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.
Specializes in M/S, LTC, Corrections, PDN & drug rehab.
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.
I still stand by my point that it was still fresh in her mind & probably lead to your dismissal.
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.
Best wishes.
I completely agree that tracking systems are needed and helpful for a lot of reasons. I have no problem AT ALL with managers monitoring their staff or pharmacies flagging questionable narcotic usage. But ....as was the case with OP, they need to find out what the issue is about and of course counsel for unsafe practice or practice that does not follow policy, no matter the rationale.
I do have a big problem when the issues are not properly investigated, or when someone is falsely accused or disciplined just because it is flagged or "MIGHT BE" a diversion issue.
I still stand by my point that it was still fresh in her mind & probably lead to your dismissal.
I'm not arguing your point of view, but you don't have all the details and therefore you are stating an opinion based on partial information. There was no "fresh in her mind". Both were brought up at the same time and the first one was shown to be flagged in error, right then and there. This thread came about when I made a comment using my own experience as an example. I didn't intend this to be about me, but felt compelled to answer some questions that came about as a result of what I said in my comment.
Specializes in M/S, LTC, Corrections, PDN & drug rehab.
I'm not arguing your point of view, but you don't have all the details and therefore you are stating an opinion based on partial information. There was no "fresh in her mind". Both were brought up at the same time and the first one was shown to be flagged in error, right then and there. This thread came about when I made a comment using my own experience as an example. I didn't intend this to be about me, but felt compelled to answer some questions that came about as a result of what I said in my comment.
What? It wasn't fresh in her mind but yet were brought up at the same time? So then it would be correct to say they WERE fresh in her mind. You got flagged by the pharmacy twice, I'm sure she thought it was rather bizarre.
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.
You are incorrect on that. Diversion is just not taking the medication meant for the patient. It's also selling. Not all drug dealers are addicts. Many won't touch the the stuff, but know they can make a quick buck. So, passing a urine screen does not ever make you innocent to the BON.
I'm just responding to this one comment. The OP understands she made a mistake and has said she understands. I understand what she was doing, but the Pyxis takes about a minute. I'm sure she won't have another issue. And I know nothing about travel nursing.
What? It wasn't fresh in her mind but yet were brought up at the same time? So then it would be correct to say they WERE fresh in her mind. You got flagged by the pharmacy twice, I'm sure she thought it was rather bizarre.
You misunderstood what I was saying. I replied to a comment that said when the second accusation came up, the first one was still on her mind. Also...have you read the posts I made? The first one was an ERROR. They were questioning a dose I gave saying there was no order for it. As we looked through the chart and the binders of documentation we FOUND THE ORDER. IT WAS ORDERED. No wrong doing. The second one also had no wrong doing but I couldnt explain it at the time. I later found the reason it appeared suspicious, but in fact also had an explanation r/t the time stamps between the Pyxis and the Wow's not being in sync.
And BTW, what is bizarre about all this is that I lost my job over faulty flagging and an incorrect assumption that I must have an issue, and thinking such as yours making judgments without all the facts.
You are incorrect on that. Diversion is just not taking the medication meant for the patient. It's also selling. Not all drug dealers are addicts. Many won't touch the the stuff, but know they can make a quick buck. So, passing a urine screen does not ever make you innocent to the BON.
I'm just responding to this one comment. The OP understands she made a mistake and has said she understands. I understand what she was doing, but the Pyxis takes about a minute. I'm sure she won't have another issue. And I know nothing about travel nursing.
Point well taken about selling and not necessarily using. I never thought of that.
Specializes in M/S, LTC, Corrections, PDN & drug rehab.
You misunderstood what I was saying. I replied to a comment that said when the second accusation came up, the first one was still on her mind. Also...have you read the posts I made? The first one was an ERROR. They were questioning a dose I gave saying there was no order for it. As we looked through the chart and the binders of documentation we FOUND THE ORDER. IT WAS ORDERED. No wrong doing. The second one also had no wrong doing but I couldnt explain it at the time. I later found the reason it appeared suspicious, but in fact also had an explanation r/t the time stamps between the Pyxis and the Wow's not being in sync.
And BTW, what is bizarre about all this is that I lost my job over faulty flagging and an incorrect assumption that I must have an issue, and thinking such as yours making judgments without all the facts.
Wrong or not I'm sure she still thought it was weird you were flagged TWICE. I think you are missing what I'm saying, had you been flagged once, I'm sure you would still have a job.
Specializes in Critical Care, ER and Administration.
I'm in administration. I've had RNs take narcotics and replace them with saline. Your behavior sets off huge alarms. At the facility I work at you would have had to take a drug screen as well as being on probation. Your actions could be reportable to the board and in some jurisdictions to law enforcement. I would strongly recommend a change in practice. I would also recommend reading your policies and procedures on drug administration and on the handling of controlled substances. This is an area where a lot of RNs get into serious trouble.
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.
When I initially read this post, I interpreted it as her as dismissing your explanation- not the entire issue, itself. I understand what you're saying, now ....doesn't sound like you were treated fairly.
Yea This is definitly not good practice. What if you lost it or accidentaly threw it out then how would you explain the missing med. You're really not supposed to walk around with ANY meds in your pocket let alone a narcotic.
Not a good idea to pre-pour narcs especially. Always the chance that you can get them mixed up and give to someone else. Believe me I know about bad workplace experiences. Maybe you need to find a new workplace with better staffing. You don't want to get a bad report on you at the State level. I definitely understand the pressure you are under but the State Review board will hold you responsible and not ask questions about staffing.
OrganizedChaos, LVN
1 Article; 6,883 Posts
I still stand by my point that it was still fresh in her mind & probably lead to your dismissal.