Fired for Pyxis discrepancy

[Kristen75]

I was terminated from a position because 5mg of Valium was ordered and I removed 10mg of Valium from the pyxis. I gave the 5mg of Valium and went to waste the other 5. The nurse that went with me signed into the pyxis, selected the patient, selected waste and then had me log in under my info. I selected the waste amount and then hit accept and went on about my day. A few days later I was terminated because they said I didn't waste the med. I know it was wasted but was told that the pyxis doesn't show a waste. How does this happen? I know it was done. I requested a drug test but was not given one, just terminated. Any advice?

[emergenceRN17, ASN, BSN, RN]

Hearing stories like this scare the crap out of me. I'm a second year student and pray this never happens to me.

[Conqueror+, BSN, RN]

The OP is seasonal. It may be that their census is low and they wanted an excuse to get rid of you. I've seen it happen. ALOT

[Ambersmom, BSN, RN]

This was the first issue. Never had any patient complaints or other problems. I had been working at the hospital for 2 months as a seasonal employee. I had said that we are doing it wrong but was told that is how we do wastes at this hospital. I asked for a drug test immediately but was refused. I was also refused proof to see the Pyxis records. Heck, there is a seasonal nurse working there that got busted for DUI and he got to keep his job. I know the first thought everyone has is, guilty. But I know how scared I am of not wasting and know I am fanatical about having a witness and wasting. In 4 years as a nurse I have never had this happen.

Suggest you have a private drug test done if its only been a few days, that can only help you. What happened to the 5mg's you wasted? Did it go in the waste container?

[Ambersmom, BSN, RN]

Do you mean the actual non-administered portion of the meds? They are squirted or crushed and flushed down the sink in the presence of the witnessing nurse. "Wasting" it in the Pyxis is simply the documentation process; Nurse 1 logs in, clicks waste meds, selects the med that was wasted, and enters the amount of waste and reason for waste (generally it is because only part of the drug was given--0.4 mg of a 1 mg syringe of Dilaudid was given per the Rx--but can also be if the nurse dropped the drug on the floor, or the pt decided he/she didn't want it after the nurse removed it from the packaging.) Then Nurse 2 enters his/her login info as the electronic signature.

If a med is returned--say the pt decided he didn't want his pain med, and the nurse hadn't yet opened the prefilled syringe/blister pack--the two nurses document the same as for a waste, except you select "return med" from the menu. I can't remember what exactly the Pyxis does, but the Omnicell (another electronic med cabinet) has a locked box that opens up. Nurse puts the unopened drug into the box, and then it locks automatically when the box is closed. It's a drop-down box kind of like a sharps container, so another nurse coming along can't just pretent to return a med but then steal meds from the box. The pharmacy staff then handles the disposition of the meds--they either dispose of them or re-stock them into the cabinet.

At my place, we have an actual waste container, basically a glorified sharps container and wastes go in there.

[Sour Lemon]

Suggest you have a private drug test done if its only been a few days, that can only help you. What happened to the 5mg's you wasted? Did it go in the waste container?

It's been a lot longer than a few days. This thread was started in 2015.

[Kallie3006, ADN]

Something doesnt add up here at all. The med was pulled, given, wasted with a witness, waiting not captured, pixis unplugged, plugged in again, reset, witness is MIA unwilling to answer calls or texts, management terminates with what seems to be no internal investigation, drug test not done, and will be reporting to BON? I dont understand what the thought process is thought this ordeal.

I would definitely retain council. While everything is fresh I would write down any and all recounts of the day in question, and the discussion with managment. Write down everything you remember while its fresh, you may not remember something valid going on the thought that you will never forget that day, because something will be missed. If you have retained council do not speak to anyone ( BON, former coworkers, former boss ect) without talking to the lawyer first. I would also try to see what their policy is on you seeing your employment file, most places you have to request it in writing and you can view it at HR, see if your attorney can get this for you. Ask about getting a hair drug test completed, this goes back 2-3 months and should cover the time in question. File for unemployment yesterday. They will probably try to fight it just heads up. Did the hospital have a policy stating if a narc discrepancy occurred it was immediate termination? If so did you sign anything stating you received this information and agree to it?

This is awful and I'm sorry you are having to go through this.

[Kallie3006, ADN]

Haha I just saw the date lol, my bad

[elijahvegas, ASN, RN, EMT-P]

everything about this was handled inappropriately.

firstly, this shouldn't have been a waste at all. it should've been a return. second, i wouldn't have called any other random coworker to worry about this. i would've taken it straight to my charge nurse and have charge witness. much more credible, and if they plan on taking you down, theyd have to sink a charge nurse with you.

there is a menu to fix when a discrepency is created in the pyxis. theres a specific option for correcting the count that says "1 tab ordered, accidentally removed 2 tabs" and a whole bunch of other options like that. when you select that option and returned the tab, it would've automatically recalculated and fix the narc count and eliminated the discrepancy, and once pharmacy is brought up to speed, everything would be squared away.

it never should've been wasted because thats a narc that wasn't ordered and eventually becomes unaccounted for, especially if its 2 nurses working together to divert narcs.

sorry youve been fired for this, i suppose this is a bit unorthodox judging by a lot of these responses but at my facility, this wouldve gotten me torpedoed out the front door