RN job in jeopardy please help

[fe3]

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 them out, snapping one off, shutting the drawer. Apparently the rest of the pack is missing now, drawer is empty. We have the Pyxis system with fingerprints, they say I was the last one to access, no other nurse, no techs, they've searched everywhere, floor, trash, shredder.

They were nice about it but I'm placed on leave and they're "going to call me" it's implied that if the 8 Ambien don't turn up I'm fired. I would think someone diverting meds wouldn't pull out all the meds, leave the drawer empty and carry them around for the whole shift and expect to come back the next night. But since I don't have any answers for them and the drugs aren't able to be found, I see their point. What can I do or say? I have no idea on earth what happened, I've worked there several years and I've never had a problem, this is my first nursing job.

I'm scared not only will I get fire I'll lose my license, what should I do?

[TazziRN, RN]

Did you insist on a drug screen? If not, you should have one done first thing in the morning.

[ann945n, RN]

Agreed, get a drug test, fight to protect yourself

[UM Review RN, ASN, RN]

I've heard of meds getting lost inside the machine itself. However, you said that you know the package was returned.

Did they check the Pyxis for any returned meds, by chance? I find it quite hard to believe that you were the last person in the Pyxis at 2100, don't you?

[gladtobeOB]

Fe3

Sorry to hear of this. Yes you may have been the last to remove Ambien from the Pyxis but you certainly was not the last person to use the PYXIS. Anyone could have accessed that same drawer and removed their desired medication for their pt and then removed the ambien. Just think about it or was ambien the only medication found in that particular drawer. Good luck and keep your chin up.

[caroladybelle, BSN, RN]

Did you insist on a drug screen? If not, you should have one done first thing in the morning.

That really does not help the OP much. Even if s/he tests clean, she still could be diverting for another/for sale.

I find it difficult to believe that NO ONE needed a sleeping pill after 2100.

[meownsmile, BSN, RN]

Did you exit your screen after you pulled the other med? If you didnt anyone could have come up behind you, pulled meds and it would be signed out on your pass. I think id be wanting to see that printout. They can run a printout of all pyxis actions for the eveing. I would want to see if there was a inventory run after you signed out the med.

[TazziRN, RN]

Fe3

Sorry to hear of this. Yes you may have been the last to remove Ambien from the Pyxis but you certainly was not the last person to use the PYXIS. Anyone could have accessed that same drawer and removed their desired medication for their pt and then removed the ambien. Just think about it or was ambien the only medication found in that particular drawer. Good luck and keep your chin up.

Hmm? Isn't Ambien controlled? I don't know, I don't deal with sleeping pills in the ER.

(A drug screen) really does not help the OP much. Even if s/he tests clean, she still could be diverting for another/for sale.

Actually it would, because it shows a willingness to fight for her job. And I have known addicts to divert for sale, but never for another nurse.

[caroladybelle, BSN, RN]

Actually it would, because it shows a willingness to fight for her job. And I have known addicts to divert for sale, but never for another nurse.

Not necessarily another nurse, but another person - loved one/friend. And yes I have known nurses to divert for companions.

Yes, it shows a willingness to fight for her job, but many times when a large number of pills are missing (instead of a scant one or two), the worry is more with dealing/diverting, rather than personal use.

And in this case, the administrative worry seems more with the facility covering their rear end, not trying to save a nurse. I have known numerous cases of small or large amounts coming up missing, and generally they do not suspend someone, without a positive drug screen/proof. Meaning that she could drug screen crystal clear, with it not helping her case.

(I speak from experience - I once was the last code prior to 25 narcotic tabs coming up missing - as a traveler. The manager questioned me, but did not suspend me, and actually extended my contract later on. I offered a drug screen, but she said that it was moot, that number of pills is usually more a theft issue than an abuse issue. And that I had shown myself to be impeccably trustworthy. On the other hand, I have had managers that would do a freak out if a reliable nurse appeared to have financial problems/be a little stressed, and any of her patient's had slightly higher narc use. A lot depends on the manager, the administrative climate, the rep of the nurse involved and the overall circumstances. Some are looking for reasons to harass nurses, and some assess the full evidence before taking action)

[fe3]

To answer some of your questions: I work in a specialty unit, not many patients are prescribed Ambien, maybe 5% -10% of our patients on any given night.

I do remember counting the tabs, putting the number in, snapping one off. I do not specifically remember putting them back or shutting the door, however I took other meds out at that same time for several patients so it's all a blur plus that was a very busy time of the evening. They told me they did search inside the machine itself, apparently this was all done today when I was sleeping.

I am willing to do a drug screen if that helps, they didn't ask and it didn't occur to me to offer. I got the idea that they seemed to assume I'd misplaced it rather than stolen it, they did a lot of searching around the unit, Pyxis, trashcan, shredder - but I can't imagine I would take out a whole sheet of tabs and not put them back.

Yes, the drawer has many narcotics in it but just a triangle is open the drawer seems to spin around inside and only show a large pocket shaped like a triangle pocket for the meds. However the cover can be lifted and all the meds in the pockets counted, we do that with the charge nurse when there is a discrepancy. It looks like a clock or a pie shape with twelve or so pockets. I've counted meds and put them back hundreds of times in those drawers and only once did I close the drawer with the meds still in my hand and noticed right away and had to reopen and place them back in. Where would I have put them? Or could someone else could have taken them somehow? Did they fall on the floor and another nurse or patient took them? I worked with four other RNs, two CNAs and one LPN last night and I can't imagine any of them taking my meds, I know and trust them all. One of our new day shift RNs was still there though, charting late, so that's 8 potential people I guess, I don't know her at all. Our Pyxis is in the nurse's station but the station is open to traffic and the hallway just a few feet away - and 2100 is a very busy time at the Pyxis and it's our only one on the floor. This is driving me insane.

[LoriAlabamaRN]

I am so sorry to hear what you are going through!

About two years ago, we had a situation where thirteen Percs went missing, turns out (after an exhaustive search) that they were accidentally thrown in the trash, the nurse in question actually pawed through the garbage until she found the bag from the nurse's station and there they were. So many things can happen when we try to do fifty things at once...

[BSNtobe2009]

I'm not a nurse, so I have no idea of how those machines work, but I was just sick at reading your post. I can't imagine what you are going through, because there is nothing worse than being accused of something serious at work and not be able to prove your innocence.

How long have you worked there? If there is any time for them to use discretion it's now.