Diversion in group homes?

[Emergent, RN]

Today I went to discharge an elderly, alert and oriented woman from the ER. She resides in a group home. Her family was there and would be taking her back.

She told me that the caregiver from the home called and told her to be sure to get a prescription for pain medicine from the doctor.

I told the doctor what transpired. He said to tell her to take over the counter medicine, which was fine with the patient, but I got a feeling would be a disappointment to the group home.

I'm now wondering, how monitored are are narcotics in group homes? How much diversion is occurring?

[FashionablyL8, CNA, LPN]

I'm a MAP certified direct care worker, and work in group homes. We have to keep controlled medics in a lockbox, in the locked med closet, sign for each dose given in the country book and do a count every shift. If the count is off, we call the manager and trybto figure out the discrepancy. It's usually that someonevforget to sign out a PRN. I've never seen it not getbfigured out, butbIm surebthatbwould need to be reported as a med occurance and turn into a pretty big deal. So, maybe I lack imagination, but I'm thinking the only way to divert would be to sign the pills out as scheduled doses and/or PRNS and then keep the pills, giving the resident either nothing or something else. None of our residents are prescribed large amounts of narcotics or benzos, so I can't see how that would be worthwhile. Unfortunately, I'm sure it has happened, at least at other facilities.

I'm glad that I am able to pass meds, and make sure to be very careful and educate myself on the medications I'm giving. However, I'm really not sure if I think that it's safe to let people pass meds and be entrusted with controlled medications after taking only a short class and passing a knowledge test and med pass.