Quote from docpsychrn
That is what scares me...the staff nurses never count the pyxis. It hadn't been counted since Sept of last year. So that means that hundreds of meds have been pulled since that time with no count ever made but now they are asking me where the meds went just because I had 2 pts that didn't want that particular med. Again, I never waste or return a narcotic or controlled substance without a witness. When it comes to Tylenol etc, I just leave it in there and move on to the next med. We pass meds on so many adult pts that want so many prn's and then emergency meds etc that the pxyis is our savior with determing who has had what meds for when we chart our prn's. We scan everything we give and it automatically goes right into our charts. So, it it's not scanned, it's not given (or that's the way it's suppose to be). I've seen a lot of mistakes made with this system but I have never given a med and not scanned it. So, I am really upset that I am being questioned as to why meds are missing when I have never had a med error or anything since I have worked with this employer. I have made 3 med errors my whole career. I just don't know what to do....what to say...what they are going to do regardless of what I say to them...
I'm guessing by the 'doc' in your name that you are a correctional psych RN? If this is the case, I don't understand how the medications have not been counted in the PYXIS. Is your facility NCCHC accredited? Counting medications is a requirement for for accreditation. Also, your pharmacy department should have been doing audits at certain intervals. Who checks for expired medications?
I also understand the big deal this is because everything is different in a correctional healthcare facility if something is missing. The worry is an item has been stolen and/or given/sold to an inmate.
FYI for non-correctional nurses: when something desirable like pain medication or a single needle goes missing in a correctional facility, staff can be looking at felony charges if it is found to have gone into the underground prison economy of contraband. Something like one missing angiocath or missing pain medication can cause an entire prison to go into lockdown. Almost every prison facility has internal investigators whose job is to investigate staff and try to find who is "dirty" or bringing in/selling contraband.
Tramadol is basically treated like a controlled in most correctional facilities because it is desired by many. However, if the facility is going to treat tramadol like a controlled when it is missing, they need to treat it like a controlled every day and count it at every shift change. This sounds disorganized.
I don't see an obvious problem with your nursing license because the medication has not been counted in accordance with controlled medications. I do see a problem with your employer due to legal risks in the correctional environment.
It may sound odd to an investigator that you had two times where you canceled taking out the medication right after the drawer opened. I would think you will have to explain this. I'd expect a special investigations file to be opened. If you are innocent, there will be no evidence, and you have little to worry about. It is stressful to say the least, though.