They made an appointment for the Depo shot (it was either her 2nd or 3rd time), she went in and was given the Gardasil. We are still not clear on whether the doctor ordered the Gardasil - but the file states the patient was in for Depo and given Gardasil.
You need to find out what the
ORDER was for. Pull the record and then you will have your answer. It will be interesting to see. Because there will likely be one of two results. A) the depo was ordered and the nurse gave the wrong thing; or B) the gardasil was ordered in error and the nurse gave what was ordered (though still shares responsibility in the patient getting something different than she was supposed to that visit). If it was the latter, then you may have a bigger problem than you thought, (ie the doc was willing to let the nurse take the fall for his or her mistake). If that were the case, then I would have a problem having an unethical doc. If it was as you think it was, ie the nurse really did mess up, then I'd feel better about staying with the practice. JMO
A few more thoughts. Many places are moving toward an electronic medication administration system. Some practices may not have them yet, though, as they're obviously very expensive. But they do pay for themselves by preventing errors (for the most part, they're not completely foolproof). Again, I don't work in a doctor's office, but here's how it would happen in a hospital with an electronic system: medication/vaccine, etc, is ordered by physician. Order is approved by Pharmacist, then taken off by RN. RN obtains the medication (ETA out of a computerized medication dispensing machine), and scans it into the system. The system checks medication, and if it's incorrect, it can go no further. Error displays. If it's correct, you can proceed. Lastly, the patient's armband is scanned. If all information does not match up, again, you cannot administer medication. It's a great system (and documentation is FOREVER and cannot be unscrupulously altered). Just wanted to let all of you who have concerns about medication administration, that, if places don't have these systems yet, they probably will soon. It's the way of the world in 2009.
Another thing you may look at is the credentialing of the nurse. Was it an RN, or an LPN? I am an RN. I do not perform tasks blindly. I am trained and paid to think critically about what I am doing (and, as a pp mentioned, I am held accountable for my OWN actions). I also talk to patients. I would have had a conversation with this patient before I even had a medication in my hand. "Hi, how are you? What brings you here today? A depo shot? Oh, OK, let me see how that's coming along." Then I would go check the ORDER and if it said gardasil, when I knew the patient was there for depo, I would have a conversation with the doctor about it and have him or her change the order. These types of interactions go on every day. This is the reality, which is why I think my nursing colleagues here are feeling a little defensive. The general public often doesn't understand what we do and how it all works.
