Very little witnessing going on with drug wastes on my floor! - page 6
by Nurse ABC | 12,685 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 17, '12 by MoopleRNQuote from psu_213That's a good point that' I've never thought of. No, I don't witness the administration of the med after the waste. Maybe it still got diverted. Hopefully the patient's c/o pain (and the f/u) that would carry on to the next shift would be a head's up the pain isn't being controlled. You raise a really good point that I don't have a practical solution for!A quick question for everyone who actually stays in the med room to watch the other nurse waste the med...do you actually go with that nurse to make sure that nurse actually injects that med into the pt? Whats to say that nurse didn't draw up 0.5 mg dilaudid, you saw him/her waste the other 0.5 mg, then he/she injects the pt with saline and takes the dilaudid for him/herself? Point is, if you are going to be 100% certain the narc actually gets to the pt and is not diverted, don't you have to witness them actually give the unwasted portion of the med?
- 0Oct 17, '12 by PMFB-RNThat's a good point that' I've never thought of. No, I don't witness the administration of the med after the waste. Maybe it still got diverted.
*** The vast majority of people I give narcs too are intubated and sedated. Usually on propofol. They are in no shape to say wether they got thier narcs or not. Diversion at the bedside would be really, really easy.
Hopefully the patient's c/o pain (and the f/u) that would carry on to the next shift would be a head's up the pain isn't being controlled. You raise a really good point that I don't have a practical solution for!
*** No solution needed. The more controls you put on pain meds the less will be given. For example our hospital used to use PCAs all the time. We have a nurse push PCA policy in ICU and we usually ran a basil rate. Then a year ago the PCA charting and checks went from being pretty easy and quick to very time consuming and difficult. All of a sudden we hardly see PCAs anymore. The nurses don't advocate for them so the physicians hardly write for them and when they do the nurses just groan. The nurses would much rather do IV push pain meds than deal with the huge time demands our current (new) PCA policy demands. It is my observation that pain is not as well controlled as it used to be.
- 0Oct 21, '12 by PediLove2147We usually witness, the nurse will draw up the medication and waste the proper amount in front of the witness. The nurse then takes their syringe and empty med bottle in the room to scan and administer. Easy enough and no one is witnessing then running away. Occasionally, if it's really busy people will say they trust you and you waste without anyone around. It takes an extra second since it's expected that you have everything ready when you take a med out of the pyxis.
- 0Nov 23, '12 by tmattd78I often couldn't find anyone to witness so I just said I was giving the whole of dilaudid or morphine, then would come back later to waste when someone was with me. There were a few times in the last several weeks where the shift would end and I couldn't waste the medications I had not given. For some reason someone on my floor likes starting rumors. She said I was having an affair with a day nurse (I work nights). She later told someone in administration that I was using drugs in the bathroom. When they heard this and saw that my wasting didn't match, they fired me and now I'm being brought before the board. I am probably going to lose my license. Always waste right away with a witness. Make them watch you and report them to your manager if they wont.