Hello fellow nurses. I have something to get off my chest, and I cannot discuss this with coworkers so I sought out all of your opinions. FYI: I am a new grad RN, currently working in LTC for about 7 months.
A few months ago, during a med pass at 5 pm (supper), I left a pill in the pill cup next to a resident who normally will take the pill, if not, the aide will help her take it (it was senokot). When I left it there, I acknowledged to the resident that I am leaving a pill beside her and would like her to take it. A family member of another resident sitting at the same table, saw this and commented "She won't remember to take that," in a very rude manner. In response to her hostile personality, I was firm and told her "She usually does take the pill, if she does not, I will follow up and be back to make sure she does". I left saying this and administered pills to the other residents at this time. I came back to the same table while giving a pill to another resident sitting on the same table as this family member and the original person I left the pill beside, I asked the aide "did A.I. take the pill?". The aide responded and said yes. I then proceeded to administer the crushed pills to another resident while waiting for her to finish IN FRONT OF this family member.
This family member then went to my director and reported me for inappropriate medication administration. I was written up for something that did not even result in harm or distress for a resident. I was disciplined for "leaving a medication beside a resident that has dementia," instead of waiting 5 minutes to help her take it, I proceeded to admin meds to the other 30 residents before time runs out.
I honestly feel like this is unfair. Also, my director was very strict and had a look of no mercy when telling me that this is just "unacceptable practice". Also, the family member who reported me has a history of issues with many co-workers, and the management team knows that.
So, tell me, give me your honest feedback. Would you write me up for this? I feel a sense of indignation towards my director.
I'm not going to rehash what most people have said. I do want to add a couple of thoughts though.
The family member didn't know what Med was being left. Even if they knew is was senna, they didn't know if this was a common practice in the facility or what other meds might be left beside a patient with dementia. Their concern is understandable.
While senna is pretty innocuous for most people, it is a medication. At my facility the pre filled 10cc NS flushes are considered a medication and can't be left out. A med is a med is a med.
I've made some errors but always learned from them. I hope you have a long career with lots of high points and very few lows.
Would I write you up for leaving Senokot? No, but I would talk to you and counsel you not to leave medication around unattended.
In the military I wouldn't write an article 15 (non-judicial punishment) for a non-egregious first time offense. Writing someone up without counseling is bad form and bad leadership. If it is done behind someone's back it is even worse.
Specializes in LTC,Hospice/palliative care,acute care.
Our opinions really don't matter.It's grounds for termination at the LTC where I work so you are lucky (compared to the two nurses I used to work with who did this) It's bad practice,it is something that should have been drummed into you during clinical and your orientation to your facility.Own your error,learn from it and move forward.As for LTC's setting new nurses up to fail ....NEVER cut corners during your meds pass...
In the military I wouldn't write an article 15 (non-judicial punishment) for a non-egregious first time offense. Writing someone up without counseling is bad form and bad leadership. If it is done behind someone's back it is even worse.
What if the first offense was a med error? Nothing major, but say nurse gave acetaminophen instead of ibuprophen and the patient wasn't allergic and had no liver issues?
Specializes in LTC,Hospice/palliative care,acute care.
What if the first offense was a med error? Nothing major, but say nurse gave acetaminophen instead of ibuprophen and the patient wasn't allergic and had no liver issues?
Our facility has a progressive disciplinary process,don't most? First offense ,verbal warning,second written and education including an observed med pass,third-is the last.....for incidents like you have described.That does not include leaving meds at the bedside or pre-poured in the med cart....
Our facility has a progressive disciplinary process,don't most? First offense ,verbal warning,second written and education including an observed med pass,third-is the last.....for incidents like you have described.That does not include leaving meds at the bedside or pre-poured in the med cart....
I'd say it would likely depend on the situation, but med errors are ALWAYS written up, not as a punitive measure, but as an "incident report," the purpose of which is to identify where the breakdown occurred and prevent it from happening again.
Unfortunately, yes, your actions did warrant your being " written up". By leaving the medication for the patient to self- administer you did not honor several of the " rights" of medication administration, and, you falsified your documentation saying you administered the medication at a specific time but really didn't. We all understand the importance placed on timely medication administration, but if you cut corners and then expect to not be called out by your employer or your online peers, you are mistaking.
What if the first offense was a med error? Nothing major, but say nurse gave acetaminophen instead of ibuprophen and the patient wasn't allergic and had no liver issues?
I don't consider this a med error and "what if"s aren't apart of the situation. Acetaminophen can be safely given to people with liver failure by the way. We do it all the time in the ICU and there are many studies supporting the efficacy and safety. Ibuprofen is more likely to cause issues.
Incident reports are different than getting written up. IRs fix systems issues and promote better education, just being written up doesn't.
I don't consider this a med error and "what if"s aren't apart of the situation. Acetaminophen can be safely given to people with liver failure by the way. We do it all the time in the ICU and there are many studies supporting the efficacy and safety. Ibuprofen is more likely to cause issues.
Incident reports are different than getting written up. IRs fix systems issues and promote better education, just being written up doesn't.
If a drug not ordered was given in place of one that was, it was a med error.
At my facility, all "write ups" were called incident reports. I haven't worked there in a while though, so who knows what they are called.
Tex.
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I have the dumbs. How do I do this?