Diversion Of Narcotic

[RN0202]

:angryfire I was asked by the hospital personnel to get a drug screen because a patient I had stated she did not get her Dilaudid, and did not get full affect from the medication.. She was sleeping when it was given to her and I had a witness when taking the med from the pxysis, and I signed it off and charted it. I am now suspended until the test comes back. I

feel wrongfully accused, I worked 2 days after this occurance and managment called me into the office after my shift was over. What are my rights, or who can I contact about this.

Thanks for your help

[Tweety, BSN, RN]

Just sit it out. You have the right to be paid for your time off when the test becomes negative. You will be vindicated soon enough. I'm sorry you have to go through this, but administration is just following procedure.

In the future I would reconsider giving a sleeping patient pain medication. If I have a patient in severe pain, or chronic pain and I know it's best to give it to the atc, I always wake them. Sometimes they still don't remember it, but I let them know they are getting it.

Good luck!

[BBFRN, BSN, PhD]

I agree with Tweety. Never give a sleeping patient narcotic pain medicine. Wake them up, because you do need to make sure they are easily arousable anyway. And if it's PRN, they will wake up on their own and ask for it.

[Antikigirl, ASN, RN]

Did you sign an agreement to this when you took on the job..that they do testing for this in this mannor? That just bites, especially when you consider that most facilities are nurse short! I would be as mad as a yellowjacket being sat on if someone did that to me, or called me in to cover for this!!!

But oh well..admin is admin..they have to follow rules too, even ones we don't understand, like or agree with...

If you are concerned, talk with your States board of Nursing about your rights! One, you should be paid during this time, so make sure that is in order! Two, make sure this isn't on your record for any reason! Three..always wake a patient up, or if you think they are too rummy..I guess in your facility have a second nurse come in to verify you gave the med.

I would be in big trouble at my facility...my patients can't remember if they ate lunch 5 minutes after they eat it, let alone meds!!!!!! Heck..they don't even know their meds IE the reason they are at my facility! LOL! "Oh...I take a small white one, a big one I have to have cut in half..and it still is too big..and...one day I took too big of a bite of my sandwich and choked, and I was so scared..took me three days to have BM!" LOL!!!!!!!! That's my guys!!!!! (everything ends with a summary of their BM's...uhggg always!!!!!).

[meownsmile, BSN, RN]

Most hospital administration has the right to request a spot test whenever they want. Usually refusal is grounds for dismissal(at least at non-union hospitals). Hang in there, no reason to be upset with it. Use the extra days off to get some well needed rest and when it comes back negative it will be back to work as normal.

I agree though, dont ever give a sleeping patient pain medication. I know we are taught not to assume a patient is sleeping but you MUST get the patients attention verify your patients need of medication with a pain rating and document it. I make it a point to tell my patients "Mr/Mrs i need to(fillin the blank),if they complain when i have to wake them, or if they complain of not getting any rest, I tell them "the hospital is here to help you get better not to get rested,, patients go home to rest". I have no problem waking people up, or lets say getting their attention.

Good luck.

[Antikigirl, ASN, RN]

I started my shift by asking each of my patients about when they would like their pain medications...and would bring up the subject of waking them up if asleep. I reminded them that to let it go till the pain woke them up was not a very good idea, and I would be happy to come in and give it to them at a specific time. That really helped..it was like setting individual patient centered schedules..and they sure seemed to appreciate it! I would also tell them when vs were taken, any cbg times, or other scheduled events were to take place so they had a warning about when I was going to be in the room! They appreciated that too! Just took a few moments out while I did my begining of shift assessments!

And yep...don't we all have a phrase or two about being in the hospital and sleeping! LOL! I think I knew mine in my sleep "okay, now who told you you get to sleep? 24/7 around here, I would speak to your travel agent about this stay huh? LOL!!!!" That got them laughing :)...but that is my way...always keep em laughing (unless they just had an enema..then watch out!!! LOL!)!

[z's playa]

I know from experience as a pt that I am always awakened from a sleep to be asked if I want meds but if I'm asleep..it means I don't need it unless the nurse suggests and I ask before hand, to stay on top of the pain by being one step ahead of it. Then they administer it to me every 4 hours or 3 hours whether I ask for it or not. They know if I wait until pain is too much...I wont last until next dose. This is actually a good thing to do. Sometimes clients try to sit it out until its unbearable but it only makes the breakthrough tough. My 2 cents.

z

[Nurseboy1]

If a patient needs pain medicine that badly they won't be asleep. When patients request pain meds from me and I go in there and they are asleep, I simply return the med to the pyxis and go on with my shift.

[z's playa]

I cuncur.(sp?)

Or.....

I agree.

[URO-RN]

I like pyxis. At my last job our machine had an automatic read out, plus if we had any problems, we had a pharmacist on our floor to deal with it. I always made sure I kept the receipts for any narc I gave during my shift, and always, as you did, have someone witness if you are returning narcs.

I have patients say, "oh, leave it here on my table..I will take it soon". I say, "I am sorry, I can't do that. Call me when you are ready to take it.". Then I go back and do what I wrote above and watch them swallow the pill(s).

There is nothing more unpleasant than to have adm. question your integrity or motives.

[lifeisbeautiful]

I am so sorry you have to go through all of this. I don't know a lot about the law regarding how hospitals have the right to demand a drug test because a patient accuses you of not administering the medication. Something just doesn't sound quite right about that. We get patients in the PACU that accuse nurses of not medicating them all of the time because the patients are so doped from the anesthesia, they can't remember a thing. Many patients wake up after their surgery and ask us if they've had their surgery yet. :chuckle I hope all of this works out for you.