accusations

[bldailey]

My story starts aprox 2 months ago when I forgot to wast about 4mg of morphine. The next day I was told I needed to take a urine drug screen because of this. I took the drug screen and and passed. That same day I was able to show and produce in the sharps container in the patients room. I showed the drugs to pharmacy and I was told to waste then with the house super. I was not written up or counceled, there were no reprecusions for my mistake. After that , I was very sure I was quite consited that I had all my narcotics wasted correctly. @ weeks ago I was called to human recources and told I was being put on paid administrative leave pending an in vestigation into possible drug diversion, It was a shock. I was off two and half weeks and then called in for a meeting today at 4pm to human resources. The DON was there along with the director of human resources. It was pointed out to me that some weeks I was less then others with my prn narcotic use and that another week I was way over the normal use. I suspect this is a week that I worked over 60 hours that week and that I had a patient that was requiring pain medication every 2 hours and my other patient every hour. I am an ICU RN. The DON sat there and stated several dates that my documentation was perfect and no discrepancies. Then she started off with dates that showed that I charted sometimes in the nurses noted but not the MAR. She said that a couople of times the omnicell shows I wasted more milligrams than what would have been able to be wasted according to what I had given the patient, the omnicell does not allow that mistake. She also cited a few times that she claims I did not waste enough of the medication in the omnicell. I had been very careful about keeping track, running my own narcotics usage report so that I was correct in my wastage. I would also waste then log back in because the omnicell will bring up an immidiate warning that you have meds to waste. I have a hard time beleiving that I have not wasted as much as she claims. I know at times it is easy to go through the waswting processs with two people and at the very end you can think you are done instead of hitting waste now, you hit exit, I know because I one day realized this was the case and wondered how many times I might have actually done this and then it looks like I did not waste. I was not allowed to see any proof from omnicell print outs or showed ant Mars to show I did not document. I asked for a copy of the accusations that the DON was reading me and I was refused. She asked me to sign the last page of the accusations without allowing me to read the contents that I was signing. I would not sign. She commented on one time I had given Dilaudid to a patient with no order, not true, I pulled the drug out, broke the seal then rechecked my orders for giving the med, I relized there had been an order change so I wasted the dilaudid with another nurse and I contacted pharmacy to let them know. The DON also cited that twice I had pullled out a 10mg morphine vial twice when I could have pulled out a 4mg. The reason was that the patient was not getting pain relief , I received a verbale order to get some more morphine then back to the room the MD verbally orgered a now dose of 4mg. I thought we would go higher becuase the 4mg dose was not working so I pulled out a 10mg, I did this twice. I also had for years been in the practice in the ER to pull out a 10mg and mix with 9cc of saline to mix at a 1:1 ratio, wher we often titrate to patient pain relief. I have been an RN for 18 years , I have never been accused of or counceled for improper charting or wasting of narcotics much less been suspected of diversion. I was asked several times if I needed to reveal anything. I said no but then I also stated that I had pain on a foot one day so I had gotten an open used bottle of lidocaine that would be thrown away and I attempted to make me a lidocain patch for my toe, I was told that this was stealing medication from the facility. I honestly thought that at the end of the meeting I would be written up, have to come up with a corrective plan of action and possible be put on probation , and even frequent drug testing if thats what was required. I even offered a hair sample. NO, I was terminated. I was not allowed to see any of the omnicell rerorts or the patients notes and mars so that I could defend myself. Patient saftey comes first. I have never been accused of unusual behavior or missed anything signifivant to patient safety. I am a very caring nurse and a good nurse. I don't claim to be pefrect with charting but this is too much. I don't know what to do. Certainly there are other jobs but I take much pride into what kind of reputation I have. I am very well lkied at my job by my coworkers, my physicians and most importantly my patients. Can someone please comment, I am very very upset. I was told a letter would be sent to the board of nursing, I work in New Mexico and I have an Arkansas compact license. I have a 100% clean record. What do I do. I almost wanted to beg the DON to think about it and give me a chance to prove myself, but I kept my dignity, I did not become emotional, I just said thank you for your time and proffesionalism and I left with my head hanging. I am trying not to be devestated. I will adress myself as B, ICU RN. Someone please resond, I need someone to relate to.

[hppygr8ful]

You need a lawyer familiar with wrongful termination cases. You at the very least have a right to review youremployee file and rebutt the charges against you. I would go get a hair folicle test at your own expense and go to a lawyer.

At face value (and I really good at sniffing out addict behavior. It takes one to know one) You're story doesn't jibe with addict behavior. I could be wrong - Nurses usually get caught when their addiction causes them to get sloppy. But for now I would pursue your legal options quickly - the longer you wait the harder it will be to prove your case.

Hppy

[bldailey]

Thank you so so much for reading and answering my post. It brightened my day.

[Kdog]

Sounds fishy.
Anyway, why would you take the lidocaine? I don't think that was professional. You can't do that.BUt the other stuff would bother me too.
Get a lawyer,,,

[cali510]

The sooner you get an attorney, the sooner you will be able to deal with this. The American Association of Nurse Attorneys has a referral service for attorneys experienced in dealing with nurse related legal problems. www.taana.org

[gbcn030707]

I had a similar situation. I have been nursing for 16 years. A travel nurse for 10 years with many different companies. I looked on Hyperdermics.com to find the "best" travel nurse company for my last assignment before locating permanently to Florida. Cirrus was the company that I found. At the time My children were toddlers and had not started school. My final permanent position was to be in Florida because they had a great Autism program and both my toddlers have Autism, and by the time I finished the assignment they would be ready for school. I packed up my house in NC put everything in storage. My self two kids and my mom who is disabled headed to virginia. First contract was 3 months the staff was great so I thought, atleast thats how they acted. I was given students to orientate and the whole nine yards. Keep in mind I am a traveler. When my assignment ended the manager asked if I would stay for another assignment because there were alot of new grads coming out of school. It worked out since I was still waiting for my Florida License. So I signed another 3 month contract. During that time a male traveler that was also with my agency started having alot of issues that I thought was really weird because he was a great nurse. The next thing I knew is he was gone!!! Fired!!! Later I found out it was because at time he refused to take a 3 pt ICU assignment which I aggree with. Normally when you take a 3 pt ICU assignment All three are not Vented and sick as hell on 5-6 gtts but this was the norm at this place, but I went on with the assignment. while there I met another travel that was with Advantage Rn, by the time I left we had become really good friends we worked together and always helped each other out because we got the worst assignment. We did outside activities with the staff, laughed, joked and had goodtimes. So this contract ended and now I had my florida License I started applying to Hospitals Near Tampa Florida about 2 months earlier, but most want you to have your license in hand. Next the manager and supervisor called me in the office and asked me would I consider a sixty day extenstion because I was such a good fit for the staff and by then all the New nurses would be out of orientation and ready to hit the floor i said I would think abou itt, but I explained that I wanted to get settled in Florida before my children actually started school, and also I needed to get my mom set up with new doctors in Florida. Then my company called begging me to do this so like the fool I am I agreed. dont know if I mentioned it but I was in there housing. O.K. one month in I thought everything was fine came to work that night was called in the office by the same Manager and Supervisor who asked me to stay. I was told that 30 vials of pheneran and 6 tramadol tablets were missing out the pyxis and I was the last one to enter the pyxis. I was in shock. I was told I could not work that shift, and sent to the lab to take a urine drug screen. I was unaware that there was a drug screen for tramadol and phenergan. I was sent home and told to call my agency in the morning. That morning my agency(CNO) called me and said that they were looking into it and they didnot believe it and so on. Well as soon as I got off the phone I checked my email and there was an email from my recruiter telling me that I needed to vacate there housing by the end of the day. I was pissed!!!! and in shock. I said youre not going to wait for the drug screeen she said no. I told her I atleast needed a day to pack because as they new my kids were with me, she new my whole situation. Well she said she would call me back. She calls me back and said for me to stay one more day I had to pay Cirrus 100.00, So I called the apartment rent office to try and work something out and was told that my company informed them four days ago that I would be vacating and that there was another traveler that would be moving in that weekend this was Thursday. I was in shock so of course I paid the company the 100.00 and found an apartment in florida using the internet before I left there housing. So of course I never saw the apartment and had to go on faith. so myself, mom, and 2 toddlers drove 15 hours to Florida. The urine test came back negative and Cirrus had the nerve to call me and ask me to take another assignment with them. I hung up the phone in her face. A month later a get a letter that I would be invesitigated by the virginia board of nursing and it could effect my other state licenses. The board of nursing investigator called me I answered the questions, but she was asking me questions about any illness my self or children had. basically she was trying to find out if we had any illness that would require me to need phenergan and tramadol. The investigation lasted a year I was cleared when it was discovered that the pharmacy tech made an error when loading the pyxis on the number loaded, and because it was not a narcotic and there is not a count done when entering it. It was not discovered until a nurse went in the pyxis to get a phenergan out and it was empty. The pharmacy tech entered an inaccurate count. I found this out from the board of nursing. Cirrus never bothered to say anything. A copy of the findings were sent to myself, Cirrus, and the hospital. I was cleared of all charges with the board and never recieved one apology. I did seek a nurse attorney and was told that agencys can let you go even if they think a misdeed has been done they dont have to have tangible proof, I dont know if it is the same if you actually work for the hospital. I have learned first hand that all these travel companies are in it for one thing making money by suppying a body with a license. They are not going to go agaist a facility because you are only one person vs thousand of travelers that they can potentially send to that hospital. All those nurses at the hospital that I thougt were with me turned on me and totally believed everything that was said so I learned a valuable lesson, the only person that stoke by me was the advantage rn traveler that was there with me. So even if you think your travel company is the greatest trust me if anything goes south they are going north.

[Kdog]

I don't understand why the hospital did not investigate the pharmacy tech also. They make alot of mistakes w loading the pyxis.
Sorry you had to go thru that but it was not fair just because you were the last one to use the pyxis... THe whole staff should have been looked at.
But travel nurses get fired for next to nothing. Wondering if you can sue the hospital for WRONGFUL accusation and firing...