TL;DR Home care nurse, mom is diluting Ativan, need advice.
Hello,
I’m a private duty LPN for a local pediatric hospital. I’ve been a nurse for years now so it’s nothing new.
Onward,
I’ve been coming to a home for awhile now, the child has hx of seizures and muscle rigidity. They’re given Ativan concentrate routinely, this is the primary method of seizure control. There is “known” diversion going on. It’s suspected mom dilutes (you read that right) her Ativan and leaves diluted ass medication for her disabled kid. Humanity.
Several of us have notified our respective supervisors, we were given the ******** advice to “document your findings” but not say that directly. I was asked to write a statement, in which I declined bc I’ve been burned in situations like these before.
The medication is dispensed 10-12 bottles at a time. Cyclically the child will start having a shit ton of seizures, and the medication will have a watery consistency. There are other “backup” meds to be given PRN but they’re not as effective.
Today I noticed the same watery bottle, so I looked at the three remaining bottles and the tamper seal is white, indicating they’ve been opened. They also were watery, not like the usual viscous Ativan.
My questions: I’m stumped bc giving a known altered drug seems like a huge liability. The kid is a few clusters from a grand mal that would do some damage. We’ve already told management who is apathetic and loose lipped, so any reports goes to this one senior RN who’s very tight with the mom. Again I’ve been used as the scapegoat and pissed on by management when they’ve ignored diversion, and it was discovered and they had to address it (hope that makes sense)
Any advice or input? I thought of contacting our in-house attorneys and asking. I’m just torn as if any of this **** hits the fan, we all know this has been tampered with, and hello, liability.
Report it to CPS, and that's hopefully all you have to do.
You could also talk to the pharmacist, see if they would be able to test the strength because someone may be diluting the med. If they can, and it turns out to be diluted, call the police about theft/diversion. Really, your agency should be doing that, but if they wont, someone has to.
I wouldn't be hesitant about making a written statement for your agency. They can't go ahead with investigating if no one will come forward and officially complain. At this point, what do you care if your coworker and the mom find out you noticed that when the med gets watery, seizures increase. You are looking out for that child!
canoehead, BSN, RN
6,909 Posts
Report it to CPS, and that's hopefully all you have to do.
You could also talk to the pharmacist, see if they would be able to test the strength because someone may be diluting the med. If they can, and it turns out to be diluted, call the police about theft/diversion. Really, your agency should be doing that, but if they wont, someone has to.
I wouldn't be hesitant about making a written statement for your agency. They can't go ahead with investigating if no one will come forward and officially complain. At this point, what do you care if your coworker and the mom find out you noticed that when the med gets watery, seizures increase. You are looking out for that child!