Very little witnessing going on with drug wastes on my floor! - page 3
by Nurse ABC | 12,767 Views | 55 Comments
I'm new to this med-surg floor. When we get a drug like morphine out of the Pyxis it asks if we are going to give the whole amount. If we say no it asks for a witness. The "witness" will come in and scan their badge and leave.... Read More
- 0Oct 14, '12 by lockheart678At 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.
- 0Oct 14, '12 by turnforthenurseRNIt'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.
- 0Oct 14, '12 by halfpastQuote from CASTLEGATESWhat should we be looking for?If you want to find whose using on your unit, it's not that hard to find 'em if you KNOW what you're looking for. Most every unit has at least one. Why don't people think about the rules and why they're there? We went to school for how long to get our licenses? We could easily be supplying our friend for their death.
- 0Oct 14, '12 by FurBabyMom, BSN, RNIts 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?
- 0Oct 14, '12 by FORTHELOVEOF!!!!Not all nurses hang around to witness the waste, but your system sounds a little flawed. Ours lets you take out what you want and will show a variance if the amount given is different than dispensed and then you take another nurse in to waste with you to get rid of the variance after you administer the medication, or the end of your shift. Either way you don't know if someone replaced the narc with NS unless you witness the whole ordeal and that isn't realistic.
- 0Oct 14, '12 by DroogieRNI didn't read all the replies, so feel free to ignore. Most don't stick around to waste and don't expect you to, either -- and often there just isn't the time. Don't ever witness for someone you don't trust implicitly. Probably you can count those who qualify on one hand, if not one finger...
- 2Oct 14, '12 by brandy1017How about the doctor orders a standard dose Ie 2mg MSO4 or 2mg of dilaudid, etc. Problem solved! Instead we waste medicine the patient could use and is paying for and the patient doesn't get the full pain relief they deserve! I think that's what ridiculous about it all!
- 1Oct 14, '12 by IndyFor what it's worth, I wish all of y'all that are squirting the waste in the sink would just stop, take two seconds, think about it, then squirt it at the trash can. The trash, particularly the paper trash, will absorb the stuff, and it won't go into the water supply. Ok? Ok. My second thought is that if you're in such a bind with the scanner doohickey then draw your drug, waste, tape the vial to the syringe, go do your thing and scan the thing near the patient. No problem unless it's one of those ampule things, then I have to say I just waste and throw the ampule in the sharps. I will do the long way of documenting in the computer without scanning because I don't want to haul around a piece of sharp glass in my hand or pocket.
Also, it's pretty easy to pick out who is unstable by who trusts you quickest, without knowing you from Adam's housecat, and if you need to prioritize what things to really watch the waste on, it would probably be the pills that have to be cut in half, etc. Make sure you see where the other half went. (also if you see some fool trying to eat the napkins out of the trash...)
Also you can note whose patients actually sleep versus whose patients are on the call light constantly for pain med. Hmm. And docs don't write standard orders for all of what's in a vial all the time, because that stuff is supposed to be based on weight, situation, and tolerance... not on what's convenient for the nurse. Not all patients are huge and addicted. Some are little and delicate.Last edit by Indy on Oct 14, '12 : Reason: left out words