[VegRN]

I would like to know what you all think about this issue.

I have been a nurse for 5 years, on one of my shifts, a pt requested pain medication. I brought 4 tabs in the room and the pt stated they wanted only 3. I put the other in my uniform pocket and intended to return it. Well, every time I had did have time to return it, I couldn't find another nurse to verify the return. And then at the end of my shift I was bombarded with things that I needed to take care of. To make a long story short, I forgot to return the narcotic tab. It was left in my uniform at the hospital during my off days and I discovered it on return.

The manager informed me that it was a huge deal that this had happened and I needed to do x, y, and z (paperwork). I did what she told me to do and apologized and also explained that it was not intentional and that I will try to be more conscious in the future.

I honestly don't think this was a big deal, it was an isolated incident and I have a good work record. I got busy, forgot to return it and I came forward and made it right. Other nurses that I have talked to seem divided about it. Some think it was a serious issue. Others don't think it was a big deal.

What do you think?

[student456]

did you chart that you gave 2 tabs or 1? If you charted that you gave 2 and you didnt then yes its a big deal. I think that it was a serious issue anyway and isnt there a legal issue of carrying narcotics in your pocket that belong to pts? At least you came forward and admitted your mistake. You probably wont make the same one again. Think of it as a learning experience

[VegRN]

I charted the proper amount that I ended up giving to a pt. I did not chart more than the pt actually took.
Also, I work in a psych lockdown unit so leaving meds at the bedside is also a serious issue. I always thought the answer was to put them in my pocket but I guess that is now out.
Thanks for your input.

[KellieNurse06]

Oh geez......your supervisor is getting bent out of shape over one pill??????? And you found the pill, right??? Good grief.......there are more important things to worry about for pete's sake! It's not like there were several missing........I could see if there were a few missing or it happened other times as well.....but that's just nuts! And you came forward with it as well......geez God forbid! Your honesty alone is commendable.......
I don't know the policy at your facility regarding what happened but it seems like she made a mountain out of a mole hill.......she needs to worry about more important things...... Maybe I am too laid back, but that's just nuts!
I would also (if it were me) ask for a blood test/urine spec right then & there ...that would nip it in the bud for anyone who is questioning you .....but that's just me.... I am sure everything will be fine..don't get too worked up with worry.....

[VegRN]

Thanks Kelli
I guess I just don't understand what the big deal is. Maybe someone can enlighten me on what management is thinking. I didn't mischart anything, all narc's were accounted for. I had absolutely no intent to do anything wrong, I just forgot to return it and I noticed before anyone came knocking on my door to question anything.

[canoehead]

I don't think anyone is accusing you of trying to do anything wrong. The big deal part comes in because regulations weren't followed. The regulatory groups that keep track of controlled meds are very very strict, and the hospital in turn has to be very strict to maintain compliance. Now they have to cover their butts, and yours, in order to maintain licensure. Just go along with it.

If I have to waste a med I take a patient sticker and stick it to the side of the Pyxis. I work alone at night so I have to wait until shift change to waste. If the med is stuck there someone is sure to notice it before hand off is over.

[morte]

Originally Posted by canoehead

I don't think anyone is accusing you of trying to do anything wrong. The big deal part comes in because regulations weren't followed. The regulatory groups that keep track of controlled meds are very very strict, and the hospital in turn has to be very strict to maintain compliance. Now they have to cover their butts, and yours, in order to maintain licensure. Just go along with it.

If I have to waste a med I take a patient sticker and stick it to the side of the Pyxis. I work alone at night so I have to wait until shift change to waste. If the med is stuck there someone is sure to notice it before hand off is over.

but you cant do this wth a narc, it wouldnt be under double locks....
i think the answer to the op is to ask the patient before you pull the med...

[jjjoy]

There are those managers who treat potential big deals as if they already were big deals. For example, accidentally forgetting to return a narc on a regular basis IS a very big deal. Forgetting once is just human, in my opinion. There's also the case where even if that particular case isn't a big deal, the requirements for dealing with it are burdensome and time-consuming and the manager is being pressured from above to (become god-like and) "make sure it never happens again!" So they make a big deal about it.

Where I work, our supervisors treat one incident of clocking in one minute late from lunch as if one were more like a hour late! They give this VERY SERIOUS look and say in a VERY SERIOUS tone "You NEED to clock in ON TIME, EVERY time." Even after I'm the one who admits my mistake to them before they find out (I make this mistake two or three times a year). I wonder how they act for actual serious breaches of policy... glad I don't know!

[jill48]

I'm sure it was innocent, and it sounds like your nurse manager thinks so too. But this is why you should never pocket any narcs. I know, I've done it too. But it just gives people reason to suspect other things. And I'm sure we all have those types of people floating around that are looking for us to make a mistake. No big deal now, just learn from it. Good luck.

[jjjoy]

Originally Posted by jill48

No big deal now, just learn from it.

I'm not trying to be argumentative; I'm sincerely curious what people mean when they "learn from this" in regard to something that was an honest mistake, that you know what went wrong, and that's very unlikely to happen again (as in this case where it was the first time in 5 years she'd done that). This type of statement can makes me feel defensive because I feel like it's saying I made that mistake because I didn't know something and now I do. But in a case like this, the person doesn't have any new information except knowing that every now and then they miss something important. It's good to know that and be aware of one's strengths and weakness. Is that what one means by "learn from it"? Or do they mean it more literally, like "learn never to accidentally take narcs home"? which I'd assume most would already know.

In this case, the OP could learn to never take extra narcs out "just in case" or to always check with the patient first... which she probably would've done anyway in an ideal environment. However, perhaps the CNA just reported that the patient requested pain meds, the med room is right there and the patient is at the far end of the hallway. To go check on the patient first will not only take more time (and who has extra of that?) but will allow more opportunity for the nurse to be interrupted and distracted and may lead to a significantly greater delay in the patient receiving the meds. I can imagine if a patient complained about not getting their requested pain meds for 20 minutes because the nurse got sidelined into dealing with another important situation and being told she should've found a way to get the pain med to the patient faster. It can feel like 'damned if you do and damned if you don't.'

In this type of case, what I learn from it is that no one is perfect and that I can't do everything perfectly all the time, even if it seems that that's what's being asked of me.

That even if I do the responsible thing and immediately 'fess up, I may not get any recognition for that and just get lectured about what I did wrong (as if I didn't know it despite my having volunteered my mistake).

That I have to look at the bigger picture (this is the first time in 5 years and no other history of similar mistakes?) and even if my supervisor is giving me a hard time and making me feel incompetent and irresponsible, that I can know in my heart that I've reviewed the situation, recognize the problem and won't do it again - at least not for another 5 years when the 'perfect storm' arises and my fallibility shows itself.