How would you handle this info?????? Please advise!

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Specializes in LTC.

I was off work 10/30 and 10/31 (2nd shift). A nurse has recently come back to work after her husband committed suicide a few months ago. I went to school w/ her and she has always been a party hard kind of person...loves to drink and pop pills and smoke pot. Ok....well..when I went back to work on 11/1 the other nurse that had worked with her on halloween said that this nurse left early both the 30th and 31st...about 9pm....to go drink. She came in on halloween with a huge hangover and was bragging about it..then disappeared for over 2 hours...turns out she was in an empty bed ASLEEP. She worked my unit. Last night on 11/1 one of my pts told me "I never got my eye drops last night." and I asked her if she was sure. She said "yes Im sure. You always give me my drops." and so I said ..'well..maybe you've run out let me look and see.." so I open up my cart and there they are ..both of her eye drops over half way full so she definitely wasnt out. I then told her "well. I dont know what to tell you. I wasnt here so I have no way of knowing if you got them or you didnt other than what you're telling me. " but I believe her b/c she is oriented x 3. So then comes shift change and Im looking through my narc book. I noticed that on this same pt a vicodin had been signed out for 9pm by this nurse. I go to last months records (it was changeover night on the 31st) and look to see if anything was documented about giving her this vicodin....nothing was there...nothing was on the mar, it wasnt signed out on the mar and it wasnt documented anywhere in the chart, on the report sheet or on the pain flow record. I think this nurse was not only hung over...but I think she might have taken that vicodin for herself. I didnt get a chance to finish looking but I plan to go through it all with a fine tooth comb tonight when I work and see how many "prns' she actually signed out for on that narc book. It didnt even catch my attn. til I was counting off with the night nurse. The count itself was correct so thats why I didnt notice it before then. My question is this.....should I mention this to the DON? And how? I wasnt actually there so I dont want to say anything that isnt true but the nurse that told me about it is legit. She also told me that something was wrong with one of the pts on my unit and the aides couldnt find that nurse so she had to go check my pt for low bld. sugar. Once this nurse woke up from her lovely nap..she said she felt alot better and left early..again. I did leave my DON a note and stuck it under her door that she needed to check the time punches for 2nd shift on those dates but I didnt sign it or nothing. I disguised my handwriting b/c I dont want to be the one who gets someone fired. This nurse has issues, but..she also has 3 kids to feed, clothe and house. On the other hand...if you are STUPID enough to go get blistered and come to work w/ a hangover......you got no business being in this field...much less responsible for medicating anybody...of any age or condition. This nurse is only PRN...but shes always been unreliable, unpredictable, and shes always been a party girl. I couldnt believe it when she was actually hired to start with. She got fired from her last job for refusing a drug test b/c she got caught sleeping on 3rd shift and probably a few other things....and whats so de ja vu about that is that the facility she was fired from for this is the absolute worst facility in this area. i just dont know what to do with this info. I dont want to be a rat but at the same time why cant I take one freakin night off and not have to wonder if my pts are being cared for? The DON put her on a probationary period already and let her get off scott free when she made huge med errors not too long ago....we had to write up 4 big ones in one shift from her...she hung the wrong IV bags, etc etc....If I had done that I would have been written up and probably fired. What would you do?

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you do need to involve the DON, but with the most professional manner that you can muster. Since the PRN nurse is still there after several errors, one most be careful....it would seem she may have some "pull" somewhere/somehow......good luck

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Specializes in Utilization Management.

"A nurse has recently come back to work after her husband committed suicide a few months ago."

If my husband committed suicide as recently as a few months ago, I wouldn't care about narc counts or IV bags or being hungover at work. Of course, if it were me, I wouldn't be at work. Maybe the DON feels she is unstable in some way and that's why she hasn't done anything. Not that it makes it okay. I think it sounds like this nurse needs some kind of intervention, rather than just continuing to be fired from facilities. Something really bad is bound to happen eventually if not.

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Specializes in LTC.

Ordinarily I would agree but she's done these things since she was first hired two years ago she is a known no call no show several times plus she has always come in late or called in it's just her working style I told her that if she ever needed someone to talk to she could call me and I'd listen in hopes that she wouldn't go the same route her hubby did .however what she's done isn't safe practice. I think the don goes easy on her because she has a dtr herself with a drug and alcohol problem but I could be wrong . One day I'm afraid she's going to cause a serious injury to a pt by coming in hungover I also know that when one is hungover you can still show etoh on a blower as this happened to my best friend resulting in a dwi for her and it had been 12 hrs since her last drink. I haven't said anything to anyone yet still not sure as to how the best way to bring this up would be.

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Specializes in Wound Care, LTC, Sub-Acute, Vents.

wow you seem to know all the dirty things going on in your facility. even the dons dtr supposed drug problem you know as well.

it sounds like you do want her to get fired because you took it upon yourself to be the investigator and went extra mile and left a disguised note to the don regarding checking the time she punched out. what does her punching in and punching out records has to do with you? even if she leaves early, doesn't she have to be relieved by the oncoming nurse? so she is not abandoning her patients. if she is abandoning her patients then that's a different story.

if i were you, i would bring my concerns to the don by writing a letter with facts only and discuss it with the don. make sure you make a copy of the letter for yourself.

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How would I handle this information? I think it is not in your best interest to get involved at all. In my opinion, you are making sweeping judgements on a nurse when you have little facts. (Because back in the day she drank and used pot? Have you actually seen her do this now?) Unless she is reporting directly to you and/or you have reason to believe that her shift report is inaccurate to cause a patient you are responisble for harm, it is certainly not worth getting involved in the gossip and drama. (or starting the gossip and drama!) You say that an alert patient tells you she did not get her eyedrops. If you are concerned that she is not getting Vicodin that is signed out to her, did you ask? Writing "anonymus" notes to your DON (and perhaps the nurse in question has an agreement with the DON to work abbreviated hours--you do not KNOW this) will do nothing but give you the reputation as being a pot stirrer. To extend a compassionate hand to someone who has some serious family dynamics going on would be the better way to deal.

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You need to report this to the DON.

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Specializes in Wound Care, LTC, Sub-Acute, Vents.
how would i handle this information? i think it is not in your best interest to get involved at all. in my opinion, you are making sweeping judgements on a nurse when you have little facts. (because back in the day she drank and used pot? have you actually seen her do this now?) unless she is reporting directly to you and/or you have reason to believe that her shift report is inaccurate to cause a patient you are responisble for harm, it is certainly not worth getting involved in the gossip and drama. (or starting the gossip and drama!) you say that an alert patient tells you she did not get her eyedrops. if you are concerned that she is not getting vicodin that is signed out to her, did you ask? writing "anonymus" notes to your don (and perhaps the nurse in question has an agreement with the don to work abbreviated hours--you do not know this) will do nothing but give you the reputation as being a pot stirrer. to extend a compassionate hand to someone who has some serious family dynamics going on would be the better way to deal.

:yeahthat: i totally agree with you. most of the info are gossip and drama. and regarding the prn vicodin, she may have just forgotten to sign the mar. nurses forget to sign the mar all the time.

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Specializes in LTC.

Well if this helps any.....I did ask this pt if she got a pain pill that night..she told me that she did not ask for one and that she didnt get it. Luckily she didnt question me as to why I was even asking her. And one night I was at a coworkers house for a cookout/birthday party and this nurse actually sent a text that I saw with my own eyes asking my friend if she knew anyone who wanted to buy xanax pills from her. Ive never said anything about that either. In school this girl used to brag all the time about her binges the nights before school. She lost her drivers license and had to ride to clinicals one am with another student in my class..who told us that she wouldnt be able to let her ride w/ her again b/c she was taking xanax's and pain pills on the WAY TO CLINICALS. Shes even mentioned to me several times in the past 2 yrs about her drinking and her pills...Ive just always steered the conversation in a different direction b/c I didnt want to know about it. In school when she would come in after a party night her eyes were always red and watery..slurred speech and slow body movements. And as for this vicodin not being signed out....this particular pt RARELY takes a vicodin. Thats what threw up a red flag to me. I figure in time if shes doing something she shouldnt be doing, it will catch up to her on her own. And when I told her if she ever needed to just talk on a bad day that Id listen..I did mean that. But on the other hand, when 5 different people all say the exact same thing its kind of hard not to believe it. If it was just one or two....thats usually questionable. And I dont think its fair to another nurse to have to take on 30 extra patients on top of the 30 she already has just so one can go out and get blistered. That should be saved for an Off work day.

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Specializes in LTC, Neurology, Rehab, Pain Management,.

This isn't about an employee's cry for help, this is clearly about safe pt medication administration. If your loved one were under the care of an unsafe practiotioner, how would want this to be handled? Report what happened and how it happened. If you do nothing, nothing is accomplished. If you are afraid, then keep track of your observations and present the facts using a time-line. You will need to prove this person is unworthy and unsafe in a professional manner. Has this person ever been reported to your state board? Get all your facts together before taking action. Good luck!

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Specializes in LTC, Memory loss, PDN.

Wow, a lot of hear say, assumptions, conclusions, and pot stirring. How would I handle this info? I certainly would not play messenger boy or detective for someone else. If the other nurse is, as you say, legit, then she needs to do the reporting. If she will not and you are truly concerned, you can relay that another staff member has made troublesome statements and the DON can take it from there.

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Specializes in Community Health, Med-Surg, Home Health.

Experience tells me that the OP does have an issue to be concerned with. Unfortunately, situations like this can be sticky. You are not sure if the DON is aware, there is a chance that the nurse that may be using drugs might blame it on another nurse, thus, putting the innocent person's license and life in jeopardy and even set up for harassment.

For now, I would privately document the activity to see if there is a pattern, be cognizant of the personalities of the people in power (ie...is the nursing supervisor or DON supporting this behavior...sometimes this HAS happened) and then, sleep on it with prayer (or whatever you resort to for clarity). For now, let's support the OP and pray for the best outcome.

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