Hi. I was wondering if anyone has any experience of being falsely accused of med diversion due to giving meds 1-2 hours after pulling them out of the pyxis.
I am so upset and frustrated since my manager recently told me that the pharmacy put me on an alert list for possible medication diversion. The only reason for this is because I have pulled out morphine at times and not given it until 1-2 hours later. There isn't any medication missing. No accusations from patients. NOTHING else.
I am so upset that this is happening. I work on a really busy floor and I often have pulled out a pain med in expectation that the patient will ask for it, though when I go into their room, they are sleeping or don't want it at that time. Rather than return the med immediately, I hold onto it until they need it so I am prepared for the next time. I am on a floor where there aren't any CNAs at times, nor a resource RN and sometimes no unit clerk and every minute counts. I have been beyond frustrated with the work environment and now I am being falsely accused of this. I am trying not to get upset but it's truly difficult.
She never said she put meds in her pocket or on her person. She might have left them in the patients' med drawers.
Semantics
They are "on her person" (ahem possession) whether locked in her pt's med drawer in her pocket, etc when one states "I held on" to the med:
I am so upset and frustrated since my manager recently told me that the pharmacy put me on an alert list for possible medication diversion. The only reason for this is because I have pulled out morphine at times and not given it until 1-2 hours later. There isn't any medication missing. No accusations from patients. NOTHING else.
I am so upset that this is happening. I work on a really busy floor and I often have pulled out a pain med in expectation that the patient will ask for it, though when I go into their room, they are sleeping or don't want it at that time. Rather than return the med immediately, I hold onto it until they need it so I am prepared for the next time. .
Thank you for the comments everyone. I definitely immediately changed my practice. It was definitely poor judgement and I'll never be doing that again.
It sounds like your manager is very decent. She communicated with you clearly, instead of ambushing, escorting you to HR, and demanding a urine sample right now. You didn't get suspended, just instructed on policy and told to change.
Good for you for coming around to the sensible response. It is natural to be upset at first.
Unfortunately, this sort of thing happens and I know how frustrating it can be. I understand your attempt to be more efficient, and I Know full well how busy it gets having worked on units with similar staffing. The problem is that when it comes to narcotics, hospitals are hyper vigilant these days, and many managers ready to jump to conclusions. You must follow ALL policies and procedures related to narcotic handling no matter what or you can end up where you are or worse.
i once had a similar thing happen where the pharmacy "red flagged" me. It showed me taking out a dose, and then a dose of the same med charted a few minutes earlier by a different RN for the same patient. It looked like I took out the dose after one was already
given, without me charting my dose was given. And this was SEVERAL MONTHS later when I was questioned about it. Turned out, i ran and got it for the other nurse and she gave it. Which is a common practice in the ICU I worked in at the time. A patient can be going down, the bedside nurse cannot leave the patient in that moment, and so others run a get things for her/him. I was accused and "and let go". I didn't remember the situation and couldn't answer to what had happened at the time I was questioned. I was stumped until I was told later by a friend who still worked there, that the time stamps were off on ALL the Pyxis machines compared to the WOWs. This is serious business and nurses are being wrongly accused. I had no recourse at the time. It was a travel position, at will hire/fire without Union coverage. My recruiter told me to let it go as she believed me, but had no way to stand up for me. Horribly frustrating!
Unfortunately, this sort of thing happens and I know how frustrating it can be. I understand your attempt to be more efficient, and I Know full well how busy it gets having worked on units with similar staffing. The problem is that when it comes to narcotics, hospitals are hyper vigilant these days, and many managers ready to jump to conclusions. You must follow ALL policies and procedures related to narcotic handling no matter what or you can end up where you are or worse.
i once had a similar thing happen where the pharmacy "red flagged" me. It showed me taking out a dose, and then a dose of the same med charted a few minutes earlier by a different RN for the same patient. It looked like I took out the dose after one was already
given, without me charting my dose was given. And this was SEVERAL MONTHS later when I was questioned about it. Turned out, i ran and got it for the other nurse and she gave it. Which is a common practice in the ICU I worked in at the time. A patient can be going down, the bedside nurse cannot leave the patient in that moment, and so others run a get things for her/him. I was accused and "and let go". I didn't remember the situation and couldn't answer to what had happened at the time I was questioned. I was stumped until I was told later by a friend who still worked there, that the time stamps were off on ALL the Pyxis machines compared to the WOWs. This is serious business and nurses are being wrongly accused. I had no recourse at the time. It was a travel position, at will hire/fire without Union coverage. My recruiter told me to let it go as she believed me, but had no way to stand up for me. Horribly frustrating!
I don't understand . You pulled the med, another nurse gave it. Only one dose was removed from the Pyxis, the patient received one dose. Where is the discrepancy?
I don't understand . You pulled the med, another nurse gave it. Only one dose was removed from the Pyxis, the patient received one dose. Where is the discrepancy?
I know it's a confusing story.
I am on record as having pulled the med a few minutes after it was documented as given
by the assigned nurse. I was not told it was a descrepancy. I was called into the managers office and confronted r/t the "red flag" by the Pharmacy. She was questioning me about this and another narcotic issue which I explained clearly and she dismissed. She was simply being suspicious and told me in light of her "questions", she was not comfortable in continuing my contract...even though I was extended 4 times, had no history of problems in the past r/t this sort of thing and I got along really well with the rest of the staff, doctors etc...In other words, I was doing very well there. I couldn't explain, at the time, the second issue. I told a friend about it and she checked the Pyxis machines and a few Wows and let me know they were ALL off by a few minutes. So it LOOKED like it was documented earlier than when I
pulled it out, but obviously, it wasn't as I
brought it to the assigned nurse immediately. Another example of how nurses are presumed guilty without evidence and in some
cases, like mine, there is nothing you can do about it. If she had reported this to the BRN I would have fought tooth and nail. My 4th contract was almost over, so I let this go as advised by my recruiter at the time. I was pissed beyond belief, humiliated as she kept saying she "hoped I get help" which was frustrating beyond belief. I realize now that if I had asked her to look up if there was a descrepancy, it would have at least been partially explained. The whole thing was confusing, out of nowhere, and I just couldn't figure it out in that moment. My friend suggested checking the time stamps between the Pyxis and the Wow's...then it made sense, but too late.
I was called into the managers office and confronted r/t the "red flag" by the Pharmacy. She was questioning me about this and another narcotic issue which I explained clearly and she dismissed.
The "other narcotic issue" might make it much less confusing (depending on what the issue actually was).
Specializes in M/S, LTC, Corrections, PDN & drug rehab.
I know it's a confusing story.
I am on record as having pulled the med a few minutes after it was documented as given
by the assigned nurse. I was not told it was a descrepancy. I was called into the managers office and confronted r/t the "red flag" by the Pharmacy. She was questioning me about this and another narcotic issue which I explained clearly and she dismissed. She was simply being suspicious and told me in light of her "questions", she was not comfortable in continuing my contract...even though I was extended 4 times, had no history of problems in the past r/t this sort of thing and I got along really well with the rest of the staff, doctors etc...In other words, I was doing very well there. I couldn't explain, at the time, the second issue. I told a friend about it and she checked the Pyxis machines and a few Wows and let me know they were ALL off by a few minutes. So it LOOKED like it was documented earlier than when I
pulled it out, but obviously, it wasn't as I
brought it to the assigned nurse immediately. Another example of how nurses are presumed guilty without evidence and in some
cases, like mine, there is nothing you can do about it. If she had reported this to the BRN I would have fought tooth and nail. My 4th contract was almost over, so I let this go as advised by my recruiter at the time. I was pissed beyond belief, humiliated as she kept saying she "hoped I get help" which was frustrating beyond belief. I realize now that if I had asked her to look up if there was a descrepancy, it would have at least been partially explained. The whole thing was confusing, out of nowhere, and I just couldn't figure it out in that moment. My friend suggested checking the time stamps between the Pyxis and the Wow's...then it made sense, but too late.
I don't believe that the manager just dismissed your first narcotic issue. I believe that probably lead to your contract being cut.
I don't believe that the manager just dismissed your first narcotic issue. I believe that probably lead to your contract being cut.
Unless you have work as a traveler, you cannot understand the situation. Travelers are under the Hubbard telescope. If the manager dismissed the first issue , it was TRULY trivial. This manager did not have the inclination to treat the traveler fairly and "dismissed" her for the same reason my dog licks herself.
Specializes in M/S, LTC, Corrections, PDN & drug rehab.
Unless you have work as a traveler, you cannot understand the situation. Travelers are under the Hubbard telescope. If the manager dismissed the first issue , it was TRULY trivial. This manager did not have the inclination to treat the traveler fairly and "dismissed" her for the same reason my dog licks herself.
What I'm saying is I'm sure it was on the manager's mind when the second narc issue came up & helped lead itself to the dismissal. While the manager might've said no big deal, I'm sure she was still thinking about it.
LadyFree28, BSN, LPN, RN
8,429 Posts
Semantics
They are "on her person" (ahem possession) whether locked in her pt's med drawer in her pocket, etc when one states "I held on" to the med:
Doesn't diminish the advice given.