Should I back off?

Nurses General Nursing

Published

Problem:

Computer order states:

2 tabs PO Q HS

Paper MAR states the same.

The nurse that passes PM meds gives this medication, signs her name to the narcotic count sheet, but doesn't sign it on the MAR. Then when the next nurse comes on duty, she does not realize this med has been given, so gives it again. CAusing the client to receive pain medication in double the dose a few short hours apart.

This behavior has been reported 4 times that I know of, the DON has spoken to her, and the nurse in question says she is going to contact the doctor and have the order changed. (She's a rather pushy nurse who likes things her way).

As of last night, she changed the MAR to read 2 tabs at PM and HS PRN pain, and told the oncoming the order had been changed. Come this morning, order was checked and compared with computer... order not changed. Continued to read as always... 2 tabs PO Q HS

Med error written up again, and turned in.

Here's another issue. The nurse that constantly gets caught in this mess is me. I have only been at my job 2 months, and the day shift nurse does what she chooses when she chooses. I have reported this to other nurses who were training me at the time, they wrote it up as a med error, and since then, I have caught it 3 more times, the latest being this morning.

I'm afraid I'm stirring the pot, but I don't feel med errors should just be let go like this. Especially when it involves a narcotic pain medication.

Am I pushing too hard? My husband tells me to watch my back..... that I'm making enemies. But I really like my job. Should I back off and go with the flow? or continue to do what I feel is right?

I'd double check all my facts before calling this a big med error, because condition supercedes time. So what if the patient wanted to go to bed at 5pm.

That's a good idea, but he doesn't. Last night he was up well past midnight.

Since this is a habit of hers that you know about because you have been burned by it, I would make it your habit to check to see if there is any evidence of her having given the med before you give it in the future. The first clue would be that you come to work and find out that she worked that assignment. But you still need to follow up on this. If the doctor wants a different order, fine, but if the doctor refuses to modify the order, then something needs to be done about this situation.

THAT'S what I'm talking about! She does what she wants, with no regard to what is told her.... we just got a new admin, so I'll hang around a bit longer just to see. But if it doesn't change, I will be job hunting within the next few months...

I do not know that I would job hunt just because of the actions/non-actions of one wayward nurse. You can take steps to prevent getting caught up in her misdeeds. Another job might land you in a stew of a far worse nature.

Thank you all for your wise words.... I just feel that this place has the potential to be a good place to work, but things have to be straightened out one thing at a time.... and this is one of the worst problems....

Just wasn't sure what to do. But now you have all given insight and helped me to realize some steps I must take.

And I will definitely be checking the computer orders against the MAR before I begin medpass......

Thanks again everyone!

i dont know why, but this seems fishy to me.. Does she (or he?) do this with other types of medications too.. or just narcs? I agree with someone else and would consider the issue of diversion.. I just dont get why she would choose to give a med on her shift when its not due? And then she never signs the mar? and he or she has the "i do what i want attitude?"...its odd.. and suspicious.

i dont know why, but this seems fishy to me.. Does she (or he?) do this with other types of medications too.. or just narcs? I agree with someone else and would consider the issue of diversion.. I just dont get why she would choose to give a med on her shift when its not due? And then she never signs the mar? and he or she has the "i do what i want attitude?"...its odd.. and suspicious.

I also agree with this post. All the makings of a classic diversion scenario.

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