Asked to bring narcotic keys back, got in car wreck

[Nurse Beth, MSN]

As always, JKL33 gave helpful insight. This is indeed a valuable, if hard-earned, life lesson.

I'm relieved to hear you're unharmed and safe. However, experiencing a car crash can be both traumatic and frightening. I hope you're allowing yourself some time to relax and recover from what happened.

You made the right choice by contacting the DON immediately upon recognizing the mistake. I know that feeling of getting home and reaching into my pocket to discover narcotic keys!

The accident wasn't your fault and happened under very challenging conditions. It is unacceptable to ask you to drive back on a dangerous road at night, especially after you told her the conditions. Such a request jeopardizes the organization by risking an employee's safety. The appropriate response should have been, "Thank you for reporting this. Please bring them in first thing tomorrow morning and ensure you get a good night's rest."

Her reaction likely stems from a rigid, rule-following mindset that lacks sensitivity to the situation. If she was unaware of the second set of keys, she should have been. If she was aware but denied it, she is not only incompetent but also untrustworthy.

 Here are a few thoughts on how to move forward:

• Have a calm conversation with your Director of Nursing (DON). You've already taken responsibility by addressing the mistake, which must be acknowledged. Clearly state that the weather made it unsafe for your return, and highlight your promptness in notifying her about the error and taking corrective action.
• Ask about protocols for managing narcotics keys and protecting employee safety, particularly when weather conditions present hazards.
• Document the incident. If you haven't already, writing a brief report or note detailing the chain of events is wise for your own records. This way, you have a clear timeline in case there are follow-up questions or concerns, or if you experience any medical problems resulting from the accident. It will also help you process the situation more clearly.
• Reach out for help. If you're feeling stressed, discuss your feelings with someone—a coworker, loved one, or counselor. You don't have to face this alone. Experiencing a car accident can lead to delayed shock.
• Reflect on your well-being. Put yourself first for the moment. You're dealing with a lot, from long shifts in hazardous weather to the pressure of ensuring the safety and care of your residents. Take a moment to check in with yourself. Maybe there are things you can do to ease stress, like getting extra rest when possible or asking for help when the workload gets too heavy.

Your safety and well-being are the top priority, so I hope you're okay and this doesn't become anything more serious than a stressful moment. 

Very best wishes,

Nurse Beth

 

[JKL33]

Looking forward to answer from Nurse Beth, which are usually neutral and cover a lot of bases.

I suspect that legally working against you are the facts that 1) You are responsible to turn in the keys at the end of your shift 2) You have at least some sort of legal obligations to make good decisions to protect your own health and safety, even when it is not easy to make those decisions (sort of like how after something has gone wrong we are told we should have used better "nursing judgment.")

In this scenario it isn't a nursing judgment but a regular life decision. We all know that you probably were primarily concerned about patients and having them be able to get their medication, and also possibly concerned about losing your job if you didn't return those keys. And that you were essentially lied to (probably willfully). I suspect, though, that legally you would still be obligated to make a decision that doesn't endanger yourself. For example: What if it were that the narcotic keys were in a burning building that was about to collapse, would you be expected to go in there and get them? No. The patients would have to go to the ED if they needed narcotics until a new key could be made if there really, truly was no spare key in existence. Even if *you* had been responsible for the keys being in the burning building in the first place, you might be in other legal trouble but you still would not be legally obligated to risk your health/life or personal property getting them out again.

Edit: Take out burning buildings and make it a little more realistic: What if you had crashed your car and ended up in the ED on your way home the first time? What would they do then? Well, whatever that answer is, that's what they should have--and could have--done rather than lying/being lazy and telling you that you needed to endanger yourself to come back. And...unfortunately, that's what you should have told them. 

I don't know, I'm not a lawyer. But I suspect that, legally, this is going to go in "life lesson" category.

Now you learned something about coworkers and supervisors and nursing, to boot. They lie. Even if they aren't lying their answer might come from a place of ignorance, laziness or any other type of wrong motivation that leads to a wrong answer. Always stay calm and ask yourself if things make sense before making your decision.

What I can tell you is that I would do most anything in my power to find a new job if I strongly suspected (or was able to confirm) that my supervisor lied to me about something like this and put me in a position to have to make a hard decision that then went wrong, even IF I'm the one responsible for the decision I made. I'd be out of there.

 

[Deborah Hallstrom]

When you left work, wasn't the next shift's nurse there to take over your patients? It's the next shift's nurses responsibility to get the keys and report from the nurse at the end/beginning of the shift.  I would write up a corrective actions report and submit it to the DON and request a meeting with the DON to discuss it as it's a matter of health and safety for patients and staff.  Include data concerning the adverse affects of mandating double shifts and what other facilities have done to address it ~ do a cost  analysis to implement your corrective actions that saves time & increases efficiency =  $  is the bottom line for management.

[Mickeyii]

This is why I love, love, love the Pyxis. 

[moveoveronce]

Thank you for the excellent heartfelt responses from contributors.  Here is my take on this situation.  I understand that the Director of Nursing made a hasty decision of directing the RN to drive back to the hospital during an inclement weather.  It resulted in a disastrous event. The nurse could have been injured or killed from the accident.  Rookie mistake by the nursing boss.  With cool head and basic application of what all nurses are good at, CRITICAL THINKING,  this could have been an under control event.  Yes, there is going to be an investigation and paperwork to be filled out, and maybe a possible reprimand; but nobody is going to die for a missing narcotics key.  I was thinking may be the DON just do not want to be bothered by paperwork and decided to cut corners.  Unwise move always results in undue haste that makes waste.  Moving forward, the unit where the RN is working needs to do a root cause analysis of this narcotic key issue.  Everybody is tired after 12 hours of painstaking patient care.  We understood it.  But the shift turn over is as important as doing patient care.  A quick checklist of important items to be given to the oncoming nurse might help.  Please  have mindfulness and presence of mind during turn-over sessions.  I know it's easier said than done but we are in a profession that requires it at all times.