Two Narc Discrepancies, One Night

[Meeperz]

Okay, so I have been an RN on a busy telemetry floor in for exactly 10 months and 7 days after starting there as a new graduate. During that time, I have seen four different nurse managers and just about every kind of patient imaginable. However, this most recent manager has it out for me. She has nitpicked about everything I have done. Unfortunately, she dropped in my inbox last night two narc discrepancy write-ups from one night.

One, was I am more than willing to admit I didn't document the waste on because I was unaware that it was considered a narcotic (10mL of pink lady). The other (0.5 mg of dilaudid) I could've sworn I got a witness to document with me as my patient was getting around the clock down to the minute, but I think it may have been a new hire who may not have charted the waste correctly. Anyway, I have been crying nonstop. I love my job despite the craziness I have endured, but this manager seriously hates me, as she told me when I first met her that she, "Doesn't believe anyone inexperienced should be allowed near this floor."

I guess my question is what should I do and what should I expect to happen? I told them on the paperwork I would gladly submit to a drug screen to resolve this as I have nothing to hide. Please help, I haven't eaten or slept for quite some time now and I am tired of crying.

[jadelpn, LPN, EMT-B]

The machine in which you take out the narcotic should have a record of exactly what occurred. Additionally, most medication areas have cameras, and it would be easy to see that you wasted, and that you had a witness.

Do you have a union? If so, call a delegate. Do you have Liability Insurance? If so, contact them (if not, get it for your future).

There are any number of drugs that are nicknamed pink lady, so not sure what you mean. If you are saying a GI cocktail, count me as one who didn't realize it was controlled (some use benedryl in it----I dunno that was not controlled as I recall) Also, some barbituates have that nick name (and yes, those are controlled)...so as far as that goes, I don't know.

Bottom line--this needs to be resolved, and going forward, make sure that you are wasting a-z together with someone, and that all of the documentation is correct and complete. Do not expect another nurse to waste a non-existent waste with you, so be sure that you are pulling showing wasting....all in the med room, all with a witness and that you are then going to the pyxsis and completing. And get a list of what is considered a high risk kind of a drug beyond the "usual" in your facility.

Protect yourself now and going forward. Speak to a delegate. Speak to your malpractice insurance.

[Meeperz]

Thank you for replying. Yes, I do have malpractice insurance. I will reach out to them. I really had no clue that pink lady or any GI cocktail was controlled. I remember at the time Googling the ingredients just to be certain and no website mentioned phenobarbital as an ingredient. As far as the dilaudid goes, I walked her through it verbally so I thought she'd gotten it right. Sadly, as soon as her orientation was up she stopped coming in for her shifts so I don't even have her to vouch for me...

[jadelpn, LPN, EMT-B]

I have never heard of phenobarbital being used in a GI cocktail, either. Sure it is not phenegran?

In any event, the machine can ask for a witness. And usually GI cocktails are unit dosed. And the camera is your BFF as far as proving or disproving anything.

And wastes on your medication dispensing machine ask for a fingerprint (or a code) and just a few buttons to push. Which if the nurse somehow messed that up, there would be a record of that, as well as the camera that showed you were wasting.

Your malpractice insurance should be very helpful to you in this.

[applesxoranges, BSN, RN]

I have never heard of the "pink lady." I have heard of GI cocktails but our mixture isn't controlled. Ours are greenish though. I know it has lidocaine, maalox, and some other drug I can't remember right now.

[Pat_Pat RN]

I have never heard of the "pink lady." I have heard of GI cocktails but our mixture isn't controlled. Ours are greenish though. I know it has lidocaine, maalox, and some other drug I can't remember right now.

Donnatal?

[SleeepyRN]

I've gotta know. What is pink lady?

[NurseStorm, BSN, RN]

Here in Canada it is a small drink used for GERD/heartburn, containing xylocaine (or lidocaine) and diovol. Neither controlled.. Don't know what OP's contained.. didn't you have to mix it up therefore should know what was in it? lol

[Been there,done that, ASN, RN]

Thank you for replying. Yes, I do have malpractice insurance. I will reach out to them. I really had no clue that pink lady or any GI cocktail was controlled. I remember at the time Googling the ingredients just to be certain and no website mentioned phenobarbital as an ingredient. As far as the dilaudid goes, I walked her through it verbally so I thought she'd gotten it right. Sadly, as soon as her orientation was up she stopped coming in for her shifts so I don't even have her to vouch for me...

Management cannot throw you under this bus alone, they must contact the nurse you wasted with, whether or not she is still employed.

As far as the pink lady.. were you required to sign it out? If not, then it's not controlled in your facility.

New nurse manager is power tripping, stop crying and deal with power tripping #4 manager.

In the future, do not Google anything. Any source you find is not pertinent to your facility's policies and procedures. In this case , you should have consulted pharmacy.. not the world wide web.

[teleRN0515]

Pharmacy premixes ours. It is included in our narc count for some reason... ??

[Guest219794]

Pharmacy premixes ours. It is included in our narc count for some reason... ??

This and the OP confuse me.

Do a lot of nurses give meds without knowing what they are?

Pink Lady? How can you safely give anything if you don't know what it is?

[AgentBeast, BSN, RN]

Maalox (Or whatever antacid) and Lidocaine aren't controlled substances.