reporting me to the B.O.N in the process.
Well now, if you wrote it down it's libel, if it was a verbal accusation then slander, and my wrongful termination suit with the employer is all but assured.
My experience with this kind of thing is not so much righteousness on the part of the accuser as it is more of a bid for brownie points at someone else's expense. So my caution is this, take care and think twice about throwing someone to the wolves willy nilly since sometimes on occasion, that just may be the meanest wolf in the pack.
Let's say for the sake of argument the nurse (me), as you suspected, had not given the pepcid, but vehemently denies the omission and falsification stating instead that one had been "lying around" and that had been the one given. The administration, not having liked my "shifty eyes" and "snooty attitude" for years, chooses not to believe me, takes action and terminates my employment denying my retirement benefits and reporting me to the B.O.N in the process.
Well now, if you wrote it down it's libel, if it was a verbal accusation then slander, and my wrongful termination suit with the employer is all but assured.
Hold it...in this example, the nurse didn't give it, then tried to cover up her mistake by lying about it. Then, he/she sues because it becomes a he said/she said due to the fact that the med was falsely documented as given.
What are you trying to say here? The only conclusion I can draw from this example is that you're trying to say that liars are really good about covering their tracks and getting the people who reported them in deep ****, so don't do it?
Hold it...in this example, the nurse didn't give it, then tried to cover up her mistake by lying about it. Then, he/she sues because it becomes a he said/she said due to the fact that the med was falsely documented as given.
What are you trying to say here? The only conclusion I can draw from this example is that you're trying to say that liars are really good about covering their tracks and getting the people who reported them in deep ****, so don't do it?
Not at all, what I am saying is that barring an admission of guilt, the Burden of Proof is squarely on the accuser(s).
The Nurse does in fact lie about it, but it is not provable. The irony of the scenario is that the guilty party becomes the aggressor with the legal presumption of innocence intact.
Conversely, the scenario could also as easily be an innocent, who still becomes the aggressor with the same presumption of innocence and burden of proof as they were for a guilty party.
As I do on occasion tend to be somewhat cryptic in my written forum responses, allow me clarify.
My response is not only for your benefit, but to urge caution in this regard to the membership in general. We are professionals, and as such are subject to both slanderous as well as libelous damages incurred as a result of unsubstantiated accusations that may be acted upon by a poorly informed or otherwise motivated administration.
The legal presumption is that medical documentation is factual, to say otherwise is to accuse one of falsification, a serious criminal offense.
Let's say for the sake of argument the nurse (me), as you suspected, had not given the pepcid, but vehemently denies the omission and falsification stating instead that one had been "lying around" and that had been the one given. The administration, not having liked my "shifty eyes" and "snooty attitude" for years, chooses not to believe me, takes action and terminates my employment denying my retirement benefits and reporting me to the B.O.N in the process.
Well now, if you wrote it down it's libel, if it was a verbal accusation then slander, and my wrongful termination suit with the employer is all but assured.
My experience with this kind of thing is not so much righteousness on the part of the accuser as it is more of a bid for brownie points at someone else's expense. So my caution is this, take care and think twice about throwing someone to the wolves willy nilly since sometimes on occasion, that just may be the meanest wolf in the pack.
This is why I recommended in a previous post, as a couple of others did, that only the facts of the discrepency be reported, without the inclusion of any suspicions or accusations. Plus, I maintain that if the OP does not do this, she leaves herself open to the possibility of an accusation of wrongdoing by the other nurse involved. I agree that it should be done carefully, but it must be done nevertheless.
Edit: I deal with medication discrepencies often in the ED when I have to check the omni. If I ever find something that I can't explain, the facts of the discrepency go to my manager, no suspicions or accusations, but the facts that are presented on the printout from the omni, and then it's up to her what to do about it. There's no way for me to get around this. I don't see this situation as any different, except that it would have been possible for the OP to try and sweep this under the rug due to not having a printout from an omni cell that shows discrepencies that need to be justified.
If I ever find something that I can't explain, the facts of the discrepency go to my manager, no suspicions or accusations, but the facts that are presented on the printout from the omni,
Which as you note is a required responsibility.
However, as you also noted, there is a supposition and presumption of error on the part of the OP towards a co-worker who has legally documented otherwise.
In my opinion, you should not ask for a forum opinion on a matter, and then backpedal when the response is not palatable.
My experience with this kind of thing is not so much righteousness on the part of the accuser as it is more of a bid for brownie points at someone else's expense. So my caution is this, take care and think twice about throwing someone to the wolves willy nilly since sometimes on occasion, that just may be the meanest wolf in the pack.
TOTALLY agree with this. You are making enemies for yourself if you start throwing around accusations that are unfounded. Maybe the meds were missed, maybe they weren't. Maybe she would fess up to missing them if you confronted her, maybe she wouldn't. Regardless of whether she did or did not miss the meds, she's not going to like it if you report her to management. I prefer to give my coworkers the benefit of the doubt in these types of scenarios -- she charted she gave it, that means that she is saying that she gave it -- why don't we take people at their word? Perhaps an error was made, but no one is perfect, and it is to no one's benefit to create an workplace environment where nurses feel like they need to watch their backs for fear of a report or write-up.
I am shocked to see how many people on here equate missing a few doses of Pepcid to the diversion of narcotics. That hurts and angers me, as much as a message board can do that. Are you people all really that judgmental?
This is why I recommended in a previous post, as a couple of others did, that only the facts of the discrepency be reported, without the inclusion of any suspicions or accusations. Plus, I maintain that if the OP does not do this, she leaves herself open to the possibility of an accusation of wrongdoing by the other nurse involved. I agree that it should be done carefully, but it must be done nevertheless.
Edit: I deal with medication discrepencies often in the ED when I have to check the omni. If I ever find something that I can't explain, the facts of the discrepency go to my manager, no suspicions or accusations, but the facts that are presented on the printout from the omni, and then it's up to her what to do about it. There's no way for me to get around this. I don't see this situation as any different, except that it would have been possible for the OP to try and sweep this under the rug due to not having a printout from an omni cell that shows discrepencies that need to be justified.
How does the OP "leave herself open to the possibility of an accusation of wrongdoing by the other nurse involved"? I am not following that argument. The OP wasn't even in the building at the time. What, exactly, are you proposing that she can be accused of?
The omnicell example presented here doesn't hold water. With omnicell discrepancies, I am assuming that you are saying that there are medications MISSING from the omnicell that you need to report. In the OP's instance, there were too many meds left in the box. It's not the same thing. I also strongly suspect that you are talking about missing narcotics (I haven't ever worked in a facility that keeps track of discrepancies on the count of non-narcotic medications - there are just too many), which also is a completely different scenario.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
grandmawrinkle - there are people here who - if this were a discussion of traffic offenses, view going 56 mph in a 55 zone as equivalent to a hit and run accident.
I've gone round and round with some. . . but now I back out of interacting with them.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
I am not a mean nurse, nore do I have temper issues. I am just applauded that someone would report something they HAD NO KNOWLEDGE of. YOU can suspect somone untill cows come home, but you cannot report someone unless you know for that they are committing fraud. You suspicions may be unfounded, but yet innocent person may get into trouble. What is someone( DON) asks her about it, and she panics and gives a wrong answer?? ALL your fault.
I still say what you did was wrong and had no merit
XB9S, BSN, MSN, EdD, RN, APN
1 Article; 3,020 Posts
Could I please remind all posters that flaming and personal attacks will not be tolerated here. I have removed quite a few posts to ensure that you are complying with the terms of service. There have been quite a few so if you can't find your post I've deleted it, if you wish to discuss it feel free to PM me
You can disagree without being rude or attacking so please can I respectfully request that if you feel the need to comment in a way that would constitute an attack on another member take a deep breath and walk away (figuratively speaking)
Thank you