bad mistake... how do i move on? - Page 4

We ALL make mistakes, some big, some small.
What I am concerned about is the pocketing of the syringe. Once you use it, you really must throw it out. What if someone assumed you were going to use the dregs of it for yourself? Morphine is a serious drug. I think that behaviour needs to be corrected, it will also stop the chance of this happening again.
Good luck!

Good point. And offering to take a UDS won't automatically clear your name because they can assume you're going to sell/trade/give it to someone else. And that happens quite frequently in the world of diversion.

You know, there are some threads that I think only ED nurses should speak up in. This is one of them. You'll still get a variety of opinions, even among ED nurses, regarding when and how to waste, and I respect that, but if you haven't worked in the ED environment, there are some things that can be hard to understand.

I'm surprised that health care legislation in the US has allowed the practice of keeping narcotic syringes in pockets to even develop.

In Australia the narcotics are kept in a locked cupboard, which is only opened in the presence of two registered nurses. The total amount in the cupboard of the drug you are dispensing is counted by the two RNs and the count is recorded pre and post dispensing the prescription required. This, as well as the patient, prescriber and dose being administered is all recorded in a ledger that is checked once per shift by two RNs against the actual counts of drugs in the locked cupboard.

Doses discarded are also recorded and two RNs go to the bedside to dispense the narcotic to the patient.

What are the rules regarding the safe keeping and dispensing of narcotic drugs in the US?

My hospital is generally pretty low tech, so I imagine what we do is pretty common.

We have a Pyxis machine, where you have to enter the patient's information before accessing any drug. You can only access the drug you enter. For anything addictive (narcotics, benzos) or really expensive, you must count the number of pills/vials already in the slot and enter it on the computer before proceeding. If your count doesn't match what is in there, an alert is sent to our management. When you waste, you need a witness. If you don't waste and don't give the full amount (documented in MAR), management knows somehow. Also, our Pyxis is connected to the electronic charting system so anything you pull for a patient will show up on the MAR. When we switched to this new system there were apparently a lot of terminations for diversion from people who were pulling narcotics on other people's patients.

My hospital is so busy and we give so many controlled drugs in the ER I can't imagine finding another RN to sign out the drug and give it with me. I have enough trouble finding someone to waste with me or verify insulin.

Did you learn from your mistake? I'd say so. You will be a great nurse. Be thankful this wasn't a fatal mistake to learn from.

Don't keep syringes of anything on you. I don't care what the department is "ok" with. I'm sure there are other nurses that don't do this. If JCAHO was in your department, your bosses butt would be in serious trouble.

Also, key importance is that you did NOT give anyone hep C.

Well i guess you learn your lesson my friend! Always remember this it does not matter how busy you are do things right check pt name and dob. check the med is it the right med. i know the feeling the charge nurse on top of you because that's what they do to look busy as if they are working etc. just stop for a second THINK then DO they can fire you for been a slow ER NURSE but no body can take your license for been slow. now for killing someone or any other big mistake you may lose your more precious thing you license ok, good luck dale duro!