Working with a nurse who isn't allowed to admin narcotics? - page 2

I lady I work with got in legal trouble, didn't report it to the board when renewing her license and now is on probation with the board. According to the files on the board's website she isn't allowed to touch any scheduled meds.... Read More

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    I'll add that from things I've read in the past here. She could be diverting, and you are inadvertently hiding it by pulling a certain amount... and so with other nurses she asks as well. She might have a system of some sort in place.

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  2. 3
    Just keep in mind that if you slip an anonymous note under a door you will not be anonymous for long. Cameras are everywhere.
    wooh, kogafietsen, and beeker like this.
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    Well then, drop it in the mail.
    rhondaa83 likes this.
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    Here's how someone explained it to me--if you are an RN and an LPN gives your oral narcotic, then you go do their IV things for them (sans PCA pump or any narcotic); you get your supervisor or upper level (even charge nurse) to do IV narcotics.

    I am surprised that the NM doesn't know because if that person has a Board Order, then usually they are in a monitoring program. Monitoring programs have forms that must be filled out. Therefore, one must disclose this information to the NM. Are you sure that the NM isn't trying to protect the privacy of the nurse?

    How long have you been giving her narcotics? I know in Virginia, standard narcotic restriction is 6 months and then it is on a case by case basis after that--if you mess up, it is longer. If you fly on the straight and narrow, then you will not have the restriction as long. I am just wondering if that nurse only needs it done for a certain amount of time.
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    I think it is really rude of her to ask people to give her narcs without offering to do anything in return. In your position I might just say to her that I am just too busy, unless she can do a dressing or hang an IV for me. Regarding her other restrictions, it is probably best to not get involved unless it directly affects you. Your manager and HR are probably well aware of her restrictions and are handling the situation as they see fit. No reason to step in to that one unless you want life to become more difficult than it needs to be for yourself and everyone involved.
    Orange Tree likes this.
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    You won't necessarily know what your nurse manager has discussed with your colleague about her license limitations. You're not supposed to know these things; it's confidential. But if another nurse is ALWAYS asking you to pull and administer her narcotics -- especially on a busy surgical floor, that's an enormous imposition on your time. You have to assess the patient's pain level, make sure the medication ordered is appropriate, pull it from pyxis, administer it, and then reassess the pain level later. I'd want to know two things: first, that this nurse really is not supposed to be administering narcotics. That means a discussion with your manager. And then if she is not supposed to be administering narcs, you need to work out a fair re-distribution of labor. That means if you're busy medicating her patients, she could be doing your hourly glucose checks and recording them, or starting your IVs for you -- or whatever you really hate to do that she could be doing for you while you're busy with her patients. It's up to your colleague to take on an appropriate level of YOUR work to make up for HER work that she's asking you to take over. If she's not doing so, I'd speak to her about it, and if nothing changes, I'd speak to the manager. You can't let her patients go unmedicated just because she's slacking.
    Pepper The Cat, SE_BSN_RN, wooh, and 3 others like this.
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    I work with nurses in recovery from addictions. It does strike me as a poor choice of units for not where she needs to be with narcotic restrictions. However, lets assume that it's the only job she could get (for discussion's sake). It is totally appropriate for you to offer to do her narcs IN EXCHANGE for her doing a task for you. Ruby's right on with ideas. Also, the nurse may be to ashamed to bring her restriction out in the open (that's too bad because she's wasting a lot of emotional energy trying to cover up what is perfectly obvious to everyone else). The nurses who make the best recoveries are honest with the staff when they return to work and are SUPPORTED by the staff, not vilified. I don't know about working with students - have never seen that restriction in my state. Just remember, she is really, really struggling.
    OCNRN63, SE_BSN_RN, poppycat, and 1 other like this.
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    Talk to your NM.

    Also do you feel comfortable administering a narcotic when you weren't the nurse who performed the pain assessment?
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    Bad nurse: Hey squatmonkie, can you give narcs to the patient in 403 and 404?
    Squatmonkie: Sure, while i'm doing that can you round on my patient in 408 and retake the vitals on 412?

    You scratch my back, i'll scratch yours.
    poppycat and wooh like this.
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    I worked with a nurse who was in a monitoring program when I worked at a rehab ortho trauma, SCI, etc, a lot of Schedule II's and narcs were given. We were informed by the NM and the nurse as well. I would assess pain, administer the med, and reassess. Since the unit also had vents, the nurse assigned to cover pain meds was not assigned a vent. She was very helpful, and made sure if someone was giving narcs, she was checking on one of our pts or doing accu checks. She was on a six month monitoring program. Some nurses were not as receptive to helping her. She lasted nine months, and was able to give narcs by the seventh month. Looking back, I hope she was able to recover, especially after she was willing to share how she diverted.

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