Great, my license is on probation, whats next???

[Jadranko]

. . A 30day Pyxis report they came up with showed 16 descrepencies on 16 different patients. The several medications on that "one day" was not one of the charts the board wanted to subpoena, perhaps because I would usually return them in one way or another to the patient.

Of the 16 reported we ended up with 2patients I checked out a gram of mag for and no orders, and no documentation of it being given. In one of the instances I showed the Boards reps my nurses notes included that the patient was having increased ectopic beats sine the first 6hr post CABG, and that I was adding a mag level to the K level. I drew and sent the lab work at 1830hrs I was able to find that and the result in the chart. I didnt know the value till that day. I sent the lab work and left the mag for night RN asked her to check on the results and that this surgeon wants mag levels to be replaced if less than 2.2, turns out it was 1.9. Told the investigator see I didnt give it, the RN never called for replacement orders either.
The third patient,a gm of Calcium Gluconate, no orders,no documenting of it being given. After hearing the patient received multi units of blood and blood products during the case, even before I admitted the patient I checked it out to put in my patients room. I even took out Gluconate verses chloride besause of the surgeons preferences, know to me for years. It was replaced by anesth MD, and pressors weaned quickly calcium came back low 7 range no need to call/ask for orders. Just credited it back. .
Okay, patient four. 20mg lasix checked out, no written orders,nor documentated on MAR as having been given. This one is most ironic to me.A registry RN new to the unit,but cute;my demise. Had gotten orders for her patient to get 20mg Lasix IV now, night RN did not want to "bother the PA's "with the low urine output since hemodynamics were fine, but the patient had crackles in all fields and was on 70Fio2 via mask, got lots of fluids post op. An hour after waiting for the lasix to arrive via tube system or activated on patient profile to the automated Pyxis no Lasix. The chart had not been worked on yet by the unit sec. being new she didnt want to tell her how soon she wanted it. The orders were faxed and and hour later I got involved, after seeing someone be upset I try to find out why and if I could help. Had her call the Pharm by phone and verify the order was received and to send it asap. Another 30 to 60min later she has not gotten it yet, I go take a look and listen to the patient, and agree with the orders for lasix. I ask her if we could get the man OOB to the chair in the mean time, she said great, was to swamped to get him OOB sooner by herself.I've seen the magic of getting up to a chair help this situation thousands of times. Activity, reposition the lungs, use gravity a little, some times a little higher systemic blood pressure helps too. Now the surgeon is rounding and a little ticked off the lasix has not been given with the order written NOW, two hours ago. This was my next career ending mistake. I take the nurse to pyxis look her profile up and no lasix on it, I het over ride button to get it but her daily registry password will not let her override. I sign in and check out 20mg Lasix by overiding, staff passwords can overide, wish it didnt now. I held the little bottle in the air and said " I can get in trouble for doing this ,someone could call it practicing medicine without a license" she laughed. I told her I would appreciate when her lasix does show up if she could credit a dose back to my guy, she agreed.Again to follow up on that, not on my radar. Yes it was wrong to do it but you have thousands of these ethical dilemmas in a nursing career. Today I would send the RN to pharm window or if I had the time go for the nurse, if I ever get to practice nursing again its gonna have to include big time watching my six,or back. Two pts had zofran checked out I did not remember to get the orders for it the current compazine order was defunct, a shortage and none in the hospital, credited it back at end of shift.The other 10 descrip. were falsely reported, in one form or another. Suggestions????
I

[blessedby2]

FIRST OFF YOUR CAREER IS NOT OVER. DID YOU ALREADY SIGN PAPERS SAYING THAT YOU AGREED C THE DISCIPLINARY TERMS? I WENT THROUGH A FALSE ACCUSATION AS WELL ET IT RESULTED IN DISCPLINE. IF YOU WANT TO EMAIL ME IT IS aspenmullins@yahoo.com