Very little witnessing going on with drug wastes on my floor! - page 2

At my facility we ALWAYS watch the waste. We do it right in front of the sink, our acudose is next to the sink, we draw it up and someone witnesses it and then we sign off on the waste, ALWAYS. I have never seen someone just walk away. We don't walk away to another room to draw it up.

You don't have to walk away...if you are the one who is the witness just watch. Now if the nurse urges you to leave then there's a problem. Yes it's common and if there are any issues they can drug test you. The reality is no one has time so they may trust you but you don't trust them so just watch...nothing wrong with going by the book. If word gets around that you always watch wouldn't it be interesting to see who doesn't ask you to witness. I myself always have them stick around just in case...some of those nurses are very tricky when it comes to diverting.

There is ALWAYS time to witness a narcotics waste. Trust or not, I am putting my license on the line to document that I witnessed the waste. I don't care if I have a reputation of being too uptight. Besides, it's always the ones that you TRUST who may have diversion problems. When they are eventually caught, your trust will cost you when an internal investigation shows that you and many of the trusted colleagues falsified records as a witness. In my opinion, shortcuts and trust never works. Stick to actually witnessing a waste.

The standard joke in my hospital is "will you waste this 1ml of clear fluid I claim is fentanyl?". Seriously though you are not reponsible for what other nurses do. However when YOU accept responsibiliety of witnessing a waste, make sure you actually do so.

I always made them stay to actually witness me and it was a rare occasion when I didn't stay to witness them. We had an omnicell and when I needed a waste, I'd draw up the entire contents, waste what I didn't need, document with my witness on omnicell, and carry my dosed-ready syringe and empty vial to the pt's room. It didn't take long.

In the acute care settings, I was never watched, and I always watched.

Same way with insulin.

My Advice to you is dont sign for what you didnt see! I worked in a hospital where we did what you described and an RN was using it on herself!
I have never ever since that time not witnessed a waste

At my first job, I always watched the waste. I never saw anyone around there who would just walk away without watching the med be wasted before signing their name. Where I work now, people will just state what they're wasting and half the time, they've already squirted it out before you even had a chance to look. I do watch people waste, but most don't watch me when I do it. The way they've got their system worked, it would be so easy for someone to get quite a stash if they have a drug problem. I've even heard of someone who did have a drug problem before I ever started, yet that experience has not changed anything that they do.

So much easier to just put a camera in the med room. Then we can all just do our jobs without putting our license on the line for someone else's actions.

It's like that where I work, too. There is a camera in the med room and all of us trust each other, too. We had a nurse who we knew was stealing drugs, it was very obvious...so when we always stood there and watched her waste. Otherwise, we just put in ID/password or fingerprint and then go back to the craziness on the floor.

I don't stick around for the waste. If someone wants to use narcs on the job, it really isn't that hard. As someone stated, they can draw up the narc, and refill the vial with water. We never know what is in the vial.

What should we be looking for?

Its a policy thing. You need to follow your facility's policy. Bottom line. It's the only way you'll be covered under their malpractice insurance for any claim. When I worked med surg I didn't have bio access to the Pyxis (my fingers didn't pick up on the sensor)... So there was that. My facility had video surveillance in the med rooms. I always just drew everything up completely with a blunt fill needle or with a filter needle (if ampule), wasted the correct amount in the sink in the med room and took the vial/bottle with me to scan than put everything in the room sharps. The nurses I worked with who wasted correctly did it this way.

If I was witnessing for someone else - I made them do it my way. I worked too darn hard for my license to lose it over narcotics. I was also the nurse that checked vitals (respiratory rate/quality/SPO2, HR and BP etc) before hauling out the IV narcotics. Cause sometimes it is contraindicated to give narcotics depending on a patient and their status. And, most of the time I put my patients narcs in 5 ml of saline because well how else can you push 0.25 mL of a narcotic over the recommended IVP time?