How does your facility confirm you are giving all your meds?

[fairyluv]

we had an issue at my LTC facility that a nurse was not giving all the meds and once it was confirmed, she was let go. Now the way they went about it was really wierd. Resident had a peg tube and all meds were given thru his peg, there was some suspect that he wasnt getting his meds. So there was a note placed under the residents gown by the peg tube stating that whoever found it was to turn it in to Admin. it was found and turned in on the next shift. they terminated the nurse after determining that she was not giving him his meds. is this a normal way to confirm this ??

[SuzieVN]

You can put all of the systems in place to monitor whether or not a medication has been drawn up, punched out, push out, scanned, and all of that stuff. It does not mean that the human at the end of the equation is still actually giving a medication to the patient. All of those systems only deal with accountability up to the point before where the patient is actually given the medication. Even with the newer computerized systems, you can have all your medications scanned and you can even scan the patient, "accept" the administration of the medication, and dump the medications in the trash.

With that kind of deal going on, your medication count would be correct, the MAR would be updated correctly, everything would look exactly as if the patient had actually gotten the medication. The only way that it could be proven that a patient is actually not getting the medications would be if there were lab values associated with those medications that could be referenced against, or someone competent was able to actually witness the medications not being given.

Labs, as when a patient seizes, then the med level is next to zero? Very common, it used to be, with liquid Dilantin. They were always ordering levels because so many nurses didn't give it. What you summarize is true. Much like nurses that divert, there's always a new way to steal drugs. But there's always a new way to find out, also. Never ends.

[SuzieVN]

well most of his meds are in liquid form and he gets bolus cans of feeding as well. it really kinda bothers me cause the cna was the one who was telling the DON/ADMIN that this nurse wasn't giving all her meds, so the DON had the CNA place the note there and monitor it. the CNA said it had been there all day until the next shift found it. insinuating that the nurse had not been in that room at all that day. Even if they suspected that the nurse was not giving the meds, why not confront her after the first med pass ?? why let her work the rest of the day and work all day the next day and then fire her once she clocked out ?? really pee poor management as far as I'm concerned and as soon as I can I am hightailing my behind outta there. This kinda booby trappin stuff don't cut it with me. I'm so darn paranoid it's not even funny. I'm really considering going in to another profession, which sad since I've only been a nurse for 6 months. I wanted to be a nurse to help people, but I find it difficult to actually help when I'm constantly looking over my back to make sure there's not someone with a knife ready to jab it in me.

Check my new post in this section, about 'writing people up'. You'll get a laugh, at the same time being aware of the seriousness of what you have posted, in here.