Missing Percocet

Esme12, ASN, BSN, RN · May 10, 2012

Welcome to AN! The largest online nursing community.

I am so sorry this is happening to you. We do not offer legal advice here at AN. You have a documentation inconsistency and a missing narcotic. You really don't have any "rights" per-se. You can be suspended/fired for "suspicion". There is no burden of proof in the business world. If you have malpractice I would contact them immediately for advice and legal representation. If not you may want to seek legal representation anyhow. They can report it to whomever they wish but whether it is "followed up on" by that agency is up to that agency.

You can get fired for one percocet. The BON and DEA probably won't pursue it but they will watch to see if this becomes a habit. Nurses have lost their licenses for improper documentation of narcotics.

I am sorry you are going through this....I wish you the best.:paw:

Rob72, ASN, RN · May 10, 2012

because that nurse said he didnt give it he forgot.

If he signed it out, it was administered. Period. If it wasn't documented, it didn't happen.

Get legal advice. Talking and/or explaining beyond what you have documented will not help you. In short- shut up.

lumbarpain, ADN, RN · May 19, 2012

Nursing note documentations should be checked for administering pain meds/narcs. I know we have to document whenever a pain med is given to a patient...it cannot be just signed out on the MAR and not documented why the patient recieved that pill. I have had times with a night nurse that was fired because her narc count was off by 2 pills, not one!!! and it wasnt the first incident for her. When counting we did it a certain way.....sometimes pills would pop out due to the foil getting punched and weakened by handling the cards themselves. So we taped across those certain foil seals that looked like the pill was going to come out soon. Pills come out and drop into the med cart often. Numbering pills on the card itself was another method a facility did to make sure that the nurses were actually giving their meds out to patients!!! But missing pills is another thing.

lumbarpain, ADN, RN · May 19, 2012

Best thing I have always done is try to avoid giving out Narcotics as much as you can. If you can give Tylenol or a patient can have aspirin or another OTC med. By all means give that instead. I like to use alternative ways of pain relief for patients but of course in most cases this isnt strong enough.

CapeCodMermaid, RN · May 28, 2012

If I'm your patient and need pain meds, please don't give me a tylenol or aspirin if I have a natcotic ordered. To suggest it's better not to give narcotics because count might be off is bizarre thinking.Always double check when you're signing narcs out. Look at the card AND the book before you pop the med. And when it comes to the end of shift count, always look at the book and the card to make sure the numbers match.

caliotter3 · May 28, 2012

If I'm your patient and need pain meds, please don't give me a tylenol or aspirin if I have a natcotic ordered. To suggest it's better not to give narcotics because count might be off is bizarre thinking.Always double check when you're signing narcs out. Look at the card AND the book before you pop the med. And when it comes to the end of shift count, always look at the book and the card to make sure the numbers match.

Excellent advice in this post. I noticed that a nurse I used to do count with would slant the book away from my view so that I couldn't see it during count. She got perturbed when I caught on to what she was doing and started to insist that the book be kept within my view. Not out of the realm of possibilities that someone can "call" something different than what the book shows in writing. You have to be extra vigilant.

lumbarpain, ADN, RN · May 29, 2012

Im a new nurse less than a years experience.While counting narc with my relief he stated percocet count was off by one pill.I work the same cart daily in a ltcf. The narc was scheduled. An Im the prime suspect.
the booked looked like this so i see why im a suspect
1/1/12 1given 26left my signature
1/1/12 1given 25left my signature---- i accidentally signed twice so i put a SINgle line and initialed then transcribed 25 again by mistake. and called out 25 during the count which was right on the card but wrong in the book because i never signed the 25 th pill out just the 26th because the pill was already missing.The oncoming nurse & his relief caught it but didnt report it . So when i returned count was still off. I didnt catch it in the am count either & no one said anything to me.Finally caught the error when counting at 1500 with another nurse.
Rn supervisor looks a says he gets it sceduled at 0900 & 2100 they forgot to sign. I go "oooo," but really it was "Noooo" because that nurse said he didnt give it he forgot. So now we have a missing percocet for real.And little ole me is suspended & drug tested.
My question is at least 3 nurses had those keys, why only me getting test & suspended and what are my rights.Will the bon or dea be notified? Could i be inpsioned for one 2.5/325 percocet. Help Me!

If a person is experiencing minimal pain I would offer tylenol by all mean first as ordered by the Physician.. And not because I would be afraid to use a narcotic. that is bizarre within itself. People need more than pain meds to relieve pain, comfort measures, family visits, just plain sitting with the patient will relieve pain, deversional activities. and just plain good laughter!!!!!!! THE BEST MEDICINE!!!!! Pain is not only caused by physical means, it is instigated by other means, such as anxiety, stress, depression, So I would as a more Holistic approaching nurse to alleviate pain moreso FIRST without resorting to narcotics. The mind is a very powerful tool used in the control of pain, but some nurses are more into the conventional methods of treatments and rely on those means essentially. I incorporate other measures FIRST before loading a patient up with meds that will only cause him future physical as well as mental problems,(such as dependency)

However some nurses prefer to rely on just popping pills in patients mouths and leaving the room quick enough. I am not that type of nurse.

lumbarpain, ADN, RN · May 29, 2012

Im a new nurse less than a years experience.While counting narc with my relief he stated percocet count was off by one pill.I work the same cart daily in a ltcf. The narc was scheduled. An Im the prime suspect.
the booked looked like this so i see why im a suspect
1/1/12 1given 26left my signature
1/1/12 1given 25left my signature---- i accidentally signed twice so i put a SINgle line and initialed then transcribed 25 again by mistake. and called out 25 during the count which was right on the card but wrong in the book because i never signed the 25 th pill out just the 26th because the pill was already missing.The oncoming nurse & his relief caught it but didnt report it . So when i returned count was still off. I didnt catch it in the am count either & no one said anything to me.Finally caught the error when counting at 1500 with another nurse.
Rn supervisor looks a says he gets it sceduled at 0900 & 2100 they forgot to sign. I go "oooo," but really it was "Noooo" because that nurse said he didnt give it he forgot. So now we have a missing percocet for real.And little ole me is suspended & drug tested.
My question is at least 3 nurses had those keys, why only me getting test & suspended and what are my rights.Will the bon or dea be notified? Could i be inpsioned for one 2.5/325 percocet. Help Me!

If a person is experiencing minimal pain I would offer tylenol by all mean first as ordered by the Physician.. And not because I would be afraid to use a narcotic. that is bizarre within itself. People need more than pain meds to relieve pain, comfort measures, family visits, just plain sitting with the patient will relieve pain, deversional activities. and just plain good laughter!!!!!!! THE BEST MEDICINE!!!!! Pain is not only caused by physical means, it is instigated by other means, such as anxiety, stress, depression, So I would as a more Holistic approaching nurse to alleviate pain moreso FIRST without resorting to narcotics. The mind is a very powerful tool used in the control of pain, but some nurses are more into the conventional methods of treatments and rely on those means essentially. I incorporate other measures FIRST before loading a patient up with meds that will only cause him future physical as well as mental problems,(such as dependency)

However some nurses prefer to rely on just popping pills in patients mouths and leaving the room quick enough. I am not that type of nurse.

NotFlo · May 29, 2012

Well just not giving many narcotics is not a good solution at all. I work primarily rehab and these people are wanting their PRN narcs Q4hrs esp during the day, they want to be medication before PT/OT and after, they want to be medicated before dressing changes, then there are all the scheduled oxycontins and all the resp. people who live on ativan or xanax round the clock to keep the anxiety of not being able to breathe at bay. Then there are the dying patients who need roxanol and ativan intensol up to every hour...

I give out tons and tons of narcs.

You have to be careful with them, yes, and esp. look at the number in the book and the number of pills actually left on the card...the nurse you're counting with can call out anything, leaving you with an off amount at the end of your shift (if what they called out wasn't correct).

I know one nurse who likes to sit behind the desk while the other nurse is at the cart counting...that way the nurse counting has no way to see the book at all. No way, this doesn't fly with me.