RN job in jeopardy please help - page 4

Shell shocked. Worked last night, they called today and asked me to come in today early. Administrator there plus managers, still befuddled. I gave an Ambien to a patient at 2100, I remember pulling... Read More

  1. by   SillyLilly
    Yes!! Ive been reading your post and felt sick for you. I am so glad. I have not worked witha Pyxis much, so I couldnt really say anything about that.

    You may not get an appology ever. They were following their protocol, and probably think they dont have to apologize, though they should say something.... you went through alot of stress...

    Anyways, I am happy for you!
  2. by   LoriAlabamaRN
    What a relief! I am so glad that you were vindicated in this manner. Be careful about the rumors that have no doubt begun swirling around, it may take a while for them to die down. I would insist that my supervisor notify my coworkers of the discovery if she has not done so already...
  3. by   fe3
    I was called immediately but I had worked the night before and was sleeping. They called again and this time someone else was home to wake me because I turn my phone off and wear earplugs but by then the day was nearly over. I will be sure to check policies. They told me they already searched Pyxis thoroughly but the pharmacy apparently knew other places to look inside the Pyxis and there it was. I have been documenting everything and will from now on and always have witnesses as well. In this case, I did nothing wrong, this could have happened to anyone, the med packet apparently caught when I closed the door and somehow got stuck inside but I think rumors are swirling anyway.


    Quote from mrsalby
    Ok, Congrats on finding the med. I am glad they called you and offered somewhat of an apology, but understanding their position and policies that is how it may be done.

    Which brings me to policies. I would double check policies or manuals on hospital standing about drug discrepancy to address a few concerns. (and to CYA, in case it ever happens again)

    1) Why were you not called immediately upon the discrepancy being found. What is policy on this. Lack of timely notification, whether you are sleeping or not, shows ill faith on their part. Plenty of time for your future credibility to be torn apart by co-workers. Additionally, the call may trigger you to remember something or an accidental placement in wrong drawer etc and save EVERYBODY trouble.

    2) You should have been able to come in and assist with the search and observe counts upon the discrepancy being found and you being immediately notified. What is policy on this? Even if your were sleeping, how many of us wouldn't run in to assist. provide drug screen, search, review MAR's etc to save our license and livelihood. Also, if their search of the Pyxis was so thorough, why did parm come in and open it and wah lah there it is....You may insist on a more thorough search if you could have been there. Why wasn't pharm notified initially to come "open".

    3) Back to being notifed...if you are being investigated or questioned you should have a right to know if you are being reviewed. What is hospital policy on this. They were investigating you without notification, they should have notified you immediately and advised of your Admin leave pending the results of the investigation (CYA for them). They caused you undue stress hmmm...

    The hospital I work at does these things along with Drug screens for anybody with access to the Pyxis within so many hours. Including those that have already gone home. Once notified you have 2h to screen.

    For future for all of us...

    Upon notification, request to be present to assist with search, MAR reviews and counting. In the very least, you should be allowed to observe. If you can, contact union or lawyer to fight for your rights for this.

    We all stress and our minds may be blown but we are trained to work under these conditions... Think, my life, my license, my livelihood are under attack what do I need to do. Go into the mode you have been trained to do. only now it is to protect yourself, be your own best advocate. Insist on drug screen, insist on prescence. Insist on Pyxis inventory and access review. Review MAR's of all patients in Pyxis and patient's with need for same drug and nurse for pt.

    We have been taught...legalities...documentation, documentation. Begin your own paper trail and write down everyone you contact or who contacts you reference the situation and what they say or advise. Right down times and note time spaces. Ask when was this noticed as a discrepancy and document what the person says and ask why was I not notified sooner etc.

    Then begin a memory recall and write down everyhing you can remember in the time frame of suspected incident. Who was there, what was going on, who you had for patients, acuity level, staffing level, housekeeping, techs etc. keep reading it and reviewing and adding what this triggers for memory.

    Basically do your own "self charting" to protect yourself. In this way you will begin to feel you have some control of the situation instead of letting the situation control you. Use your critical thinking skills to approach the situation with a methodical plan to direct your focus.

    Again, I am glad you were cleared and happy safe nursing to all!
  4. by   gr8rnpjt
    Quote from purplemania
    I find it difficult to believe anyone dusted for fingerprints AND got a match in that short of time.







    Wha??????
  5. by   cjj0603
    I am so sorry this is happening to you, and angry too. Our jobs require so much of us, yet we are always vulnerable to accusations even without proof, from patients, staff and management. I wish I had more practical advice to offer but all I can say is try to hang in there. Good luck now and in the future.
  6. by   Sisukas
    Quote from CRNASOMEDAY25
    Why not just put a camera in the med room, then you wouldn't have to guess as to what happens to meds?

    I thought you were innocent until proven guilty.

    Glad they got it straightened out though.

    I see I need to pray before every shift when I graduate.

    If they put cameras in the med room, how are we going to pull up our bra straps or fix wedgies without getting seen? I can't count on always being alone in the elevator .
    Seriously. Shortly before you give report, pull up your Pyxis activity for the day. This for 2 reasons; you can review it to make sure no one pulled anything out behind you if you spaced and walked away without exiting or didn't push the exit button hard enough; and so you can double check your med sheets against the record and ensure all your prns are signed out. I have been SO guilty of giving someone pain meds and then getting called away before I could get to the med sheets. And that helps with the appearance of diverting drugs. I've never been suspected, but had to witness an LVN being investigated.
    By the way, LVNs...in CA there is no drug rehabilitation to save your license. One strike and you're out. This needs to be addressed to the LVN board.
  7. by   goingnuts
    Quote from Sisukas
    If they put cameras in the med room, how are we going to pull up our bra straps or fix wedgies without getting seen? I can't count on always being alone in the elevator .
    Seriously. Shortly before you give report, pull up your Pyxis activity for the day. This for 2 reasons; you can review it to make sure no one pulled anything out behind you if you spaced and walked away without exiting or didn't push the exit button hard enough; and so you can double check your med sheets against the record and ensure all your prns are signed out. I have been SO guilty of giving someone pain meds and then getting called away before I could get to the med sheets. And that helps with the appearance of diverting drugs. I've never been suspected, but had to witness an LVN being investigated.
    By the way, LVNs...in CA there is no drug rehabilitation to save your license. One strike and you're out. This needs to be addressed to the LVN board.
    Wow way to go CA. they must have all of the nurses they need and then some. Seriously tho how in the world can they afford to be so strict.
  8. by   TazziRN
    Quote from Sisukas
    By the way, LVNs...in CA there is no drug rehabilitation to save your license. One strike and you're out. This needs to be addressed to the LVN board.
    Not true. There is no diversion program that keeps the recovery off your license record, but there is a disciplinary process in place similar to that of RNs who go through the BON's program rather than Diversion.
  9. by   mamason
    Quote from purplemania
    I find it difficult to believe anyone dusted for fingerprints AND got a match in that short of time.
    Possibly someone who doesn't understand how the PIXIS works. Not all facilities use them. You need a fingerprint in order to access the PIXIS system. When you punch in your id number, it will ask for a fingerprint scan before you can punch in any type of drug you are trying to retrieve.
  10. by   indigo girl
    I am really happy for you that this is over. I think that we have all learned some valuable information from your experience. Just glad it turned out OK.
  11. by   LEVODEVO
    the amount of time the drawer was open will show up on the pyxsis..so if someone came in behind you and u didn;t sign out,they cud have taken the pills...but if you can prove you were away from the pyxsis while the draw was stil open...it could help...we now have cameras in the ceiling of our icu...do have them? small black half globes...they may also show who followed you after the pyxsis...get a lawyer...it's your career....u can pay after the case....don;t roll over....and yes do a drug test...one of my jobs is cardiothoracic icu...someone was stelaing viagara..it wass in a single controlled drawer...tehy sked all the males RN'S only,we threatened to sue and greieved it successfully..sure enuf it was a female RN,taking it for herself(don;t go there!)....Again you best defense,accounting of your time and drug test...even if the hospital says there is no drug test for ambien,,the drug has certain ingredients that get ped out,like most drugs do...go to your own doc and give a witnessed urine test and pay for the test...good luck......jeesh ambien...u can buy it online anytime....what clowns...
  12. by   Tweety
    Quote from fe3
    THEY FOUND THE AMBIEN. They just called me to say the Director of the Pharmacy opened up the Pyxis today and they had fallen to the back somehow. They are going to pay me for the night I had off and I have my job. I am so freaked out though I'm not sure I'll stay (for a few other reasons having nothing to do with this involving a few individuals who dislike me and nitpick me to death) but at least I'm on good terms. I didn't really get an apology though but that's ok because THEY FOUND THE AMBIEN.

    Good news!

    Good luck in whatever you do!
  13. by   Sisukas
    Quote from TazziRN
    Not true. There is no diversion program that keeps the recovery off your license record, but there is a disciplinary process in place similar to that of RNs who go through the BON's program rather than Diversion.
    Hmmm...the LVN we caught diverting meds was not given a disciplinary process. He was just plain not an LVN any more. Perhaps he diverted more than once and didn't tell us.

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