HELP! the adon stealing out of the med cart?

pennyaline · Nov 9, 2009

"...i told her to call the state. she said she didnt know the number, it wasnt posted anywhere in the building..."

That alone is a violation of residents' rights. It is required that telephone numbers of state and local watchdog agencies be posted in public areas accessible to residents, consultants, employees and visitors. Any resident, worker or visitor is free to call these agencies any time there is concern about resident well-being.

"and she was afraid if the state came in and followed her, and the meds werent there to give she would get in trouble.."

She would only get into trouble if she didn't notice or pretended not to notice that the meds aren't there, or couldn't come up with a way to obtain the meds that aren't there. All surveyors want to see is current prescriber orders, the ability to get the meds that are missing (ie call the pharmacy and/or use the e-kit), and conscientious use of nursing practice. They also don't want to hear that she ever handed the keys over to another staff member who had no need for them. When the survey team is with you, it's best to say nothing for as long as you can. Answer only the questions asked, give them the answer they're looking for, and don't volunteer any information.

Vito Andolini · Nov 9, 2009

GET OUT! Get out, get out, get out. I applaud her for trying to do what's right for the residents, but she's fighting a losing game. If she refuses to give the NM the keys, and he gets mad, he could very well blame the missing meds on her, get her fired, and have her license examined. Just out of petty spite.
No, she just needs to get out of there. THEN call state. A surprise visit should be in order, methinks.

All she needs to do is be with him whenever he goes to the cart. And she should follow him to the room of any pt to whom he says he is giving narcs, or give them herself, at his "request". And if he takes them, he's got to sign for them and document everywhere it's required. And she should simply not allow him to take any meds out. She should tell him she needs the meds for her patients and he "would be causing the patients to do without their meds and that would be stealing and detrimental and unethical and you don't want to do that, I'm sure, Mr. ADON. No, I'm sorry, I can't help you." He will soon get the message that she is on to him and will back off. If she stands her ground, painful though that might be, he will leave her alone. And she should not argue with him.

He won't be there long, I'm guessing, once ALL the nurses wise up and stand up to him/report him.

blondnursey · Nov 9, 2009

Document what? That she gave out prescription meds to people other than the persons for whom they were ordered? That she "stole" OTC's and handed them out to staff?
That she didn't order meds when she found them missing, even if it's someone else's job to order? That she didn't call Pharmacy and get the meds delivered in a timely manner? That she didn't notify the doc and get alternate orders? Where would she document these things? Maybe in incident reports, sent to the owner, but to bypass her chain of command would be bad.
Maybe her best bet is to play dumb and just start calling the doctor every time there's a problem. The doctor will soon c/o to the boss, who will know he's been found out and maybe put a stop to the practice. This could backfire.
And the nurses who are stealing meds from the patients, especially the nurse who's hooked on the narcotic, need to be reported to the Board of Nursing and to the bosses, in writing, all of them at once, and keep a copy. She need only report her suspicion and then let them sort it out.
What a pathetic and angering mess.

she does order the meds, which is why a 2 hour med pass takes 4...but you know how it is to follow someone who doesnt put stuff in the cart. she said she offers the staff tylenol from her purse instead of the cart.

the real problem seems to be the adon. i told her to tell him to wait till her hands are free & she will stand there while he does his "audit".

told her everybody has a boss, just keep going up the chain.....this place is truly awful.

even if she has to write down a response on index card and recite it.

you guys are great, thanks for all the advice!

OldnurseRN · Nov 9, 2009

Having had to report a fellow nurse for diverting narcotics, I know it is hard. Your friend has a legal responsibility to make a report on this. She is legally responsible for the drugs in the cart if she has the keys. The DON can deny and it will come down to the person with that responsibility.

allnurses Guide · Nov 9, 2009

Find a thread that was on here about a week ago about a nurse losing her job and being reported to the BON (and getting a warning on her license) for giving ibuprofen to a coworker. Whether or not this is "accepted" in LTC, it's illegal.

Vito Andolini · Nov 10, 2009

she does order the meds, which is why a 2 hour med pass takes 4...but you know how it is to follow someone who doesnt put stuff in the cart. she said she offers the staff tylenol from her purse instead of the cart.
the real problem seems to be the adon. i told her to tell him to wait till her hands are free & she will stand there while he does his "audit".
told her everybody has a boss, just keep going up the chain.....this place is truly awful.
even if she has to write down a response on index card and recite it.
you guys are great, thanks for all the advice!

Even giving them her personal Tylenol could land her in trouble if someone has a bad reaction to it. She is licensed, she should not be risking that license. The staff need to buy their own tylenol. It's very cheap and she is not their mother, not responsible to care for them. She has no legal obligation to do so.

They are just taking advantage of her kind but foolish nature. They see her as a soft touch and would turn on her in a second if they find something they don't like about her, believe me. There is no loyalty there, no womb to tomb loyalty or commitment. They'll sacrifice her in a heartbeat if it's to their advantage. There are no friends at work. No matter how nice someone is to your face, watch your back.

Always play by the rules and follow policy and she will never have to explain why she didn't follow policy.

Tell her she's not a pharmacy and to just say no. Harsh but good advice. Anyway, these headaches could be harbingers of some serious malady and she might be helping them avoid getting properly diagnoses. Lawsuit.

Yes, of course the problem is that jerk ADON, the drug addict, the liar, the thief. Who ever heard of auditing a med cart in the middle of a med pass or any other time? What the heck is that about? In nearly 4 decades of Nursing, I've never seen a med cart "audited". She can ask him how it went and request to see the written audit report. Tell her to not hold her breath waiting for it. No audit took place, see?

Just for her own edification, tell her to see if he signed out the Vic to the right patient, did he do the pain assessment sheet and make a progress note? I'd guarantee you, he did not. but tell her to see, just so she gets the full impact of what he's doing.

Vito Andolini · Nov 10, 2009

GET OUT! Get out, get out, get out. I applaud her for trying to do what's right for the residents, but she's fighting a losing game. If she refuses to give the NM the keys, and he gets mad, he could very well blame the missing meds on her, get her fired, and have her license examined. Just out of petty spite.
No, she just needs to get out of there. THEN call state. A surprise visit should be in order, methinks.

Running away is irresponsible. It's being part of the problem. It's also detrimental to one's resume and to ever becoming vested in a pension plan. we can't always run away - ethically and with regard to our personal needs.

Vito Andolini · Nov 10, 2009

hi
my friend who is also a lpn, got a new job this week.
its a local nursing ho me with a very bad rep. i told her to be careful...
well she has called me everyday that she has worked freaking out.
seems the adon asked her for lasix 60 out of her cart, he forgot to take his that day. she said no, and he wetn and got it from a different nurse. then the next day he asked for the keys to "audit" the cart &(she was feeding and couldnt get up) then said "oh yeah i gave so and so a vicodin" but the pt showed no sigs of pain relief and vics always make him sleep.
the staff asks her for tylenol and aleve from her cart. the nurse she follows doesnt use the mar and half the pills arent there to give anyway,as she doesnt order. to make things worse, several pts have body lice and they only had expired shampoo to use. i told her to call the state. she said she didnt know the number, it wasnt posted anywhere in the building. and she was afraid if the state came in and followed her, and the meds werent there to give she would get in trouble..
she wants to quit, but doenst want the residents to continue to not get their meds & good care they deserve.
so my question is what a good reply to the adon when he wants to audit? what to do when the state comes and your meds arent there? what if you are pretty sure the adon took the narc? he is in tight with the don & owner so who else is there to complain too?
how do you deal with no meds to give?
i have told her i would ask for help on here, she is anxiously awaiting your advice.
thanks

Can you expand on "the other nurse doesn't use the MAR"? What does this mean?

kompack151 · Nov 10, 2009

Thanks everyone,

My friend posted the original topic about my "problems". The issue with people asking me for ibuprofen and such is more of an irritance, I am able to say no. The other issues, and there are more, I need to address with the state.

Undocumented falls, missing meds, ADON rummaging through carts for lasix and other meds (even narcs I believe), expired stock meds and yes, even expired lice shampoo, isolation precautions without any PPE... There's so much going on, I am not the perfect nurse but I try my best. I want to just walk away sometimes. Maybe give the state board a call, stick with it and see if anything changes. I really don't know. These would be hard to prove. I can find the narc sheet where it had missing doses and copy it. There's also a resident who fell, no incident report, and bruising on the greater part of her foot and ankle. The other things I don't know how to get proof.

The admin and don along with the adon are all friends, I did tell them how the carts are a mess, they listened, but nothing was done.

Oh and to the one who asked what not using the MAR means, the nurses (a couple) don't look at the MAR, they pop through the blister packs and sign off at a later time.

*sigh* off to work.

Vito Andolini · Nov 10, 2009

Thanks everyone,
My friend posted the original topic about my "problems". The issue with people asking me for ibuprofen and such is more of an irritance, I am able to say no. The other issues, and there are more, I need to address with the state.
Undocumented falls, missing meds, ADON rummaging through carts for lasix and other meds (even narcs I believe), expired stock meds and yes, even expired lice shampoo, isolation precautions without any PPE... There's so much going on, I am not the perfect nurse but I try my best. I want to just walk away sometimes. Maybe give the state board a call, stick with it and see if anything changes. I really don't know. These would be hard to prove. I can find the narc sheet where it had missing doses and copy it. There's also a resident who fell, no incident report, and bruising on the greater part of her foot and ankle. The other things I don't know how to get proof.
The admin and don along with the adon are all friends, I did tell them how the carts are a mess, they listened, but nothing was done.
Oh and to the one who asked what not using the MAR means, the nurses (a couple) don't look at the MAR, they pop through the blister packs and sign off at a later time.
*sigh* off to work.

Not using the MAR is a good way to miss new orders.

If the DON and Admin won't take action, your next step is the owner, assuming he or she is not also the Admin, DON, or ADON. Right?

Please take to heart what I said about getting in trouble for giving OTC meds to anyone other than patients with whom you have a nurse-patient relationship. You must stop giving anything to coworkers, for your own protection.

blondnursey · Nov 10, 2009

Can you expand on "the other nurse doesn't use the MAR"? What does this mean?

how scary to think shes medicating somebodies family............."

husker_rn, RN · Nov 10, 2009

I would be out of there fast !! At some point the fit will hit the shan and your friend will not want to be there when it does.