Didn't scan a narcotic at bedside

Sour Lemon · Jul 12, 2018

Hi everyone- just wanting opinions please. I know you can't give "legal" advice.
I've read multiple old threads on narcotic counts in the Pyxis being off and such. But I'm wondering what happens (and yes this is me) I took one norco out but forgot to scan before giving to patient? I haven't had a chance to investigate the MAR or my charting yet because I haven't worked since I got the call from my manager. I will be there tomorrow to look into it and write my "statement" of how I remember the events, etc. I'm pretty sure it was given along with my 1pm meds so I'm hoping they'll see i removed other meds from Pyxis and gave to patient at same time. All i can say is it was a mistake. Never happened before. I was told it would have to be reported to the DEA. That's all I know. I don't know anything else regarding being written up or other punishment.
Does anyone have experience with this? One missed scan? One occasion? What happened to you? How serious is it?
I'm nervous even though i know i know it was an honest mistake. Btw Been a nurse for one year.
Thanks in advance

My only "experience" is second-hand. A nurse I worked with forgot to scan IV narcotics multiple times. She didn't waste it, either. She was allowed to come in and chart it late. My involvement was to act as a cosigner for the waste so that she didn't get reported.

She did eventually get fired, and perhaps reported ...but that was after multiple incidents at at different times. Reporting you to the DEA over one missed scan seems ridiculous.

If it were me, I would seek legal advice and take a drug test since I've seen how messy these things can become. A proactive approach is probably best.

Davey Do · Jul 12, 2018

Once a upon a time, not too long ago in old nurse years, pyxis or computers were not utilized. The nurse removed a controlled substance from a locked med cabinet, noted the count and the patient who was to receive the controlled substance, administered the controlled substance, and documented the administration on an MAR.

Had the administration not been noted on the MAR, a documentation error would have resulted.

Following this line of logic, substituting the pyxis for the locked med cabinet and the computer for the MAR, all that resulted in your case, Hailbop, was an error in documentation.

The new system of pyxis and computers are great. In the old days, I made med errors here and there. Not so with pyxis and computers. The extra checks are so good that even a demented old nurse like me can flawlessly pass meds.

But that's all the new system is: a better system, and and not God. You're not going to go to Hell for making a documentation error.

At least I don't think so.

Good luck and best wishes to you, Hailbop!

And, please, let us know how this turns out!

City-Girl · Jul 12, 2018

If it truly was an honest mistake, let your manger know. Hospitals usually have systems in place for going back to chart undocumented medications.

klone, MSN, RN · Jul 12, 2018

I would offer to take a urine drug screen. Reporting you to DEA over this seems ludicrous.

cleback · Jul 12, 2018

Reporting you over one instance is crazy.

I am kind of paranoid about that, so I always check to make sure the scan shows up in the MAR before I leave the room. Maybe excessive but it works for me. I'd recommend it to avoid this in the future.

allnurses Guide · Jul 12, 2018

Something is off. All this for one Norco hardly makes sense, unless you are being targeted for other things or unless they have a line of suspicion on you.

JKL33 · Jul 12, 2018

I don't have this all figured out - but I believe they have to report missing narcotics or they genuinely believe that they have to. Or they know they can get away with scaring nurses by conflating the issue of one undocumented pill with this.

Whether it was intended to include incidents like the above are anyone's guess. But they have come out very strongly in recent years that they "must" report any missing controlled substances.

I don't think it's as much reporting a nurse as it is about reporting what they think they have to report regarding their stock of controlled substances, and not getting caught being lax about some missing narcs. So, as far as the reporting itself, I don't think have an option to consider circumstances, although in their employment decisions and disciplinary actions they do have options. And probably options regarding reporting to BoN, depending on the state.

JKL33 · Jul 12, 2018

No time to research this more/post links right now, but they do have to have procedures in place for accounting for every single controlled substance, including reporting to appropriate agencies per federal and applicable state laws. There are consequences involving the DEA, TJC, CMS, OIG, etc., for not doing so.

Hailbop16 · Jul 12, 2018

I'll find out more tomorrow but I can't imagine any reason whatsoever I would be singled out. Never a write up for anything. And yes if a drug test is mentioned- I will for sure!

As far as know any "unaccounted" for narcotic must be reported to the DEA. And I don't know whether they are reporting me or the

Incident.

also it could be that our hospital is on some kind of watch or audit - not sure.

dlkj413 · Jul 12, 2018

I would think as long as you are honest with your employer and work with them then there shouldn't be any big problems. Tell them it was an honest mistake and that you are willing to comply with anything they need you to do including a drug test. (Which you may even want to request to take one at your work so they can't come back later with any complaints or anything) I wouldn't think they'd do anything more than maybe a write up for not scanning it but I can't see how they could do anything worse than that. Things like this happen, we are nurses but we are still human. Good luck!

Hailbop16 · Jul 12, 2018

I would think as long as you are honest with your employer and work with them then there shouldn't be any big problems. Tell them it was an honest mistake and that you are willing to comply with anything they need you to do including a drug test. (Which you may even want to request to take one at your work so they can't come back later with any complaints or anything) I wouldn't think they'd do anything more than maybe a write up for not scanning it but I can't see how they could do anything worse than that. Things like this happen, we are nurses but we are still human. Good luck!

Thank you. I just can't imagine my very first med error, or offense if you want to call it that with one single pill, being enough to lose my job or be reported to DEA or BON God forbid. If so, then this job isn't for me. Because like you said we are all human. And point taken- lesson learned. Slow down, work on time management. Concentrate on task at hand.