FAQContact usTerms of servicePrivacy Policy

Can I dispute a termination where there was no disciplinary phase and could my license be in jeopardy?

Friday September 21, 2012
Printer Icon
line
Select Text Size: Zoom In Zoom Out
line
Comment
Share this Nurse.com Article
rss feed
Question:

Dear Nancy,

I recently was fired from my position of seven years as a staff RN and charge nurse on the night shift. We have two units with both of the RNs working on the medical detox side. The other side is for partial hospitalization patients, where there is usually no RN, unless one of the two nurses is called over there by the patient care technician. I was very busy and somewhat tired when I went to review a new patient chart and the narcotic sheets — to be sure they were signed by two nurses, which is missed sometimes. I noticed one of the patient’s narcotics sheets was illegible, so I rewrote it and the other RN signed it. I wasn’t thinking and tore up the first sheet and I threw it in the garbage and not in the shredder. I have been an RN for 32 years and have never done that. A nurse reported this, and I was terminated. I always have had great reviews and have been told by management what a great nurse I am. There was no disciplinary phase — they just fired me. Can I do anything to dispute this? Could my license be in jeopardy if this is reported to the board of nursing?

Morgan



Nancy Brent replies:

Dear Morgan,

Your situation is one that strongly highlights one of the basic principles in nursing documentation — when it is necessary to redo an original document that is part of the patient's legal record, one never throws away the original. Rather, it is kept in the chart with the redone page, which is dated and initialed by those who did the rewrite. Moreover, one does not CHANGE information on the redone page. Rather, it is done over because it is not readable (e.g., coffee or water is spilt on the page, making it illegible).

Hospital policy and procedures should dictate the manner in which a redo is done and the reasons why it is necessary. Also, it should include how to handle additions or corrections to a nursing note.

You stated that you redid the page because it was illegible. This may be a problem for you and your colleague, for if that were the case, how could you redo it to make it legible? You had to be able to read the sheet to redo it, so the argument would be that it didn't need to be redone.

Another concern is who was the nurse that co-signed the redo? Was she the nurse who administered the narcotics or someone who was working with you during that tour of duty — so you had her act as a witness? If she were the nurse who administered the narcotics, why didn't she take the responsibility to redo the sheet, if appropriate and consistent with facility policy?

This kind of situation is serious, and especially so when it involves narcotic medication administration sheets. Not only is the redo and throwing away the original a concern, but this kind of situation also raises a concern about whether narcotic medication is being diverted. It would be important for you to consult with a nurse attorney or attorney in your state who works with professional licensure issues.

The attorney may be able to help you with challenging the termination also. However, the fact that there was no disciplinary phase is probably not helpful in challenging your termination. The employer policy probably states that any serious conduct that violates their policy (e.g., stealing from a patient, destroying patient records) is grounds for immediate termination. When you consult with the attorney, take your employee handbook with you for his or her review on this issue.

Sincerely,
Nancy




Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.