Signing out medications for my manager.

  1. Hello Nurses-

    After several years as a home health nurse, I've just returned to hospital nursing. The manager on my med-surg-tele unit regularly asks nurses to sign dilaudid out of the Accudose for him to administer to patients on the floor. As a brand new employee still on orientation I was afraid to argue with him about whether this practice is right/legal. He contends that it is absolutely okay to have nurses sign out meds to give to him (the manager) to administer and that he "is required to give a certain number of meds each month." I asked him why he doesn't have his own access to the Accudose and he said that it's because he's responsible for reconciling the medications so it would be a conflict for him to have access. I haven't been able to find ANY literature on the internet about policies regarding signing out medications for other nurses and I want to be able to back-up my contention that this can't be okay. Any advice or references to legal or professional sources would be greatly appreciated.
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    About OlaHospiceRNBSN

    Joined: Nov '12; Posts: 2; Likes: 4


  3. by   sapphire18
    This sounds extremely fishy to me...why is it only dilaudid that she administers??
  4. by   liveyourlife747
    Sounds fishy to me too. I think my manager has a code to be able to sign out Meds for our medselect machine and I doubt she would ever ask us to sign out a med for her. I think she would either give the med herself, call us and let us know the pt needed pain med, or alerted charge to the situation if I was busy.
  5. by   PediLove2147
    Yeah definetely fishy. I haven't heard of managers needing a certain number of med passes to continue working, this must be specific to your hospital. Our manager never even goes near our Pyxis, if someone needed pain meds (I have seen her answer call lights so it could happen) she would just let the nurse know. Otherwise she would need to sign into MAK, get a scanner, give the med.. seems like a very long process. Much easier to say, 'Hey Susie, Mr Brown needs pain meds!'

    Are other nurses on your unit doing this? I too would have a hard time saying no, I mean they are your manager but I would definetely be wondering what was up. Is he documenting who/when he is giving the Dilaudid to? I just don't get why your manager would do this..

    ETA: I just thought of something else. If your manager NEEDS these med passes to continue working why does he not have his own sign in. I know you explained what he told you but if the hospital must know that having to have another RN sign out all his meds isn't very good practice?
  6. by   VivaLasViejas
    NEVER sign out a narcotic that you yourself are not administering to a patient with a valid order for it. To do so is asking for big trouble, especially in this situation, because your manager could very well be diverting and YOU would be on the hook for it as well. Please report this to the next person up the chain of command; it needs to be investigated.
  7. by   Sun0408
    Oh wow, soo fishy !!! I would be very careful, could be diverting. I hate to say that but why only one med and not all meds? Why does he not have access to the pyxis ? As a manager on the floor, he should be and RN at least, if not, they shouldn't have access to those meds at all.. I don't know but this does not sound right.

    Do others go along with this, or is he doing this to new employees. I would drop an anonymous note to risk management or someone about this.
  8. by   Penelope_Pitstop
    "A certain number of meds each month"...well, how come these meds are ALL Dilaudid, as was stated earlier? Wouldn't it just be easier for the manager to give Colace and Tylenol?
  9. by   edmia
    Sounds like diversion to me. Who signs the MAR? Who picks up the order? Has anyone watched him actually giving the med? Fishy.

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  10. by   iluvivt
    NO...DO NOT DO IT. When you sign out that medication you are responsible for it and I definitively would not be signing out any narcotics for any other nurse. How do you know that he is not taking that medication and then administering some NS to the patient. Let us just say the pts start complaining that they are not getting good pain relief. They start investigating and and lookie YOUR name is listed as signing out a lot of the doses. This would occur over a period of time,of course,as these things do but the nurse usually does get caught!

    His count excuse does NOT make sense! My antenna is up that something is not right here as others have also stated.
  11. by   nursel56
    It's a crock. And an entire regiment of red flags for diversion.
  12. by   dudette10
    Agree with everyone else. If you want some backup, take a look at The Joint Commission regulations on pulling meds for someone else to give. It's considered "dispensing" by the nurse, and it is against regulation. That is the objective backup you need to say no, even if it doesn't take care of the diversion that your manager sounds like he is doing.
  13. by   wooh
    I'm betting your job has an anonymous compliance hotline. I'd be calling it. And HR. And risk management. And the head pharmacist. The head pharmacist will probably take care of it quickest.
  14. by   neverbethesame
    I am so sorry that your manager is putting you and your co-workers in this position. He/she is likely diverting medication to feed his/her legitimate pain issue and/or addiction. Like someone said above call the anonymous hotline to report this. You could be saving your managers life.

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