Didn't scan a narcotic at bedside

Nurses General Nursing

Published

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

Unlike hospitals/facilities, pharmacies, and prescribers, nurses are not overseen by the DEA, so it's unlikely the DEA will care that you didn't scan a med. So long as you gave the medication to the patient there is no diversion to report, failing to scan the medication may violate facility specific policies meant to reduce the potential for diversion, but not following that policy is not in itself evidence of diversion.

That's true, but I'm fairly confident what they're saying is that they have to account for this in a report to the DEA. As already mentioned, other federal agencies and TJC are also interested to see that hospitals keep close tabs on their stocks of controlled substances. That said, I have no doubt that individuals not directly involved (nursing mgmt) may be shy on a few details and of all of this and may phrase things in a way that inadvertently allows the nurse to believe s/he is being reported to the DEA. And sometimes they have been vague enough to be able to use "all of this" as a scare tactic.

I'd be more worried about whether they plan to make a report/complaint to the BoN.

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Met with my manager this morning and all is well. A little "verbal counseling" as required by policy and I had to give my statement of what happened and that was that. No big deal. They didn't even mention the DEA thing. So if they have to report it then it's not a "nurse" thing as someone previously said. Thanks everyone for your feedback. I truly appreciate it and lesson learned 100%!

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Specializes in 15 years in ICU, 22 years in PACU.
and we should never co-sign for a med we did not actually see wasted. You should go back and error that out.

CANNOT emphasize this enough. Don't allow yourself to become complicit in any kind of drug diversion.

You can't really know if the clear liquid that is squirted out is actually the medication you are signing for but you must insist on seeing the fluid squirted. And certainly do not do this multiple times to cover a crazy co-worker.

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You can't really know if the clear liquid that is squirted out is actually the medication you are signing for but you must insist on seeing the fluid squirted.

This is the type of thinking that drives me a little nutty.

"It's inaccurate and pointless, but let's waste everyone's time and do it anyway."

The actual rule is that we're to witness the medication being pulled, opened, and wasted before the nurse walks off with it. That comes with its own set of challenges, of course.

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Specializes in 15 years in ICU, 22 years in PACU.
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 "https://www.deadiversion.usdoj.gov/21cfr_reports/theft/index.html"]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.

I clicked on this link and it mentioned "theft or significant loss". If one Norco is considered "significant loss" that hospital is in more serious trouble than keeping a nurse for failing to scan one pill.

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Specializes in Transitional Nursing.

In my area of nursing we don't scan the meds but we "click" them as prepped and then administered. For us, it's not uncommon to forget to "administer" various PRN meds that were intact signed out and given. As long as it's documented somewhere, such as in a narrative note, nothing comes of it. Granted, this is not a hospital setting and we don't pull narcs from the Pyxis but from a med cart with a separate locked drawer.

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Specializes in Varied.

I'm glad things work out! This is one of the many, many reasons incidents fail to be reported.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I would offer to take a urine drug screen. Reporting you to DEA over this seems ludicrous.

Kinda late to take a drug screen now. But reporting to the DEA over this does seem mighty ludicrous, unless there are other reasons that we don't know about.

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Specializes in Critical Care.
Met with my manager this morning and all is well. A little "verbal counseling" as required by policy and I had to give my statement of what happened and that was that. No big deal. They didn't even mention the DEA thing. So if they have to report it then it's not a "nurse" thing as someone previously said. Thanks everyone for your feedback. I truly appreciate it and lesson learned 100%!

I'm glad things worked out ok! I've learned to be extra cautious with pain meds and double check that the scan went thru because I once had a situation where it didn't. Another nurse alerted me and I was able to fix it thankfully, ever since I always double check.

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A first time Narc mistake happens. As long is it's not a habit then you ll probably get a slap on the hand and possibly a drug test which I would offer to do. I personally tend to chart a note at the time a narc is served as to pain lvl and location of pain. This supports my narcotic and then at least you have some computer note to support it if you boobed up the MAR.

It happens-take your lumps, shake it off and you ll probably never do it again after this experience!

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