Forgot to put narcotic back in Pyxis

[Shimbo]

This Friday I had a situation that occurred regarding narcotics but I'll start from the beginning. I work on a telemetry floor which the nurse to pt ratio is usually 1:6, since it was the day after Thanksgiving the census was about 28 in a 42 bed unit which left me to have 4 pt at this time which is awesome. The day started out good I knew 3/4 patients so report was short. I start going in my usual routine doing my assessment on my patients, then I start charting then after that I take out my medications. One pt in particular was confused and yelling so when I was taking out my meds I took out Xanax for that pt. When I was about to give my meds the PCA asks me to help one of the patients which was the one that was yelling before but this time the pt was calmer. After that I started to give my meds to my first pt then I reached to the confused pt. I decided not to give Xanax because it was unnecessary, the pt was not trying to get out bed nor yelling and the pt had a tabs alarm to.. So I left the Xanax in my locked cart in which I was meaning to return after giving meds and so I moved on to my next pt.As I finished administering all my meds a code blue on my unit occurred which of course all of the nurses ran to the room to help out. Then 5 mins after the pt was sent into the ICU, my confused patient was not responding and the breathing was labored and the only way to check the BP was manually which the systolic was heard in the 50s. I immediately called RRT which then turned into code blue however in the chart the pt had DNR A paper but was not signed. In the end we were able to stand by the DNR because there was an order on the computer for DNR A so we stopped CCPR. This pt was 91 with cancer that has spread and the family member knew the pt was dying. Unfortunately in the end the pt died, this was the first time I experience a death while working. I had to do postmortem care and chart and call the sharing network. I discharged 2 pt leaving me with 1 pt left since my pt expired. I got 2 back to back admissions along with that. Mind you this I forgot all about the Xanax I left in my locked cart. In the end of my shift I usually take all of the meds that weren't given and put it in the pharmacy outbox in which the pharmacy techs pick up. I forgot I had the Xanax in the cart which I put that in outbox. I realized that I forgot to return the Xanax this morning at 4:40 AM and called my RN friend to see if the Xanax was there and she told me pharmacy already cleared the box. Then the night RN told me I was being staff adjusted which meant I didn't have to come to work. I asked my friend who was checking narcotics which luckily was one of my closest nursing buddies and told her my situation and to let me know if there were any discrepancys. She then texted me saying there wasn't any discrepancys, but I'm still worried especially since it's a narcotic. I know for sure that I put all unused meds in the pharmacy outbox but who knows if one of the pharmacy techs saw xanax and took it. I just feel extremely stupid because I didn't check the meds first before putting in the outbox. I just wish I return the narcotic right away or checked the medications I was putting in the outbox. Should I report this first thing in morning tomorrow?

[cayenne06, MSN, CNM]

Not too long ago, we had a crazy shift on L&D and I ended up going home with half a vial of dilaudid in my pocket. Didn't notice it until I got home, almost an hour from the hospital. I almost died. I had to work the next day at my "real" job (I moonlight in L&D), so could not return it until the following evening. I called the unit right away to notify them, and brought it back the next night as soon as I got -out of work. I had visions of HR waiting for me, urine cup in hand, or a police officer waiting to bring me down to the station for questioning lol. When i got there, the nurse who came to waste with me was all "Lol, I would have just tossed it in my trash and called it a night." I did not get arrested or hauled down to HR for the second degree.

Anyway. Not really helpful or applicable to your situation. But mistakes happen, and most facilities recognize that. I would be upfront about the situation and try not to worry.