Need Advice... Nurse stealing non-narcotic medication

  1. 4 I am a new nurse and I am not sure exactly what to do regarding this issue. I am about 4 weeks into my first job as an RN and yesterday my preceptor asked me to see if any of my patients had PO Zofran. I asked why and she said that one of the nurses was feeling nauseous. She stated that the nurse she was asking for had asked for PO Phenergan but that she felt better giving her Zofran. I replied by saying "no, none of my patients have PO Zofran". I'm sure I had a funny expression on my face because she followed up with the fact that she frequently took medication like Mucinex or any over the counter medication from patients, reasoning with me by saying "you can get them from the store. So it's okay." And I responded by saying "you can't get Zofran from the store and even if you could the patients are still having to pay for the medication that you're taking from them."

    I'm at a loss and I can't get this off my mind. I feel like taking any medication out of the pixis under a patients name is stealing from that patient. I've already had issues with this preceptor and next week I'm going to finish my orientation with another nurse. (This preceptor frequently leaves the floor to talk on other floors or to go outside and smoke. There was one instance when a patient was going into ARF and we had to call a rapid response. She was outside smoking and wouldn't answer her phone when called. Another instance just recently was that one of my patients was having chest pain and I was having to make all of the decisions and call the doctors all by myself. Being new and never having to deal with those things alone are VERY SCARY!)

    Anyways... I know what the rules are regarding a nurse stealing/diverting narcotics from a patient. But I don't know what the rules are if it's non-narcotic medication. Also, I did not see this nurse take anything. It was merely a conversation. I don't want to cause a stink over this since I've already had issues with this nurse. But, I just can't get it off my mind. Is this something that I should take to my manager. Or is it something I should file an anonymous incident report over? Or should I just ignore it all together? I don't know what to do and if she does end up in trouble she's going to know it was me that ratted her out. Any advice?
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  3. Visit  JSSCELI profile page

    About JSSCELI

    From 'US'; Joined Sep '13; Posts: 1; Likes: 4.

    105 Comments so far...

  4. Visit  kp1987 profile page
    0
    Report her!
  5. Visit  LadyFree28 profile page
    11
    Since you did not see her take the medication, unfortunately you have no proof to report her; if reported, she may pass the suspicion to YOU.

    I think you handled the situation appropriately from the conversation. At this point, unless you have proof, is best to continue with another preceptor and keep honing your nursing practice; you know what to do...and you have an idea on how to handle the gray areas of nursing from this experience; pick your battles.
  6. Visit  jadelpn profile page
    1
    You made the right call here. You knew that asking you to take anything out of the pxysis was wrong if it was not directly for your patient. Additionally, machines like a pxysis track your medication. So if there's no documentation to back up why you took the zofran out, then that could cause an issue.

    Unfortunetely, it is a he said/she said as you can not "prove" that the conversation ever took place. Ultimately, you did the correct thing. In the future, be really mindful of logging out of the pxysis each and every tiime. Be really mindful of wastes and you should NOT co-sign on a waste you do not actually witness. And for now, I also not be the first to witness an over-ride.

    Seems like this nurse is feeling you out to see if you--being new--would take medications out under your name for uses not for a patient. And that stinks, as you are trying to learn, and don't need the drama, nor to be put in a bind over this.

    At the same time, to cover yourself, and any potential issues down the road, I would have a conversation with someone about this. For informational purposes only. NOT that you are looking to "get anyone in trouble", but to avoid your own trouble. Maybe that person is your union rep, who can take it from there. Maybe that person is the pharmacist. Maybe the risk management person.
    OR ask to have a meeting with your NM regarding how you are doing in your orientation, what you should focus on with your new preceptor, and just generally mention that you are curious what the policy is on being asked to obtain non-narcotic medication for employee use ie: Tylenol, Ibuprofen, etc.

    If you don't feel comfortable doing any of that, then there should be an ethics hotline that is part of your parent company. You can go that route as opposed to an incident report.
    mcmgal likes this.
  7. Visit  classicdame profile page
    7
    in my state if you fail to report you have culpabibity. The BON expects you to protect the public. How can she work??
  8. Visit  sapphire18 profile page
    4
    Quote from classicdame
    in my state if you fail to report you have culpabibity. The BON expects you to protect the public. How can she work??
    Report what? It's a matter of stealing, whether from the pt or the hospital. Zofran is not going to impair you cognitively, although its true that it is not an over the counter medication. I don't see why the BON would care about this, though.
    psu_213, KelRN215, youngheartoldhead, and 1 other like this.
  9. Visit  VANurse2010 profile page
    8
    Personally, I would stay out of it UNLESS you catch her red handed with electronic documentation (such as from the dispensing cabinet) that backs you up. You are not going to get anywhere with a she said/she said.
    WeepingAngel, psu_213, Sammie7, and 5 others like this.
  10. Visit  Caffeine_IV profile page
    1
    I would just make sure I'm logged out when done and don't leave meds out. I don't think that just because someone would take a mucinex or zofran that they would divert narcs but still be cautious.

    I also agree it could be a set up to feel you out or get you in trouble.

    It is stealing just like taking kerlix, abd pads or other supplies from the unit.
    lamazeteacher likes this.
  11. Visit  nursejami profile page
    9
    I think you hit the nail on the head that the patient is probably being charged for the medication. THAT is the biggest issue here, to me.
  12. Visit  xoemmylouox profile page
    2
    Quote from Lil'mama
    I would just make sure I'm logged out when done and don't leave meds out. I don't think that just because someone would take a mucinex or zofran that they would divert narcs but still be cautious.

    I also agree it could be a set up to feel you out or get you in trouble.

    It is stealing just like taking kerlix, abd pads or other supplies from the unit.
    This I think is worse. The patient is paying for the medication the nurse is taking. They trust us to charge them correctly. When you steal supplies it is from your employer - Still wrong, but to me it's different. To the OP ensure you sign out of the pixis as soon as you are done.
    sharpeimom and VivaLasViejas like this.
  13. Visit  Caribbean Character profile page
    3
    I would report her. This is still redirecting meds even if they are otc. Still a violation.
    sharpeimom, poppycat, and llg like this.
  14. Visit  applewhitern profile page
    8
    The patient is only charged with whatever medication that you documented was actually given to them. Just because it is in their med drawer, pyxis, or somehow available for them, does not mean they are charged for it. They can only be charged with what was actually administered to them, otherwise, that would be fraud. (This is not to condone stealing, but it is stealing from the facility, not the patient.)
    psu_213, Iseeyou_RN, KelRN215, and 5 others like this.
  15. Visit  MedChica profile page
    2
    Oh, wow. We divert non-narcs at my facility. None belonging to the residents but the facility? Yeah.

    What do we give? Tylenol 325mg and 500mg. Ibuprofen 200 mg. Allegra 160 mg. Vit A and C. Ointments like theragesic, vaseline, Eucerin and A/D. Those clear eye drops, as well.
    It'll usually be the pain meds. Sparingly. About 3-4 times a month, I'd say. An aide or housekeeping or dietary or office worker will come around with a headache, allergy flare-ups or feeling generally 'under the weather'. We medicate.
    If a nurse has 'the crud', they'll just ask the med aide for some OTC (as we don't keep anything but PRN narcs on our carts).
    It's been awhile but when the pollen and ragweed levels rise? I've popped an Allegra or two, myself.

    Until I read the responses on this thread, I didn't actually consider it 'Fraud, Waste and Abuse' because it's seen as 'not a big deal' when anyone does it. When I worked the Med Aide cart as a GVN, I was instructed to give this or that coworker Tylenol and such by my nurse/preceptor. The charge saw. They do it, too! I suppose it's all 'fraud, waste abuse' when you look at it...but different specialties just have different liberties when it comes to these things? I'll raise the issue when I go back to work, though.

    I'd never pull the pt's meds for personal use, though.
    pigletrn2009 and Fiona59 like this.


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