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Discussion

Fentanyl Patches

I'm a new nurse... my question is...

When I dispense and apply a Fentanyl patch to a patient I do not need another nurse to witness it. But when I discard the old patch, I need a witness. Why is that? It doesn't make sense to me. I would think it should be all the way around.

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    This is no different than administration or waste/disposal of any other controlled substance. You do not (generally) need a witness to verify that you have given the med - applied the patch, in this case - but you do need a witness to confirm the disposition of "left over" med.

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    Some people have been known to scrape off any unabsorbed gel left on the patch for illicit drug use. Thus the reason for the witnessed removals/disposals.

    And it really does happen!

    You'll also notice that the pharmacy gets real interested if patches have to be 'replaced' too early than regularly scheduled. Those patches sometimes do honestly get rubbed off or pulled off by accident.

    Pts do it themselves or someone mistakes a fentanyl patch for the NTG patch (OOPS!).

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    Do you need a witness to administer Fentanyl IV? No, but you do need a witness to waste it. Same thing.

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