scared of losing my license one day

Okay so recently I have been looking at my states board of labor and licensing of nursing and reading all of the disciplinary actions against nurses. Of course I do see a lot of "nurse diverted percocet for personal use" and can see that as a disciplinary action. But some of the things nurses get in trouble for I didn't even know that was wrong or could get a disciplinary action from the state board for. Some people get in trouble for administering medications early or late. Some I have seen they marked off on the MAR late. (which i know i do and everyone else i know at work have done. We have electric MAR that we mark off on the computer. well there are several times at the end of the shift i realize i didn't click on the 2100 meds and mark them off at 0700. so am i supposed to click the the exact time and make a note (late entry)? that is what i heard to do before. okay and like the other day i realized later in the shift i was supposed to give a med to my patient, well looking at it, i thought it was something that RT was supposed to give. then realized i was. okay so i marked "missed dose not given"
another thing i did was this lady wanted one of her meds early it is for gas and bloating it is written for four times daily (not prn) well her next dose wasn't due until 0900 but i gave it to her around 0600 and documented it. i did the math and it had been at least 6 hours since her last dose so i figure it would be safe. but my point is i know i do things like this and other nurses do to all the time. are these things that i could get a discplinary action against my license for. I am just terrified of getting in trouble now. i feel as if i do a good job and cause no harm but some things you can get discplinary actions against are things i know we do all the time. okay and as for documentation, im not sure i know what is legal and not legal in documentation. ive heard we have 72 hours to go back and document or modify. but is that real or something just one person said. I mean ive only been a nurse for almost 2 years so i am of course still learning. But most of the things I have learned are from experienced seasonal nurses, but I have also learned that just because someone has been a nurse for 20 years means she does things right or legal for that matter. its not like im getting in trouble at work or anything but after reading what some people get in trouble for it scares me to death. i almost want to get a job at like a doctors office or something where i feel like i won't be carrying such libility. so anyways im just wondering if anyone else feels this way. i mean my job is my livelyhood. i take my job very serious and enjoy it for the most part but i didn't realize we carry such legal libility. and a lot of these discplinary actions i read happened years before they actually got in trouble. so that means something i did when i first started working or yesterday i could get in trouble in a couple of years for. so any advise? how do i learn what are things that are legal or things i could get in trouble for? i want to keep my license.
I think you are being overly cautious. I have seen a couple of people lose their license, but it was for very serious things such as narcotic diversion and patient abuse. Giving a med a couple of hours early will not get you in any trouble. Oh, maybe with the anal retentive crazy people who work for Joint Commission, but just ignore them. They are crazy. Oh, and there are some sleazy malpractice lawyers out there, but since John Edwards has been disgraced you don't need to worry too much about that.

Most of those situations sound v. mild when they turn up in the BON bulletin/newsletter, but the situation is usually worse than the mild, "official" description suggests. People don't lose their licenses over giving one or two meds late (or early) -- there would have to be a long history of problems with medications, the person was given warnings and opportunities to improve the problem, and failed to do so, and it would have to be actually creating safety/treatment issues for clients before it got to the losing-license point, in most cases. I knew personally of one nurse who lost her license, officially for "falsifying documentation" (which sounds pretty mild, right?), but the actual situation involved the death of a client in restraints. The situation was much more serious than the official charge makes it sound.The extended length of time between the actual incident(s) and the final outcome is because the investigation and hearing process takes a long time and the accused nurse has an opportunity to appeal the outcome before everything is finalized.I know that, in my state, the state BON periodically offers educational programs on the state rules/regs and what you can and can't do. They are also available to answer individual questions from nurses about practice issues. If you are really concerned and uncomfortable, you might want to check with your BON and see if they offer similar presentations, or check with them individually about specific questions you may have.If you think about how many nurses get listed in the BON bulletin for having their licenses disciplined, versus the total number of licensed, working nurses in the state, you'll see it's only a v. small fraction that ever get in trouble with the Board.Best wishes!

People do not get their licenses revoked just for giving out meds late. Although needing extra documentation, this is not often considered a true issue.Keep in mind that what you see is a VERY SMALL percentage of the active, working nurses. And you are not likely one of those!

Another aspect you need to become very familiar with is your facility's policies and procedures. Your faciity has those in place for a reason and one of those reasons is to protect staff. Learn what they say about documentation of things like assessments and meds. Senior staff may be trying to help when they share experiences with you but ultimately you are responsible for your license. Listen, you are going to have some form of liability no matter what area of nursing you practice in. What protects you is following your BON's practice standards and knowing your facility's policy and procedures. You could also, if you are worried about it, take a documentation class to improve your charting. There are many available and you can usually get CEU's for them. Don't let your fears overtake your common sense. Many nurses never get reprimanded from the BON because they use good practice skills.Don't let this cripple you.

do you worry about losing your driver's license? I agree with highlandlass. Learn your policies. They help protect you. Ask an educator or risk management person in your facility to help educate the staff on documentation. Get a copy of your NPA in annotated version, if possible. Annotations are generally from an atty who "translates" the rules into practical language, based on how the BON has ruled in the past. Continuing education will help you stay on top of changing standards.

What I have found in reading some of the more 'petty' things people get in trouble for, is SOMEONE has to turn these people in. While I agree nurses should be monitored and not get by with major issues. But I find that for the small things, most of them are based on the revenge factor. When a nurse is reported to the BON their whole life is at stake. Most likely nurses could be counseled for a lot of these issues but someone has it out for them so they choose to turn them in the the BON. As a manager there have been a LOT of times I could have reported a nurse to the BON but I choose to counsel and educate rather than ruin a person's life.

If the board of nursing wants your license they will have them. If your documentation of controlled substances and narcotics are bought to the attention of the board for any reason, they will investigate. If the percentage of errors are more frequent then other nurses in that facility then you are guilty and there is no fighting the nursing board. So buck the rest of your documentation but document the heck out of your controlled substance.

If the board of nursing wants your license they will have them. If your documentation of controlled substances and narcotics are bought to the attention of the board for any reason, they will investigate. If the percentage of errors are more frequent then other nurses in that facility then you are guilty and there is no fighting the nursing board. So buck the rest of your documentation but document the heck out of your controlled substance.

First Law of keeping one's license to practice:Document everything to the fullest. CYA in other words. Less worry will follow you to the board meeting.

Stop worrying NOW!I am assuming that you follow hospital policy correctly.Unless you are diverting drugs, or killing your patients with lethal injections; or sexually harassing your coworkers; you are pretty much in good stead with your board. UNLESS you violate your state's Nursing Practice Act.A lot of nurses never bother to read this piece of vital information.Read it, understand it, and take it to heart. It is the legal proscription for all that you do.