Content That rnccf2007 Likes

Content That rnccf2007 Likes

rnccf2007 2,976 Views

Joined Jan 10, '11. Posts: 180 (52% Liked) Likes: 283

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  • Jun 26

    Quote from Mr. Murse
    I'm a little bothered by the fact that you are looking for validation for reporting someone based on speculation and not satisfied with their "punishment" after at least SOME investigation had indicated his/her innocence. I kind of get the feeling you may have some ulterior motives in wanting to see this nurse "pay".

    Either way, think about it from management's perspective. Some nurses get together and basically say "we suspect so and so of stealing meds, but have no solid evidence". First of all, I'm surprised they did any investigation at all based purely on coworker's speculations, but they did at least drug test him/her. What more do you expect them to be able to legally do? Even if he/she is stealing meds, they have absolutely no evidence. Do you really want your coworker to lose their livelihood based on your speculation? Does that not sound a little ridiculous?

    I'm kind of curious though, what did they do that led to your speculations that they were diverting?
    I wish I could press the like button more than once.

  • Jun 26

    I'm a little bothered by the fact that you are looking for validation for reporting someone based on speculation and not satisfied with their "punishment" after at least SOME investigation had indicated his/her innocence. I kind of get the feeling you may have some ulterior motives in wanting to see this nurse "pay".

    Either way, think about it from management's perspective. Some nurses get together and basically say "we suspect so and so of stealing meds, but have no solid evidence". First of all, I'm surprised they did any investigation at all based purely on coworker's speculations, but they did at least drug test him/her. What more do you expect them to be able to legally do? Even if he/she is stealing meds, they have absolutely no evidence. Do you really want your coworker to lose their livelihood based on your speculation? Does that not sound a little ridiculous?

    I'm kind of curious though, what did they do that led to your speculations that they were diverting?

  • Jun 26

    Quote from KJDa81
    I work at a LTC/rehab facility. There's a nurse that works there different shift than me) & there are several of us that have written statements & presented "evidence" (more like speculation) of this nurse stealing meds.
    Thing is, nothing is being done. She passed a drug test, & now is having to have her narcs co/signed.....she still has a job. Extensive record, etc. My last day at this place is coming up, but I feel if I leave & don't follow Up, nothing will be done. Why don't people care enough to take care of this situation?? What more can I do?


    "The purpose of life is to discover your gift. The meaning of life is to give your gift away."
    Stop speculating and mind your own business is my advice. You are screwing around with someone else's career based on "speculation". I'd advise you to stop.

    Just my .02

  • Jun 26

    Quote from mrsboots87
    I also give the most PRNs on my unit and I sometimes worry I will become the focus of a complaint. The good thing is we have cameras in the halls at my facility and I sign everything out as I should and give to the residents right away, so I know I would be fine. But people like this OP still make me worry a little.

    The he reason I give the most PRNs is because I believe people shouldn't have high anxiety or be in pain if they have PRN orders for relief. I have a guy who calls out all night and gets combative with cares if he doesn't get PRN Ativan at HS. I am the only person who just gives it too him at HS. The family doe not want it to be a scheduled med because they think we will just snow him. But he truly needs it. But every time I sign the narc book, there is maybe one or two other nurses who gave it to my 15 signatures.

    I also give PRN morphine more frequently than others in our hospice residents. I due watch for signs of pain, but I feel other nurses just don't think about it as much because the patients can't usually vocalize their pain while actively dying.

    Basicall, OP, don't assume. Unless you see her pocketing or swallowing pills direct from the NARC box, it is not your job to report it any higher than your manager. You could potentially ruin someone's career over a suspicion. Also keep in mind, I have plenty of alert and oriented people who sometimes think I didn't give them their pain meds when I know for a fact I did. Sometimes they just forget or have intermittent confusion. It happens. She may very well be diverting. She may not. But that's not for you to be judge and jury on.
    Me too. When I worked in ER many nurses thought people were drug seeking and I say, even if they are addicted, they still could feel pain, they are human. Many times I would get ignored for request to get the pain relief for patients, and the doctors refused to write orders until X-ray came back positive for fracture or other real things happening to poor patients. I could have been accused too but I was just doing the right thing for patient.

  • Jun 26

    Quote from Pangea Reunited
    I give a lot of pain medication, too. Sometimes I'm the only one who gives it to a particular patient (non-verbal, PEG tube, grimacing, huge wounds, for example). And I will frequently give it a little early if the next dose is due right after change of shift (as a courtesy to the oncoming nurse).
    I also have patients claim they "didn't get" their pain medication, on occasion. Sometimes they're attempting to manipulate and get an extra dose, other times they're just really drugged up and actually can't remember.
    Something may be going on with your co-worker, but it may not be. Hopefully not!!

    I also give the most PRNs on my unit and I sometimes worry I will become the focus of a complaint. The good thing is we have cameras in the halls at my facility and I sign everything out as I should and give to the residents right away, so I know I would be fine. But people like this OP still make me worry a little.

    The he reason I give the most PRNs is because I believe people shouldn't have high anxiety or be in pain if they have PRN orders for relief. I have a guy who calls out all night and gets combative with cares if he doesn't get PRN Ativan at HS. I am the only person who just gives it too him at HS. The family doe not want it to be a scheduled med because they think we will just snow him. But he truly needs it. But every time I sign the narc book, there is maybe one or two other nurses who gave it to my 15 signatures.

    I also give PRN morphine more frequently than others in our hospice residents. I due watch for signs of pain, but I feel other nurses just don't think about it as much because the patients can't usually vocalize their pain while actively dying.

    Basicall, OP, don't assume. Unless you see her pocketing or swallowing pills direct from the NARC box, it is not your job to report it any higher than your manager. You could potentially ruin someone's career over a suspicion. Also keep in mind, I have plenty of alert and oriented people who sometimes think I didn't give them their pain meds when I know for a fact I did. Sometimes they just forget or have intermittent confusion. It happens. She may very well be diverting. She may not. But that's not for you to be judge and jury on.

  • Jun 26

    I am a big patient advocate. But it appears that she wants to see the outcome of her reporting NOW, or she will report to someone else again ANONYMOUS. What is the motive of hers. Maybe I'm having this hard time understanding because she does not give full details but it is understandable on the internet. But something seems off to me. It is most subjective except for what she believes are "med errors" and the word of patients (who can lie, manipulate or forget when they take pain medicine)


    For me to possibly ruin career I must need more evidence. I'm protective of patients but I won't accuse someone of something without hard facts or serious suspicions with fact.

  • Jun 26

    PS> If I had a patent in pain and shift change was a 3 pm ( which is it is my facility where we work 8 hour shifts) and I had a patient in pain I would not hesitate to give a Q 8 PRN that was due at 3pm at 2:45. Especially since I know full well that the patient the patient probably won't me medicated by the next shift until close to 4 pm.

  • Jun 26

    Quote from morte
    I don't think the hour before and after applies to PRNs...

    Yes the hour before rule does apply to PRNs and can be given - It is so stated in the JACHO and CMS guidelines.

    Hppy

  • Jun 26

    I give a lot of pain medication, too. Sometimes I'm the only one who gives it to a particular patient (non-verbal, PEG tube, grimacing, huge wounds, for example). And I will frequently give it a little early if the next dose is due right after change of shift (as a courtesy to the oncoming nurse).
    I also have patients claim they "didn't get" their pain medication, on occasion. Sometimes they're attempting to manipulate and get an extra dose, other times they're just really drugged up and actually can't remember.
    Something may be going on with your co-worker, but it may not be. Hopefully not!!

  • Jun 26

    Quote from Ruby Vee
    If you're going to potentially damage someone's career and jeopardize their livelihood by reporting them for narcotic diversion, you should be willing to stand up and do it without being anonymous. If you say you KNOW this person is using drugs, then stand up.

    On the other hand, if you think the person may be using drugs but aren't 100% sure, then you have no business reporting that they are. Report what you SEE, not what you THINK.

    If a medication is due every eight hours prn, then 15 minutes on either side of it is not a big deal. An every two hour prn med would be different. If the patient has been waiting for everyone to get out of report so she could have her pain meds and is in significant pain, it seems kinder to go ahead and medicate her before going into report so that the next nurse doesn't have a patient in uncontrolled pain to deal with.

    You already talked to your manager; you've done your due diligence. It is now up to your manager to follow through. It is also not your manager's duty to report to you how the situation is resolved. If there is disciplinary action, you don't get to know about it. It's confidential.

    I don't see any facts in the original post -- except the 7:15 and 2:45 times which seem pretty sensible to me. Are you sure your concern is narcotic diversion or potential narcotic use rather than getting someone into trouble?
    Exactly

  • Jun 26

    If you're going to potentially damage someone's career and jeopardize their livelihood by reporting them for narcotic diversion, you should be willing to stand up and do it without being anonymous. If you say you KNOW this person is using drugs, then stand up.

    On the other hand, if you think the person may be using drugs but aren't 100% sure, then you have no business reporting that they are. Report what you SEE, not what you THINK.

    If a medication is due every eight hours prn, then 15 minutes on either side of it is not a big deal. An every two hour prn med would be different. If the patient has been waiting for everyone to get out of report so she could have her pain meds and is in significant pain, it seems kinder to go ahead and medicate her before going into report so that the next nurse doesn't have a patient in uncontrolled pain to deal with.

    You already talked to your manager; you've done your due diligence. It is now up to your manager to follow through. It is also not your manager's duty to report to you how the situation is resolved. If there is disciplinary action, you don't get to know about it. It's confidential.

    I don't see any facts in the original post -- except the 7:15 and 2:45 times which seem pretty sensible to me. Are you sure your concern is narcotic diversion or potential narcotic use rather than getting someone into trouble?

  • Jun 26

    Quote from morte
    I don't think the hour before and after applies to PRNs...
    Why wouldn't it? Otherwise a nurse would have to drop every single thing she/he is doing to go give that PRN right on the dot.

  • Jun 26

    They may be still investigating, and they don't have obligation to tell you cause it isn't about you. You reported your suspicions you did your part. And I agree with another comment, 7am and almost 3pm is not a med error. Just remember its right thing to advocate for patients but if you are wrong you can still ruin your coworkers career

  • Jun 26

    Quote from NurseGirl525
    Maybe an investigation was done and it was determined she was not stealing. Why do you think she is at least committing a med error? You can give out meds 1hour before and 1 hour after. So if the meds are due every 8 hours like you say, she is not committing a med error as 7-3 is 8 hours.

    I guess accusing somebody of diverting is a huge deal. You are potentially destroying a career so you better be 100% sure you know this is happening. Jumping to conclusions is not 100% sure. You did the right thing by talking to your higher ups. She says she investigated. Let him/her handle it. You have absolutely no idea what is going on behind the scenes. They may be gathering more evidence, be calling HR on how to handle it...... Just because you are not seeing immediate termination means nothing. It takes a lot to fire someone with that type of accusation. They need proof. Let them gather that.
    This. The NM cannot and should not share the results of an ongoing investigation with the nurse in question's colleagues.

    Giving q 8hr pain meds at 7:15 and 2:45 isn't a med error.

  • Jun 26

    Quote from Nursenicole1
    now alert and oriented patient are telling me they are not getting their pain medication when she is saying she is given them.
    Did you do incident reports on every patient who told you they did not receive their pain medication?


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