not documenting narcotic waste in pysix

Nurses General Nursing

Published

Help, I need feedback and advice! My NM, who writes me up for everything stupid under the sun, has told me she is reporting me to the BON. Here's what happened. I had a pt (drug seeking in my opinion) who was scheduled (not prn) morphine 25mg q4h and dilaudid 1mg iv q4h so she was taking something every 2h. The morphine was supplied in those inve amp 20mg/ml. So to get 25mg, I had to get .25ml out of one.(pain in the butt) Anyway, I just threw the inve amp into sharps container without wasting it with a witness in the pysix (has a waste function) To top that off, I put 2 of them,from 2 different dose times, in the mac drawer (computer/medcart) with intentions of wasting them in pysix later. I called the nurse i reported to that night and asked her to remove them and we would waste in the am when I returned to work. Well,needed to say, I fortgot to do that. I took care of this pt for 2 days and there was 6 times I didn't waste in the pysix. 2 doses (ones left in drawer) can be accounted for, but the other other 4 are gone in sharps container. We were extremely busy that weekend, and to save time, I didn't try to "hunt down" a witness. My NM says she legally has to report me. I talked with the pharmacy, and they said as far as they were concerned, no report would be sent from their end.My NM is the one doing it. Plwase someone tell me what I should do, I am so paniced over this, I can't enjoy anything anymore. I have beed nursing for 13 years, am50 years old. I miss the days of the paper trail.:bluecry1:

progress.gif

Up Vote Up Vote ×
Specializes in ICU, Psych.

I would recommend seeing a lawyer if you are worried. Not sure what the BON will say about this.

If it were a one time occurrence it would likely be no big thing, I think since it was more than one time your manager may be required to file a notice with the board.

One question that does come to mind is that you mention the old paper trail. Even then did you have to have a wittiness. If you have one now then both of you could file a medication error form with your pharmacy,however if you do not have a wittness, you may receive a warning.

Best of outcome to you!

Up Vote Up Vote ×

Thanks, Michaelfloridarn. When we did it on paper, it just seemed like everyone looked out for each other. yes, it did require a witness initial, but narcs were counted every shift, and if a blank was found under amount wasted, we immidiately addressed it amongst each other. I swear my NM is out to get me and my licence. I heard she was bipolar. She has ome pretty rotten things to me. Once wrotr me up for drinking a drink from the kitchen. And want to hear somethink weird? I can't find her name under licence lookup in our state.

Up Vote Up Vote ×
Specializes in Med/Surg; Psych; Tele.

Onenurse1,

This might be a silly suggestion, but could you possibly still go through the sharps container to find the other vials? I know that one time I had a co-worker (new nurse still on orientation I believe) misplace a morphine or dilaudid PCA vial and everyone, including the charge nurse, went on a mad search for it, which also included looking into the sharps in the med room and patient's room. And from what I understand, the vial never was recovered (we think the nurse turned got interrupted while trying to set up the PCA and the pt's family snagged i). I'm also pretty sure that there was no reporting this even to the BON - but then again, I'm not sure if the NM ever got wind of it either.

Your NM sounds like a harda$$. Why not tell her the pharmacy sees no reason to take it any further and plead with her to please just help out a hard-working nurse who just made a stupid mistake? The worst she could say is no.

I know of a hospice nurse that one time accidentally left the med drawer unlocked (manual - not pyxxis) for a short time when she got real busy, only to find something like 2 cards of ativan missing at the end of the night. Nothing happened to her - there was no report to the BON and yes the NM/Director knew about it.

I'm so sorry this happened to you. Pray hard and try the suggestions above. Hopefully this will just end up as one big scare.

Up Vote Up Vote ×
Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

We aren't able to give legal advice here.

But I will say DO not ask anyone to go through a sharps container or do it yourself. Narcotic wase is a serious thing and should have been done and witnessed at the time.

Please notify your malpractice carrier and seek legal counsel if necessary. This is not something we can cover here.

Up Vote Up Vote ×
+ Add a Comment