Accidental Diversion - Need help!

Nurses General Nursing

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Specializes in NICU, Pediatric Urgent Care.

I've been working agency for a few weeks now and on last Thursday one of my patients had a Morphine PCA - The doctor DC'd it during the shift so I pulled it and stuck it in my pocket until I could get back to the desk to chart on the sheet (it was empty so nothing to waste).

Of course I got two or three more calls that sidetracked me before I got to chart and I forgot... So I get home that night go to take my scrubs off and there's the syringe (empty) with tubing in my pocket... I set it on the dresser so that I have it in case the hospital needs me to bring it in.

So I hear nothing all weekend and I get called in for a shift today - I go in and they ask about it. I was honest and told what happened. So they send me home to get it and now I cant find the syringe anywhere... I don't know if my girlfriends daughter or my daughter may have thrown it away thinking it was trash or what???

Is there any way that the patient's PCA records all pushes to show that the full amount of the syringe was used? What do I need to do? I'm still at the house "looking for it" although I've already been through the two bags of trash and its not there. Trash went out on Friday morning so I'm guessing they tossed it Thursday night/Friday early morning.

I've never done anything like this before... I'm not a user and would very happily take a drug test. I'm scared and don't know what to do or what to expect. I know I have to go back to the hospital in a minute and tell them I couldnt find it... but what happens next? Do I lose my license?

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If they do more than write you up, such as terminate you and notify the Board, you should seek the advice of an attorney in dealing with the Board. Otherwise, you may just be learning a very difficult lesson with this.

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Specializes in pulm/cardiology pcu, surgical onc.

I really don't know what you can expect besides a drug test. Go on in and be honest with management, I wouldn't wait too long becauses that might not look too good.

Important lesson: never put what should be wasted immediately in your pockets.

We have to have an RN co-sign in the pts EMR within 15 minutes when we start, change, AND end a PCA syringe and it is monitored. Is this not common practice?

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You need to always record an empty syringe with a witness, whether the waste is zero or 20 mls. I mistakenly thought if it was empty you just put it in the sharps without anyone looking at it when I first started taking care of pts with PCAs. Always have someone verify what's in the syringe! I don't know what to say about your missing syringe. Hindsight is 20/20 :(.

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Specializes in Emergency & Trauma/Adult ICU.

I foresee that a lesson learned the hard way will be the best that will come of this situation.

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Specializes in NICU, Pediatric Urgent Care.

Well sitting in the lab now for a drug test... Dont think im losing my license or anything... They still want me to come work my shift after the test..

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Good luck!

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Specializes in Plastics. General Surgery. ITU. Oncology.

You have my sympathy OP. This sort of thing is just awful. A colleague of mine once put a pack of 5 10ml ampoules of morphine into her pocket after pharmacy delivered them. She then got distracted and forgot all about them until the next day.

Nothing came of it other than Sister reminding her to be more careful but then I think the UK is more tolerant of mistakes than the US.

Best of luck to you and I hope you don't get into trouble.

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I am sure you have learned your lesson but you should have gotten in your car and driven it back immediately to the hospital the minute you pulled it from your pocket.

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Specializes in L&D/Postpartum/Newborn, Home Health.

Yep, for sure a lesson learned!!! You really should have called and/or returned to the hosptial immediately instead of waiting over the weekend to see if someone called you about it. BUT, you'll remember next time for sure. I wish you the best!

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I can't say anything that hasn't already been said, and have nothing new to add, but good luck! Let us know how it all turns out.

I did something similar one night as well. I dropped a Percocet on the floor so I gave the clean on to the patient and went to the med room to pull out the second one. None of my coworkers were near by, and I forgot to waste the medication.

I discovered my error when I got home. Luckily I was back the next day, so I just wasted the medication when I came in. But, that still could have landed me in hot water.

Chalk it up to experience! I'm sure you'll be fine once your urine comes back clean. The fact that they didn't suspend you is a good sign :)

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Specializes in jack of all trades.

As others have said a hard lesson learned. But in the future if anything like it should happen again. Believe me it will, it may not be the same exact situation but crap happens. I always immediately called the charge and my immediate sup soon as I discovered my error and made it well known. It may have saved you a lot of headache if you had approached it immediately. I have gone as far as driving right back to the unit to in the middle of the night to return what ever I had forgotten. I long ago had to really work at teaching myself never to put anything to do with meds in my pocket for any reason. Narc keys too lol.

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