Justin Tyme - a registered nurse - joins the unit after successfully completing new employee and unit orientation. He had worked for 10 years in a similar unit at St. Elsewhere but grew tired of the 2 hour daily commute. He is thrilled to be working closer to home. The staff is ecstatic as the unit has been short-handed and the census high.
The staff likes working with Justin. He is a friendly fellow and frequently brings hot donuts and a huge thermos of Peets coffee for the staff. He is always willing to help with lifting and turning patients and often is the first one to respond to patient lights.
Justin does not always follow through on his observations and physician orders; he often misses giving routine meds. The staff has taken to routinely double-checking Justin's orders and the following shift often dispenses the missed meds.
One morning, Dr. Tauk comes in to review the speech consult he ordered the day before on his patient, Mrs. Dee Phagia, prior to ordering her a diet. Dr. Tauk cannot find the consult asks Charity N. Able, RN, to locate it and call him. Charity discovers that the order had never been placed. On follow-up, Charity discovers - not to her surprise - that Justin was the nurse who noted the order. Charity does not talk to the manager but does point out the error to Justin who feels terrible about it.
Over the next month, Justin continues to make intermittent "small" mistakes which cause no harm to patients; and the staff continues to cover.
Today, Dr. L. Ovin comes in and notices that her patient, Mr. Hart, is in atrial fibrilliation. She orders stat IV digoxin and cancels scheduled diagnostic procedures. Mr. Hart remains in atrial fib and, as you review his chart, you discover that Justin missed the last two routine digoxin doses.
What do you do now?
Found at: http://www.scu.edu/ethics/dialogue/candc/cases/covered.html
Small mistakes could be very costly in some scenarios. Especially when someone’s life is on the line. What should have been done first was making sure Justin was fixing his mistakes and doing what he was supposed to. The RN told him about the problem and how he needed to fix it and that was about it. There should have been more following up with Justin after seeing patients to make sure that they were taken care of. If that would have been done, this sitatuion would have never of happened.
ReplyDeleteI agree with your statement that there should have been a follow up. Just to double check and make sure the job was done correctly. You can never be too careful when it comes to someone's life.
DeleteI agree with the steps you recommended them to take after finding out about Justin's multitude of mistakes. I also agree that this situation could have easily been avoided had they confronted him about it as soon as they detected a problem with his work ethic.
DeleteI also agree that the situations could have been avoided sooner if they were addressed properly. When peoples lives are involved in a situation it becomes so much more important to pay attention to the details.
DeleteAny mistake is a serious issue even if it is just a small mistake. If Justin is continuously making all these mistakes, then someone needs to do something about it. The manager needs to be notified so that they can make sure he is doing his job on time and correctly. Even if all they do is check up on his patients and confront him when he isn't doing his job.
ReplyDeleteI agree that someone needs to be told about this. Even though no one has died yet, it seems like it is a matter of time before this happens however. I also think he should be watched after they tell another person about it until they know he can do his job without skipping steps.
DeleteI disagree that it is the managers job to make sure that he is doing his job correctly every time he has to do something. This is a medical field and peoples lives are on the line, he should not need someone over his shoulder to make sure he isn't screwing up. If he repeatedly messed up and is not getting any better at his job, he should not have his job.
DeleteHe should be fired form the job. He does not do his job correctly, even after someone had told him he has been screwing up. He has been bad at his job for a long period of time and should be fired because he can not pay attention to detail.
ReplyDeleteThat is an excellent point you made about doing his job wrong. I agree with you idea, he is bad so he should get fired.
DeleteSmall mistakes lead to even bigger mistakes in the future, as seen in this scenario. Paying attention to detail is a major necessity when working in a healthcare facility. He obviously did not try to fix the small mistakes he made in the past and later on it had a huge impact on a patient and his co-workers. He should be fired from his job due to the fact he made more than one mistake, some worse than others.
ReplyDeleteJustin has been given multiple chances and keeps failing, at the least he should be restricted in the things that he can do and he should put on probation and watched to insure that he is no longer doing the job he was hired to do. Allowing him to continue doing, or in this case not doing his job, while it hasn't caused injury yet can in the future and precautions should be taken.
ReplyDeleteI understand that probation would be the nice thing to do. However, Justin has had multiple times to correct his mistakes to the point where it seems like either he is incapable of correcting them or he just has no desire to. Therefore, I think Justin should be fired.
DeleteJustin has proven that he is not yet suit for a job like this. He keeps messing up the small things. This can lead to a very costly mistake. This habit is now involving the small things, but it can very shortly lead into a huge mistake. A mistake like this can bring the whole business down. The company should part ways with Justin, he has been given too many chances. But he just keeps failing.
ReplyDeleteI am a fan of the saying, "all humans make mistakes". However, I do not think this saying fits well with the medical field.Although it is normal that small mistakes will be made from time to time, this dose not excuse consistent mistakes and in this case Justin is doing just that. He is not fit for this job and it shows. When consistent mistakes are let slide, they can lead to a much bigger, quiet possibly irreversible mistake. Justin needs to be reported to higher authorities and in my opinion he needs to be let go from that position.
ReplyDeleteI agree with you that consistent mistakes should not be tolerant. I also agree with you that these can leads to irreversible effects like death in this case.
DeleteThe small mistakes Justin has been making have obviously started to add up. I would have a serious meeting with him and have some sort of punishment because he is now putting patients lives at risk. I don't know if I would go to the extent of firing him, but, maybe a pay cut or consequence like that to make him aware of his mistakes.
ReplyDelete