I work for a home health company with full-time status. I was to do a start of care on a patient for IVABX therapy. Patients are to get their first dose at the doctors office or elsewhere. My company wanted me to give the first dose, saying the patient had the same antibiotic a month ago. I believed company policy stated first doses (meaning round of doses) were not to be given in the home. As a result, my manager made me go PRN and took my benefits away. The odd thing is that I’m still getting IVABX admissions.
Should I seek legal help? To me, if you’re going to discipline an RN, making him or her go per diem is not the way. I later realized there is no company policy on IV antibiotic therapy.
Nancy Brent replies:
Dear Ann Marie:
If you were to administer an IV antibiotic in the home and the patient had a reaction in some way to the antibiotic, one of the first things that would be raised by the home health company would be your failure to follow standards of practice in administering such a treatment in the home. Antibiotic therapy in the home is quite common and there is a wealth of information available to you on the Internet, including infusion therapy standards used by the authors and researchers who published articles and texts on this subject.
You might want to review infusion therapy standards, including those governing the administration of antibiotics, to seek support for your position. Keep in mind the fact that the patient had the same antibiotic a month ago does not mean a problem might not arise with this course of therapy. There are many factors to consider: the patient’s diagnosis and the reason for the antibiotic therapy, the age of the patient, the current physical status of the patient, and so forth. Also, keep in mind that the absence of an employer policy does not exempt you from following established standards of practice and protecting the safety and wellbeing of the patient.
It is extremely unfortunate that raising the policy issue–indeed the patient safety and well-being issue–resulted in a discipline by your employer. It does sound “retaliatory”, so it would be worth your time and money to consult with a nurse attorney or attorney in your state who can help you evaluate the situation and explore your options.