Forgot to waste a narc...

Nurses General Nursing

Published

Specializes in NICU.

So yesterday I had a patient getting Morhine 3mp IV Q2hours. The same nurse wasted with me every time I gave it. The last time I gave the morphine she watched me waste but someone else was in the pyxis. We decided I would go give the morphine and then waste in the pyxis when the other nurse was finished. Well we got busy and forgot to waste the morphine in the pyxis. Yea... not very smart. Well I didn't remember until I got home last night. I called my manager this morning and she told me I had to come back in today and waste the morphine in the pyxis. So I drove 25 miles to the hospital. She called the other nurse at home and verified that we wasted the morphine and then she wasted it with me in the pyxis.

Has anyone ever forgotten to waste a narc? How does your hospital handle it? I felt like such and idiot and I was so bummed that I had to drive back to the hospital on my day off.....

Just venting.... Thanks

Tiger

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Specializes in Medsurg/ICU, Mental Health, Home Health.

it happens. i've gone home with dilaudid before, but i've never been called about it. i think my floor was a bit lax about that sort of thing. even discrepencies were shrugged off, for the most part.

please don't beat yourself up about this. it was an honest mistake, no harm done, and everything was corrected in the end!

go forth and continue to be an excellent nurse!:nurse:

*~jess~*

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Specializes in Government.

Personally, I think the manager did you a favor since she reconciled the gap and resolved it. Having worked with way too many diverting RNs, I love a tough policy. Sorry about the trip back (I hate that too!) but now at least you have peace of mind that this won't come up later as an issue.

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Specializes in ED, Flight.

First off, I think your manager had a fair solution. She solved the problem, and saved you embarrassment or disciplinary problems. :yeah:

Second, been there done that several times over the years! About seven years ago I was a paramedic in a rural county over an hour drive from home. 24 hour shifts. We didn't have narcs lockers on the ambulances; we kept the narcs on our persons. :icon_roll Quite few times I'd get relieved in the AM, and sleepily start the drive home. About half way home my beeper would go off, '911'. Call the office. The manager would have noticed I didn't hand the narcs over at shift change (the oncoming crew could pull another set from the safe at our base). And so, I would turn around and drive back to return the narcs.

When I started nursing, I went home two or three times with partially used Carpujets in my pocket or fanny pack. For efficiency's sake I was pulling the whole Carpujet, but using it in broken doses over time (per doc's order, of course). That's how we do it in EMS with almost all our drugs. Lots easier and cost effective than pulling a fresh vial and wasting every time, right? Not so smart, it turns out. I had to return to the hospital two or three times to waste before I learned my lesson. Fortunately, my supers knew clearly I wasn't diverting; but this could have been a big problem before I learned not to do that. :banghead:

So, you're not alone!

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Specializes in Psych, Informatics, Biostatistics.

Please don't beat yourself up. Your manager did you a favor. She needed to fix it and did. It's not her fault you drove 25 miles. You might want to move closer.

When I get a call like that, I never hesitate to respond.

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Specializes in Medsurg/ICU, Mental Health, Home Health.
It's not her fault you drove 25 miles. You might want to move closer.

I don't think Tiger was blaming her manager; rather, I think the commute added insult to injury. (I.E. "not only did I make a mistake, I had to put 50 miles on my car to correct it," not "that stupid NM knows I live far away, so why did she call me?")

Jess

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Specializes in Cardiac Telemetry, ED.

I have not yet forgotten to waste a narc, but the thought of accidentally going home with something in my pocket has crossed my mind more than once. I would hope to be treated as fairly as you were, should that happen.

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Specializes in Community, OB, Nursery.

In a place I used to work, if we had forgotten to waste something, we got a printout from pharmacy w/ all the pertinent info. We had to have another nurse sign it w/ us documenting the waste and send it back to pharmacy. A bit lax, that, if you ask me but it worked and nobody every seemed to get their panties in a wad.

The only time something similar has happened where I am now, it was a failed drawer in the pyxis that made the count off. (I took meds out of the failed drawer forgetting that it wouldn't count the meds in the failed drawer.) My mgr called me @ home, she called the nurse that recovered the drawer w/ me, documented it all, and that was that.

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once i got off work at 7am after a weekend option job and then drove 125 miles to my dtrs house where i was stay with the children while she was out of town for the week

ANYWAY, i drove to her house and went in to get a nap, she had sent the kids off to school so i would have until 3pm when they got home when i went in to get a shower i found the narcotic keys around my neck..i had to drive back and give them the keys, sign a pile of papers and an incident report and then drive back to get there before the kids got home from school - so glad that one of them didn't get sick and the school had to call

they say you learn more from your mistakes than from your success but i get sleepy everytime i remember that goof

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Specializes in Gyn Onc, OB, L&D, HH/Hospice/Palliative.

Back in the day when we had keys I brought mine home, opening the front door, heard a jingle around my neck, crap, drove right back, luckily I lived about 15 minutes away, I was sooo pi$$ed at myself, needless to say, never happened again. I have forgotten to have a witness many a time, we must be really lax, never called on them.

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When I worked in ICU, people were lax all the time about wasting narcs--I mean, lax about 'charting' it in the Pyxis. When I was an anesthesia student, at one particular site, waste narc were sent back to the Pharmacy to be tested and verified for being what you said it was. In that place, once, when new to the site, I squirted the waste narc into the wastebasket and I thought the CRNA was going to have a heart attack. Never did that again. Waste narcs are tracked like they are gold bricks in anesthesia. I was amazed. I understand why, given that 10% of anesthesia providers are substance abusers.

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Waste narcs are tracked like they are gold bricks in anesthesia. I was amazed. I understand why, given that 10% of anesthesia providers are substance abusers.

I don't know if I believe that percentage. If you consider that health care providers overall are probably at higher risk for substance abuse I can't imagine CRNA are much higher.

I think your manager was fair. Though they only would have caught it had they audited the MAR and the pyxis. I've never used a pyxis so I don't know how easy it is to sync with a patients MAR. Where I work I'm sure a good number of NARCs go un-witnessed/not wasted and never get caught. I don't think nurses are stealing meds I just think people get busy and if a patient gets q2 or a q4 narc and there is only a "large" size vial left it doesn't make sense to take a new vial each time.

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