Rn not giving scheduled meds

[tinkle]

Does anyone have an answer for me? I have a new RN that was just hired a week ago. She works only on the week-end. Pharmacy audited the med-carts and books. She was not giving the residents their scheduled narcotics. Narcotic cards were full. But the Mar was signed that she gave them. What do you do in your facility? tinkle

[Morgan314]

What type facility are you talking about? Do you count narcotics at beginning and end of each shift? If the nursed signed that the medication was given, isn't that falsifying documentation? Where are the narcotics stored? Does the nurse know where they are? How much orientation was the nurse given?

[snowfreeze, BSN, RN]

Re-educate. Document the re-education. Ask why no narcotics were given, document the answers.

Is the RN new to nursing or just new to you?

hired one week ago and no orienting nurse to oversee? Who oriented this nurse?

[TheCommuter, BSN, RN]

What type facility are you talking about?

It's probably a long-term care facility such as a nursing home or rehabilitation.

At the nursing home where I am employed, occasionally a nurse will initial on the MAR that she gave a scheduled narcotic; however, she never signed it out or ever took it from the locked narcotic drawer.

[tinkle]

The RN was not new to LTC and had worked in this facility before. She new the cart but I am not sure why this happened. I am a manager on another unit and heard the other managers talking about it. I was just curious what you all would say. Thank you for your comment and suggestions. I will relay this to the other managers. tinkle

[thsnursluvsgeriatric]

Hi tinkle,

Is the ward very busy? Ask the nurse to take more time to ensure that the meds are being given. Are the reminders cards in place?

[tinkle]

Yes it is one of the busiest units. I will take your suggestion to the manager in charge. This RN is a good worker and is good with the residents and aides. I don't think she meant to do anything wrong or to omit anything. I think sometimes when its busy they sign for things at the end of the shift and make mistakes when this happens. Thanks for your suggestion. tinkle

[gertiemae]

If the narcotics were scheduled meds and not PRN, that constitutes a med error for each dose omitted. This is a serious situation, especially if this is not a new nurse, not new to that center, and familiar to the med carts. Not to excuse a new nurse making the same mistakes... the patients involved did not get the medications that they needed...

The others raise a good question... if she was hired just one week ago and only works weekends, why is she not still receiving orientation?? It sounds to me like more than one person has dropped the ball, here, and once again the patients pay the price.

I am also disappointed to hear that you learned of this by overhearing others talking about this. This should have been addressed quietly by the DON with the nurse involved, and not discussed at all by the other managers, ESPECIALLY where they can be overheard!!This could have a tremendous negative impact on this nurse and her ability to be effective in her position as both a nurse and as a supervisor.(assuming, of course that the errors are addressed and do not reoccur).

[bawms]

Write up a med error on this Nurse or give copies of paperwork and you can copy meds not given in cassettes, etc.....along with signed MARS and let DON do it if you are not comfortable writing up med error.

[night owl]

I am also disappointed to hear that you learned of this by overhearing others talking about this. This should have been addressed quietly by the DON with the nurse involved, and not discussed at all by the other managers, ESPECIALLY where they can be overheard!!This could have a tremendous negative impact on this nurse and her ability to be effective in her position as both a nurse and as a supervisor.(assuming, of course that the errors are addressed and do not reoccur).

I sure agree to this. Where is the professionalism?

[txspadequeenRN, BSN, RN]

Are yall not counting the narcs at the begining and at the end of every shift?

[luvmy2angels]

These are definately med errors and where I work narc med errors are SERIOUS!! Too many and you are gone...and this nurse probably would be gone. Something just smells fishy about this.......