Pt family pocket narcotic

  1. Pt (non verbal and cannot write) with chronic bilateral knee pain. Takes norco at home.

    When in the hospital, RN brought norco to pt's room but left with medication on the table top. Pt's son pocketed the medication. Son states that he gave it to the father already. RN insist on retrieving the medication wrapper to scan. RN found that the son has pocketed the medication. Son states that he gave the pt home norco instead. When asked for the home medication bottle, son said he only had that one dose.

    RN notify care team that pt's son will pocket medication. RN cannot verify whether pt has taken home medication. PT is quiet and not reporting pain anymore. Should the MD be called? What should the next step be?
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  2. 19 Comments

  3. by   dishes
    The nurse is responsible for the administration of the medication and needs to complete an incident report for leaving the medication at the bedside.
  4. by   applewhitern
    WOW. Never leave meds sitting at the bedside, especially narcotics. I don't leave the room until I have seen the patient swallow the pills.
  5. by   Been there,done that
    The next step would be to write yourself up. You did not follow medication administration protocol.
  6. by   Purple_roses
    I never let narcotics leave my sight. I put the rest of the patient's meds in my pocket, but hold the narc in my hand as a reminder that that tiny little pill can cause a WORLD of trouble for me if it isn't handled exactly according to protocol.

    I would think an incident report would be the next step. I don't think whoever did this would get into *too* much trouble seeing as the narc was retrieved and therefore this wouldn't become a diversion issue, but the patient safety issue might be trouble.
  7. by   Guy in Babyland
    Quote from pikachu715
    Pt (non verbal and cannot write) with chronic bilateral knee pain. Takes norco at home.

    When in the hospital, RN brought norco to pt's room but left with medication on the table top. Pt's son pocketed the medication.Son states that he gave it to the father already. RN insist on retrieving the medication wrapper to scan. RN found that the son has pocketed the medication. Son states that he gave the pt home norco instead. When asked for the home medication bottle, son said he only had that one dose.

    RN notify care team that pt's son will pocket medication. RN cannot verify whether pt has taken home medication. PT is quiet and not reporting pain anymore. Should the MD be called? What should the next step be?
    Why do both of your threads read like a homework question? Using the word "RN" instead of "I" is third person which appears to be copied from a textbook.
    Last edit by Guy in Babyland on Jun 18
  8. by   hppygr8ful
    Quote from pikachu715
    Pt (non verbal and cannot write) with chronic bilateral knee pain. Takes norco at home.

    When in the hospital, RN brought norco to pt's room but left with medication on the table top. Pt's son pocketed the medication. Son states that he gave it to the father already. RN insist on retrieving the medication wrapper to scan. RN found that the son has pocketed the medication. Son states that he gave the pt home norco instead. When asked for the home medication bottle, son said he only had that one dose.

    RN notify care team that pt's son will pocket medication. RN cannot verify whether pt has taken home medication. PT is quiet and not reporting pain anymore. Should the MD be called? What should the next step be?
    It is a huge policy violation in every facility I have worked to leave any medicine at the bedside. My last employer fired someone for that.

    Was the med PRN and if patient is resting peacefully, no grimace or restlessness to indicate being in pain why give it in the first place unless it's routine.

    Hppy
  9. by   smf0903
    As the others have stated, an incident report for leaving the med without witnessing the patient actually taking it would be one of the steps after the incident.

    Secondly, I would make sure a meeting happened with the family, myself (as the primary RN), and a supervisor. Home medications brought to the hospital are locked in our facility, and narcs brought by pt/family are counted with 2 RNs and the pt and a form signed by all three with the count.

    In my opinion, this is a one-strike-you're-out deal: the patient would have a sitter (because the family cannot be trusted to not medicate patient on their own and how are we to tell otherwise). This is one of those things that is high on my tick-me-off list---patients or families who manipulate meds (OTC, prescription, or street meds) while under our care and OUR responsibility. I have zero tolerance for it.
  10. by   Ben_Dover
    That's an accusation! Nurse Fail!
  11. by   chacha82
    You can't leave a narc at the bedside. You can't leave ANY medication at the bedside. I've had patients be on the phone when I came in with meds and just point to the table. I always say, "I'm sorry, please don't be offended, but I have to make sure you take these."
  12. by   kbrn2002
    If you're honest about at this work as you have been here you should report yourself. You'd have to in order to address the son pocketing the med. You should expect at minimum a write up for leaving meds at bedside. Never leave any meds at bedside. Never, never let any narc out of your sight.
  13. by   Kooky Korky
    Quote from pikachu715
    Pt (non verbal and cannot write) with chronic bilateral knee pain. Takes norco at home.

    When in the hospital, RN brought norco to pt's room but left with medication on the table top. Pt's son pocketed the medication. Son states that he gave it to the father already. RN insist on retrieving the medication wrapper to scan. RN found that the son has pocketed the medication. Son states that he gave the pt home norco instead. When asked for the home medication bottle, son said he only had that one dose.

    RN notify care team that pt's son will pocket medication. RN cannot verify whether pt has taken home medication. PT is quiet and not reporting pain anymore. Should the MD be called? What should the next step be?
    The concern here is the patient's safety and well-being. Consult by Social Services, perhaps involve police with the son. That might be too hard on the father (to get his son arrested, locked up).
    Let MD know that his patient's family is stealing his pain Rx because the pt needs a better/different place to live, and/or the son must be banned from being around the pt's meds and he also needs a referral to Rehab. Or is he selling the stuff? What a screwed up world!

    What became of the RN? What does DON have to say? Administrator?
  14. by   VegGal
    Quote from pikachu715
    .... When in the hospital, RN brought norco to pt's room but left with medication on the table top. Pt's son pocketed the medication. Son states that he gave it to the father already. RN insist on retrieving the medication wrapper to scan. RN found that the son has pocketed the medication. Son states that he gave the pt home norco instead. When asked for the home medication bottle, son said he only had that one dose.

    RN notify care team that pt's son will pocket medication. RN cannot verify whether pt has taken home medication. PT is quiet and not reporting pain anymore. Should the MD be called? What should the next step be?
    Why did the RN leave the meds with the patient ? The RN's job is to watch the patient take their meds, not leave it with the patient, or the family. That's a classic example of why families should not be trusted with a patient's meds.

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