Wrongful Termination?

[MEANNRS]

I was terminated from my job for a med error. I gave 5mg of Coumadin when the order was for 6mg. The nurse who transcribed the order originally wrote 5mg but then wrote 6 over the 5. No cross out, no initials. I asked my direct supervisor what the order was and she said 5mg. The next day I was called and suspended, 1week later; terminated. I'm considering contacting an attorney to see if there's any reason to pursue a case. Has anyone been through this? Or have any advice?

[Lev, MSN, RN, NP]

Sounds like a setup. I wish there was a way to clarify with the doctor now what the order is supposed to be without it being a privacy violation.

[VANurse2010]

Any employer who would fire you for giving 6 mg of warfarin instead of 5, given the bad process described here, is not one you'd want to work for.

[MEANNRS]

It's just sad. I worked for that company for 8 years. It's my entire resume

[Horseshoe, BSN, RN]

I'm puzzled why you would clarify a drug order with anyone other than the person who wrote it?

[roser13, ASN, RN]

I'm puzzled why you would clarify a drug order with anyone other than the person who wrote it?

I always ask co-workers their take on any type of puzzling or unclear handwritten orders. If we all agree on what is written, I see no need to call the prescriber unless what we all agree on makes no sense. 6 of Coumadin seems odd to me. 2.5, 5, 7.5, ok. But 6?

At any rate, I totally agree that it is such a small deal that there has to be something else going on.

[MEANNRS]

I wanted to avoid calling the PCP Bc I was the 2nd shift nurse, the med was ordered for 8p and the Dr would sometimes get mean when we called at night. But you're right I should've clarified w the PCP anyways!

[Libby1987]

I remember avoiding those uncomfortable phone calls. You just have to get over it in order to protect yourself and your patients.

I wonder if your supervisor's mishandling of it, she saw the write over and evidently didn't act appropriately, made her throw you under the bus?

[imintrouble, BSN, RN]

I wanted to avoid calling the PCP Bc I was the 2nd shift nurse, the med was ordered for 8p and the Dr would sometimes get mean when we called at night. But you're right I should've clarified w the PCP anyways!

I would have done exactly what you did. Asked a co-worker what they thought, and proceeded if our interpretation was the same. That's the way it's done where I work. To say I should call the MD is CYA, but it's just not done. There is not one single MD who would have made a stink. They prefer to get as few calls as possible. Firing a nurse for not clarifying, is asking for dozens of phone calls from nurses afraid for their jobs.

There is another reason you were fired. Or a collection of reasons.

[CrunchBerries]

I used to work for Mayo Clinic and in those days (not sure about today) we couldn't be fired for a med error, no discipline at all. I think the point was so that if we caught it later nobody would cover it up for fear of their job.

I'm reminded of why I liked that policy.

[jadelpn, LPN, EMT-B]

I always check the MAR against the original order. If the write over was 6mg, I would have flagged (yellowed out--depending on paper or EMR) and re-wrote the order on the MAR so it was clear--and checked it against the original order before giving it. If this was all done on paper orders, again, I would re-write the clarification on the order set.

The MAR needs to be signed off by 2 nurses. Pharmacy or the electronic med dispenser would also need to be looked at. Also, home meds are usually based on PT INR's. Could the patient tell you how much they take? If they called the Comaudin clinic and got a dose?

So much crazy stuff with this situation.

I would call your malpractice carrier. I would see with them or an attorney what your options are, especially if you are unable to find another job, can't collect unemployment--that type of thing.

And when asked in a new job interview? "We parted ways due to a process issue that was not is a supportive climate on the unit". Or even "I was at the facility for 8 years, and was a successful, highly ethical nurse. Process delays/issues came to light that were not within my favoured practice".

Best wishes!

[MEANNRS]

It's an Alzheimer's unit so the patient couldn't tell me and it was a new med that was hand written on the mar and PO sheets both were written the same way w a 6 over the 5, illegible. I was able to collect unemployment but the company is filing appeal after appeal.

[CrunchBerries]

It's an Alzheimer's unit so the patient couldn't tell me and it was a new med that was hand written on the mar and PO sheets both were written the same way w a 6 over the 5, illegible. I was able to collect unemployment but the company is filing appeal after appeal.

My sister used to work for Unemployment. She said most times people will win their case even if they really were in the wrong and it's all financial. Unemployment is cheaper for the state than welfare benefits. Unemployment and they just raise your employers taxes (which is why they are fighting it.) Welfare, different ball of wax. If what she says is true, you will probably win in the end. And you should win this case IMHO.