Pyxis machine and nurses diverting meds.....

Nurses Recovery

Published

i have a question regarding the legality of being blamed for meds missing from a pyxis machine. there are several nurses in a 24 hour period that pull meds from the units' pyxis machine yet the pharmacy is accusing me or questioning me where several pills have gone missing and why. they gave me 2 examples of meds that i "canceled withdrawal" and then on a sticky asked where the meds were. first of all, if the patient doesn't want the med once i've opened the pyxis, i just push "cancel withdrawal" and shut the drawer. i don't bend down and count the medication that is suppose to be in that particular box before i cancel the med. second of all, can i be fired for something i didn't do despite them saying i need to answer to why there are those pills missing? again, there are numerous nurses that use this same pyxis to pull their meds or to "borrow" meds when their pxyis is low. i hurt in my gut as to why i am even being asked about this just because i had 2 "cancel withdrawals" on this same med! i have never diverted anything and i am extremely careful and cautious to always have a witness to wasting meds if they are controlled substances or even non-narcotic meds just for my peace of mind. what can they do to try and make me the fall guy? how do i protect myself when i did nothing. if i get all upset, they will think i am guilty, if i act low key and like nothing is wrong, they will say i don't care and it's me. i am in a no win situation unless someone can shed some light on what i should do. i received the letter several days ago, no one has called me at home and my boss hasn't called me. pharmacy is the only one that left me the message...please any advice is welcomed here. ive been a nurse for almost 30 years and have never been disciplined for anything...i don't want to lose my career over something like this! thanks fellow nurses!!

Specializes in Nephrology, Cardiology, ER, ICU.

Effective this week Tramadol and Soma ARE controlled, class III meds.

Up Vote Up Vote ×
Specializes in u name it.

Even more reason to get that UA and consult with an attorney.

Up Vote Up Vote ×
Specializes in adult health , critical care.

I agree with backtowork, I hope you provided a urine sample at a certified susbstance abuse testing lab and consult an attorney. If you are innocent then it should all work out in your favor. Good luck and keep us informed.:rolleyes:

Up Vote Up Vote ×
Specializes in Acute Care Psych, DNP Student.
I agree with backtowork, I hope you provided a urine sample at a certified susbstance abuse testing lab and consult an attorney. If you are innocent then it should all work out in your favor. Good luck and keep us informed.:rolleyes:

That's not the primary concern in a correctional facility. The primary concern is that the medication could have been sold/given/found its way to an inmate. That could lead to felony charges for diversion PLUS felony charges of introducing contraband to an inmate. A criminal investigator will probably investigate the matter. If there is no evidence, the case will probably be closed. One thing we can count on is that the facility will probably get its act together about counting tramadol.

Up Vote Up Vote ×
Specializes in u name it.

I have worked corrections as well and you are correct that nurse diversion is not the primary concern to the facility..it is in fact the primary concern of the BON tho, and they control your ability to practice.

Up Vote Up Vote ×
Specializes in Psych ICU, addictions.
A clean urine will help, but it does not get you off the hook from them accusing you of misappropriation.

This is true, because you'd be surprised how many nurses are diverting not for themselves but for others. Take the UDS but also get a lawyer ready in case they give you a hard time.

Up Vote Up Vote ×
Specializes in Psych ICU, addictions.
The medication was not a controlled substance.

Actually, depending on the state you're practicing in, Tramadol may already be categorized as controlled substance because it does have an abuse potential. I know Kentucky is one of them--I think they have it as Schedule IV.

But as traumaRUs posted, that's going to change for all the states.

Up Vote Up Vote ×
Specializes in CRNA, Finally retired.

Tramadol should be treated as a narcotic. Big problem if UDS shows up positive for Tramadol. Your pharmacists need to get with the program. Good luck.

Up Vote Up Vote ×
Specializes in Med/Surg/Ortho, Oncology, PACU.

Where I used to work, they always treated Ultram as a controlled substance and it had to be counted. Even way back in 2004 when I started there. I can see, now, where this extra precaution was a good one! It was always kept in a drawer that could NOT be closed without a count being put in once opened.

Up Vote Up Vote ×
Specializes in med/surg, step down, I have seen it all.

I am confused. Because if you were pulling med from the pyxis and then your patient didn't want it and you cancelled it that should be fine. But how did you know they didn't want it when you were pulling that med? Because you would have had to have taken to them and they said no thanks or they just happened to walk by the machine and said I don't want that pill. I know the pyxis well and the story you tell doesn't add up.

I am thinking you are in denial about a problem you have. I know this post is a little behind in yeas but Ijust found it odd about he pyxis machine. Don't think I am being mean but if that is the story you gave them then it probably didn't pass and you are prob disciplined by now. Sorry that happened. always waste don't cancel. Even waste non narcotics that is to save your butt.

Up Vote Up Vote ×
Specializes in PACU, pre/postoperative, ortho.
But how did you know they didn't want it when you were pulling that med? Because you would have had to have taken to them and they said no thanks or they just happened to walk by the machine and said I don't want that pill. I know the pyxis well and the story you tell doesn't add up.

This confused me at first also. But after reading posts referring to correctional facilities, it makes more sense. I don't have a lot of knowledge about them, but I imagine the nurse doesn't go cell to cell with meds. More like there is a med room that pts come to at scheduled intervals in which case they are standing there as the nurse pulls meds. (Maybe a corrections nurse could clear that up?) If so, it sounds reasonable that OP may have just cancelled in order to pull a different PRN as the pt actually would be standing right there.

It's been quite some time since the original post. Maybe OP could let us know how things turned out?

Up Vote Up Vote ×
Specializes in med/surg, step down, I have seen it all.

Oh okay. I didn't see the part about correctional facility. It was kind of a long thread and I skimmed through. I give my apologies for saying that. It just was confusing at first like you said. But that makes sense being a correctional facility. I would like to find out how things turned out too. I know this is an old thread but I am new to the forum and couldn't sleep so I was thumbing thru the posts. Just seeing how everyone else was doing in this crazy life we live. :yes:

Up Vote Up Vote ×
+ Add a Comment