It  is an error.  No different than telling a diabetic that it is OK to eat
that box of candy!  Giving someone something to eat that is contraindicated
could certainly be considered a med error.  But I think you are going to
have a hard time proving that formula is such a tainted substance, when 1/2
the babies in the nursery are routinely fed that way :-(  I think you need
to approach these situations as  incident reports. Failure or neglect to do
the correct procedure with a patient.  You need to inform the whole staff
that such errors will be treated as much in the future.ie: written up as an
incident report.

Unfortunately I think you are in a no win situation.  "You have the cart
before the horse".  In other words, she has to know there is a rule,
procedure etc first. Then you can say she violated it.  Because this wasn't
done in the first place (promulgating the procedures and warning the whole
staff) it looks like you are picking on one particular person.

Inservices are intended to educate staff.  They aren't saying this is the
way it will be done and if you don't, you will be written up.  You and the
director need to come to an agreement about how such situations will be
handled.  First, you need a written procedure to be followed.  Then  if the
nurse violates, neglects or countermands this procedure you have grounds for
saying what you did.

Years ago (like almost 20) I used to threaten people with an incident report
if mom separated from baby didn't begin to use a pump within 12 hours of
birth.  But we had a written procedure of what to do when mom and baby are
separated.

I think you need a mediator to get out of this one, if you don't have
written procedures in place.  If you do have procedures in place, then you
go girl!  Pat in SNJ

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