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.
The "other narcotic issue" might make it much less confusing (depending on what the issue actually was).
They were 2 separate issues not related in any way and I Was able to explain the first one. The second one made no sense to me at the time. It wasn't until my friend looked into the time stamps between the Pyxis machines and the Wow's that I realized what happend with the second situation brought up. I could have shown that at the time IF I had known about the time descrepancy between them.
Does anyone understand what I am trying to explain? I know it is confusing when I try to describe it. The point is they both were explainable. I just didn't know how to explain the second one brought up at the time I was questioned and the manager took the most defensive approach. HOWEVER...I WAS NOT DIVERTING MEDS and yet I was accused of it and let go.
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.
She brought up both at the same meeting. I was able to explain the first one, but stumped about the second one. I couldn't explain it until my friend explained to me that the time stamps We're off. But by then, it was too late. I was advised to let it go even though it made me crazy to be wrongly accused. It was horrible to go through.
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.
The "other narcotic issue" might make it much less confusing (depending on what the issue actually was).
Okay. I'll write a post on the subject. It is too much to explain here and I should have just waited to bring this issue up. Many assume the worst..."I must have been up to something​", if the manager accused me.
I don't believe that the manager just dismissed your first narcotic issue. I believe that probably lead to your contract being cut.
The first issue was their error. At first, they claimed there was no order for the med I gave at the time it was given, and then as we went through the chart, we found the order.
I didn't think I needed to explain this in order to understand the second accusation was bogus also. You should have been there...4 different binders, the manager and an ANM and myself. Called in 3 hours before I was to start a 12 hr. Night shift. Awoke to 2 urgent messages on my phone from the manager telling me to come in ASAP as she needed to talk to me about something "very important". I called her, got a very cryptic explanation and again told to come in ASAP. I slapped my scrubs on, thinking I would be working my shift that night, and ran out the door. When I got there, I was lead to the manager's office, sat down and then told there were "flags from the pharmacy". We then went into the issues she wanted to discuss. As we went over the first one and discovered in fact, there was no wrong doing on my part, she brought up the second one. As I said before, I was clueless and stumped until later when it became clear what had actually happened r/t the time discrepancies. I couldn't explain it then. It happened several months prior, couldn't even remember the patient (turned out wasn't one I cared for but one I helped with), and the way it was presented, was confusing to me. It took us, all 3 looking over the binders, 15 or so minutes to find the order for the med they claimed at first didn't exist. It was ridiculous! She then implied I "may have a problem" and dismissed me. Just like that. I felt like I fell down the rabbit hole, if you know what I mean. I had never gone through such a ridiculous, no control, no recourse situation such as this. As much as I tried to protest, the more she insisted and bull dozed over me. The ANM there worked with me for several months. He knew me. I felt he was sympathetic, but had no recourse of power either. He hugged me as we walked to my locker, and escorted me out the door. He kept saying something to the effect of, "I hope you understand". "I hope you don't hold this against us, because it is a difficult situation.".
Does anyone understand what I am trying to explain? I know it is confusing when I try to describe it. The point is they both were explainable. I just didn't know how to explain the second one brought up at the time I was questioned and the manager took the most defensive approach. HOWEVER...I WAS NOT DIVERTING MEDS and yet I was accused of it and let go.
I get what you are explaining, it made sense. Traveling can suck - no trust, no job security. I would be very upset by that too.
Specializes in M/S, LTC, Corrections, PDN & drug rehab.
Thank you! I started to get upset all over again when it seemed posters felt it was justified somehow.
Explainable or not, I'm sure the NM was concerned since there were flagged by pharmacy twice. If it only happened once, (explainable or not) I'm sure it wouldn't have had the same outcome.
"In expectation" that a patient will want it is not good enough when it comes to narcs. Wait until the patient asks for it, and if the patient has to wait a little while, then that's how it has to be.
Specializes in med-surg/tele/ortho w/ICU,NI,Trauma.
Make no mistakes, Pyxis, and I assume Omni-Cell, track everything you do. 7 years ago I was tasked with reviewing med recs of patients of nurses who statistically gave more narcs than average. There are always variables, but understanding what is done vs what is right can help prevent issues.
I know some nurses are more likely to give meds than others. I've seen nurses lose everything for diverting. There is a road back to practicing again. But it is tough and humiliating and VERY EXPENSIVE emotionally, financially, and professionally. Trust broken may never be regained. Work options become very different.
If you can give a clean urine sample then you are fine. Passing the whizz quiz will exonerate you. But seriously, chalk it up to a lesson learned.
Best to wait until a pt actually asks for it from now on, because so many things can happen to prevent them from actually taking it as intended. Best not to be caught with an anticipatory PRN narcotic in your pocket anyway. What if you forgot and left the floor for lunch, or accidentally went home with it in your pocket? How could you explain that? It would look suspicious and fishy.
Save time other ways, but do things by the book in this case from here on out. Being investigated by the SBON is frightening and stressful. I've never experienced it personally, but I sure can imagine having a melt down. Plus, I can think of other things to spend my hard earned money on than legal fees.
Explainable or not, I'm sure the NM was concerned since there were flagged by pharmacy twice. If it only happened once, (explainable or not) I'm sure it wouldn't have had the same outcome.
I don't care if it was 10 flags...the accusation was incorrect. What is there for a NM to be concerned about if I was able to show that the first one was flagged in error? (Actually, all three.of us found the order that was written right then and there even tho it.took some hunting thru.the binders). The second one I couldn't explain in that moment, but turned out to have an explanation as well. I understand pharmacy flagging, but then you must at least due your due diligence to see if the person should be disciplined or if there is a concrete explanation.
My WHOLE point here is that innocent nurses are under scrutiny and in my case lost a job.
BeenThere2012, ASN, RN
863 Posts
They were 2 separate issues not related in any way and I Was able to explain the first one. The second one made no sense to me at the time. It wasn't until my friend looked into the time stamps between the Pyxis machines and the Wow's that I realized what happend with the second situation brought up. I could have shown that at the time IF I had known about the time descrepancy between them.
Does anyone understand what I am trying to explain? I know it is confusing when I try to describe it. The point is they both were explainable. I just didn't know how to explain the second one brought up at the time I was questioned and the manager took the most defensive approach. HOWEVER...I WAS NOT DIVERTING MEDS and yet I was accused of it and let go.