hospice nurse needs advice

[badill00]

I am a 2 yr hospice nurse whom trained under a care manager whom encouraged me to keep extra pain medication in my vehicle for pt use in case a dying pt got "in trouble" and was unable to get any medication quickly. Her words were "never throw away a patch". For this reason I kept a few of the most prescribed meds and a variety of patch strengths. If a pt had an increase in patch strength I had one to place on him, giving the family more time to get to the pharmacy. Same way with pt's running out of meds. The first case manager transferred out and another case manager transferred in, she found out what I had been doing and in the essence of space, I was off work a month without pay, reported to the BON, and assessed by behavior health whom recommended extensive therapy for narcotic abuse. I have yet to hear from the BON, I have character letters from 3 co -workers, 1 in administration whom use to be my instructor, one from the main unit where I worked for 5 years, and one from a Pulmonologist whom I worked as a charge nurse on the floor where he admitted alot of patients.

The lady in behavior health ask alot of drug hx questions which, the few narcotic I have ever take I had a prescription for. Never had a drug screen, was allowed to return to work 4 months ago and have been working ever since waiting on a decision from this craziness.

Does this sound like something I need to get a lawyer for and what could a lawyer do?

[leslie :-D]

yes, you need a lawyer.

i'm sorry, but what were you thinking, stashing all those narcotics in your car?

it doesn't matter what the case mgr allegedly told you.

you should have known better.

please get that lawyer.

and best of everything.

leslie

[sfn2008, RN]

i am a 2 yr hospice nurse whom trained under a care manager whom encouraged me to keep extra pain medication in my vehicle for pt use in case a dying pt got "in trouble" and was unable to get any medication quickly. her words were "never throw away a patch".

we need to prtect our own. as nurses we have many ways of handling this type of need. there are locked medication boxes that can be kept in the patient's house, the car or the office. your managers need to initiate policy and proceedures to allow the field nurses a locked med box that is kept in the trunk of your car. just like meds are dispersed and counted from the med room at the office a policy and proceedure needs to be written so as to keep account of these meds. when the patient needs pain relief, chances are he needed it hours before you go there. there shoud be a practice that allows each field nurse to draw from her own stock and have it replaced when the meds arrive from the pharmacy. on a routine basis the locked-box is brought out of the trunk of your car and two nurses make an account of the administration of this medication.

is this method being done in other parts of the country?

for this reason i kept a few of the most prescribed meds and a variety of patch strengths. if a pt had an increase in patch strength i had one to place on him, giving the family more time to get to the pharmacy. same way with pt's running out of meds. the first case manager transferred out and another case manager transferred in, she found out what i had been doing and in the essence of space, i was off work a month without pay, reported to the bon, and assessed by behavior health whom recommended extensive therapy for narcotic abuse.

yup, looks like you are gonna need a lawyer to get back that back pay as well as get it off your record that there was any inapproiate handling of the medication. i see this a an error on the part of thr hospice agency, they should have seen the need and provided equiptment and proceedures for this kind of thing. in your line of work keeping pain medication on hand is the only charitable and humain way of doing things.

on the other hand if there are patients or nursing staff have any kind of proof that you were using the medication on yourself, then get a lawyer to protect during your rehab program. bon has policies and proceedures for nurses that cannot handle the temptation of narcotics and will take them back under supervion after rehab.

i have yet to hear from the bon, i have character letters from 3 co -workers, 1 in administration whom use to be my instructor, one from the main unit where i worked for 5 years, and one from a pulmonologist whom i worked as a charge nurse on the floor where he admitted alot of patients.

the lady in behavior health ask alot of drug hx questions which, the few narcotic i have ever take i had a prescription for. never had a drug screen, was allowed to return to work 4 months ago and have been working ever since waiting on a decision from this craziness.

does this sound like something i need to get a lawyer for and what could a lawyer do?

get copies of everything that is documented about the practice. you are doing your job the way you were taught. but, it may be that your preceptor did not follow up with a policy or proceedure. your intelligence tells you that to put quality patient care first, you need to be prepared. so get someone to write a policy and proceedure that will allow nurses to give quality care.

[Tweety, BSN, RN]

I'm sorry, but it's not the nature of this forum to be able to advice you on this matter.

Good luck.