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I was terminated for allegedly giving medication without an order. I feel it was the ambiguity of a computer program and inadequate instruction on the program that caused the supposed error. What should I do?

Wednesday January 9, 2013
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Question:

Dear Nancy,

I was terminated for allegedly giving medication without an order. I argued that the wording in the computer-charting program is ambiguous. After giving one dose of hydromorphone, the physician told me to repeat the dose several more times. In the program we were using when administering the drug, there is a box to indicate that the drugs should be repeated, which I checked, and it was time stamped. I was told because I didn’t actually write out the order, I was administering medication without one. I feel it was the ambiguity of the program and failure for adequate instruction on the program that caused the supposed error. What should I do?

Rob



Nancy Brent replies:

Dear Rob,

Unfortunately, this situation is a difficult one, especially because it involves a controlled substance. It is understandable that inadequate orientation to a new computer program is problematic when documenting in the electronic medical record. However, when there is a question or concern about how documentation is to be done, an employee should ask a resource person and/or get more training in the new program.

Regardless of whether one is documenting on the medication administration record by hand or by computer, the age-old principle that no medication is given without an order from a healthcare provider who is authorized to give that order still exists. The fact that the medication allegedly administered without an order was a controlled substance makes the situation more serious.

If your employer has a grievance policy that includes the ability to grieve a termination, you can try to challenge the firing with the reasons you mentioned. You can probably do this yourself, but if you think you need legal guidance, a consultation with a nurse attorney or attorney who can coach you on how to proceed and what arguments should be raised during the grievance process, can be helpful.

Cordially,
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.