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Does an RN, Who Was Terminated After Being Accused of Practicing Outside Their Scope of Practice, Have Any Recourse?

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Dear Nancy,

My employer has accused me of practicing outside my scope of practice by increasing the rate on an IV. They terminated my employment and stated they are going to report me to the nursing board. I have never made a mistake or ever been counseled before for anything. Is this action by the facility a
little extreme?


Dear Nancy replies:

Dear Adelle,

It sounds as though you have an excellent history of never having made a mistake or been disciplined by your employer prior to this incident. This history is something that is in your favor but you will still need to appear before the board with a nurse attorney or other attorney to defend yourself against this allegation.

You did not mention how the increasing of the IV rate was outside the scope of your practice but this will be an issue you need to discuss with your attorney. Perhaps you had no standing order or specific order to do so by the patient's physician. Or, it may be that the employer's policy that no nurse increases or decreases an IV rate without first checking with the patient's physician and you did not do so. Or, the employer may require a certification in IV therapy for a nurse before any independent changes take place with an IV rate.

Be sure you take your job description, employer policy and procedure used for medication orders and IV rate, specific information about this incident and why you increased the rate, whether you documented the rate increase, who you notified, and so forth. Bring with you any copies of evaluations, if you have them, of your work performance during your time as an employee at
the facility.