dispensing medications-- help!

[neilybear]

I found out today that I have been fired and am being reported to the state nursing board for dispensing medication to an employee. Is this dispensing? Can I lose my license or be reprimanded, etc? Thie is the situation: I came in to work to find that we were short staffed for the day shift. I had 3 CNAs on a long term care unit of 30 residents. One employee was a high school teenager who had become a CNA a month previously and had just completed orientation. The second employee came in extremely sick and needed to go home. The third employee was an insulin dependant diabetic who had worked the night shift and had been mandated to work another 5 hours. I called my supervisor who said she couldn't come in for about 2 hours or so because her son had had a pajama party and she had kids at her house. In actuality, she didn't come in until 4 hours after I had called her seeking help. She said I could not let the sick employee go home because of minimum state mandated staffing levels. After I called her, I found out that the diabetic employee didn't have any insulin with him and he said he'd "have to go without". He is a brittle diabetic with blood glucose levels often close to 500 despite taking his medication. I found his type of insulin in our emergency stock (which is the property of the facility until it is assigned to a patient) and gave him an unopened vial in order to prevent a serious health incident for him, which in turn would have jeopardized safe care for the residents. When the DON finally came in, I told her immediately that I had given it to him and she said I had dispensed medication without a license and could lose my nursing license. They are reporting me to the board of nursing. I certainly understand that I can not give a patient a medication without a physician's order, but the employee was not a patient and i simply gave him the bottle and did not administer it. What about the Good Samaritan Act? What if an employee was having an anphylactic reaction? Am I not supposed to give them Epi? Do I have to wait for a full out crisis or can I do what I can to prevent it? Opinions/info appreciated. Thank you

[NursedotcomPaige]

Oh gosh! What a situation! I'm interested to see what your fellow RNs think of this!

[GitanoRN]

First of all, I'm sorry that this happened to you. Unquestionably, this is a serious matter and a difficult at best, to answer without all the details of your previous relationship with co-workers and management. Having said that, I would definitely check with your state BON and be honest about the entire ordeal, at least you'll have a better understanding of what your options are. In addition, contact a lawyer specialized in medical law and ethics issues. Needless to say, also get reacquainted with your institutions policies and regulations, this will arm you, with more detail on what your next move should be. Keep in mind, you might not get your job back, but you need to fight to keep your license. Wishing you the very best of luck...as I send you hugs from across the miles...Aloha~

[npatient]

Couldn't a doctor have prescribed insulin for the employee?

[neilybear]

That's a good question, and an option I unfortunately didn't think about. I don't know the legality of me then assuming/accepting a nurse-patient relationship with the employee who is not a patient of the facility, my ability to take an order in that situation, etc. but I wish I'd thought of and at least tried that.

[neilybear]

Thank you for your kind words; it means a lot to me to feel supported right now. Regarding my history with the facility, I accepted a weekend Baylor position about a month ago. After 3 days or orientation, I began working as the only RN on the weekends; this was my third weekend. I had been assured by management that they were available for any questions, etc. and the DON lived "right down the road" and could come in if needed. Obviously, this wasn't the case as she didn't come in until 4 hours after I had called her. As I stated before, I was new to the facility, left in charge of an understaffed unit with one employee who was barely functioning as she was so sick (she was diaphoretic, coughing and said she felt like she was going to pass out), a new teenage CNA and a diabetic who had been mandated to work an additional 5 hours past his regular 8 hour shift and who didn't have his insulin. The unit was chaotic, the situation unstable, and I was simply trying to hold the unit together and provide some semblance of quality care to the residents until we got some help. I also questioned the ethics and legality of mandating an employee who didn't have his necessary medication and the facility making no effort to provide it to him if it was at all possible. And it was. It was in the refrigerator, unopened and it belonged to the facility, not to a patient. So I gave it to him to self-administer to prevent a health crisis for him and a worsening of the entire situation. The DON said I should have called her again, and she is right, but I had already called her and had gotten no support. She said she'd be in in about 2 hours but didn't show up until 4 hours later. I'm just sick about this and the possibility that I may lose my license or have some kind of warning on my license.