Fail to scan narcotics- tramadol

Nurses Medications

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Halo ,

I am a new nurse. I just started 2 weeks ago on my own. I asked the patient if she wants her tramadol but she Said it gives her headache so refused medications (tramadol) at 10 pm, so I put refused on EMAR. After an hour she wants the tra adik again and pulled it out form the pyxes. When I was scanning the meds it shows I'm giving it too early, so I thought I have to edit the previously refused documentation on emar and scan the meds. Someone called me from the nursing office and told me about the missing dose of tramadol. I told them I gave it to the patient, but not sure if I scan the meds. Would I get fired for it? This is my first nursing job and I am sooo scared. Should I lawyer up. They told me they need to have me some papers. Pls help. What is the best route to take.

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Specializes in Critical Care.

Had you already taken the tramadol out of the pyxis when the patient refused it? If you did, whatever happened to that dose, did you return it in the pyxis, if not then that would show as a missing dose: 2 doses were removed, one was charted as given.

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No. I did pull it out the Pyxis on the first time, si ve she told me before hand that she doesn't want it. After an hour I pull it out. So only 1 dose charted, since I edit the previously refused to given.

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Specializes in Critical Care.

I would clarify what they mean by a "missing dose" then, since you pulled one and gave one, there should be no missing dose.

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No. I did pull it out the Pyxis on the first time, si ve she told me before hand that she doesn't want it. After an hour I pull it out. So only 1 dose charted, since I edit the previously refused to given.

It sounds as if you pulled two doses from the Pyxis but didn't let the Pyxis know that one dose was wasted, is this right? Think of the eMar and Pyxis as separate systems-- although you chose 'refused' as your administration option on eMar for the first dose, the Pyxis still needs to know where that dose went or it will show in your administration records that you're missing a dose. Your options on Pyxis is to return the medication using the return bin and programming in the 'return' against the patients profile, or you could 'waste' the med using a witness and the waste bin. If you did either of these two things with the first dose, you shouldn't show a missing medication.

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