I accidently took home a zofran in my pocket.

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I accidently took home a zofran in my pocket and didnt notice until I took my top out of the washer. what should I do?

Specializes in Critical Care.
17 hours ago, JKL33 said:

I have a different perspective.

I would bring it back to work and speak with the pharmacist about crediting it back to the patient to whom it was charged. If it were removed from an ADC I would "waste" it electronically in the ADC program and dispose of it as advised - the exact procedure for all of this can be advised by the pharmacist.

Don't put any meds in your pocket or carry them on your person regardless what they are. Subscribe to a personal program of (as much as humanly possible) following every rule of medication administration in real time. If the patient ends up not needing it - take it back/return it properly in real time, etc.

While I understand not wanting the patient to be charged for it, I don't think returning it will help anyway since it went in the laundry and would have to be thrown away.

I would suggest keeing a small, clear plastic 8 oz water cup that is used to mix miralax in and use it to store meds not given. That way you won't forget and leave them in your pocket and it will be a reminder to return them to the ADU.

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At my hospital, there are clear plastic ziplock-type bags in the med room, and I put each patient's medication and the print out ticket for each med in the bag. If meds are refused, those go right back into the patient's bag along with the tickets. That way I always have them in a larger package that's hard to overlook, and I can easily return or waste them later. It also means I don't forget which patient's account I need to credit for the returned colace, because it's on the slip in the individual patient's bag.

If I have a controlled substance, I find a nurse to do the partial dose waste BEFORE I go into the patient's room. It sometimes takes a few minutes to find a waste witness, but I'd rather do it on the front end than risk forgetting later or accidentally administering a too large dose because I took the whole pill/vial into the patient's room with me.

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7 hours ago, brandy1017 said:

While I understand not wanting the patient to be charged for it, I don't think returning it will help anyway since it went in the laundry and would have to be thrown away.

I don't think anyone is talking about returning a laundered medication to the med dispenser. OP can take it back and waste it in the system, the same way he or she would waste any medication that was opened/drawn up, but not administered.

If a patient refuses after I've already opened a mediation or if it gets dropped, I go back and waste it in the dispensing system. There will always be accidents that happen, but the patient shouldn't be billed because the nurse forgot to correct the electronic record.

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9 hours ago, ThisIsMandy said:

Tell the truth. Exactly how, why and when it happened.

Really shouldn’t matter what “kind” of medicine it is...it’s just a good habit to follow protocol/policy.

I am — for the most part — a ”policy-nazi” BUT after, justifiably calling out my boss (but not enough to get her terminated) my life became a living hell. EVERY move I made was scrutinized to ridiculous proportions.

Follow policy/protocol, and no one can — legitimately— fault you.

I feel a duty to mention ...a nursing site with your name and picture attached is not the place to talk about "calling out" your boss (current or past).

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21 hours ago, thoughtful21 said:

(From a money/resources perspective, these are completely useless - that patient is only charged for what was administered to them, and pharmacy considers the rest waste and doesn't monitor it.)

If it's an unused vial that needs to be returned, or a controlled med, then I'm a lot more antsy about it and take it back ASAP.

It makes me uncomfortable to carry ANY meds in my pocket, but it's hard not to. Anyone else have this problem? 

9 hours ago, brandy1017 said:

While I understand not wanting the patient to be charged for it, I don't think returning it will help anyway since it went in the laundry and would have to be thrown away.

1 hour ago, turtlesRcool said:

I don't think anyone is talking about returning a laundered medication to the med dispenser. OP can take it back and waste it in the system, the same way he or she would waste any medication that was opened/drawn up, but not administered.

I will clarify - I shouldn't have used the word "charged;" I meant credit it back to the pt name under which it was removed or waste it under that name.

The overall theme being to show proof of what you did with every medication that you handle, not just CS.

I stepped things up after a group of nurses was informed of a new inflated definition of diversion, which now apparently means any med that didn't go where it was supposed to. It is either diverted (or stolen, which is also diversion). Not my words.

You don't have to tell me twice. Whatever I am doing with any med, I make sure it is clear what happened to it.

And yes, *everything* that needs to be wasted is officially wasted before I leave the cabinet except under the most extreme of circumstances.

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Specializes in Nurse-of-all-trades, but mostly Peds/GP/PDN.
3 hours ago, Sour Lemon said:

I feel a duty to mention ...a nursing site with your name and picture attached is not the place to talk about "calling out" your boss (current or past).

Agreed, thanks for the reminder!

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Yeah, I concur with the ones who said take it back and put it in the OmniCell. Even if the patient has been discharged, we can still pull them up on the Global List and put it back. I always worry that although it's not a narcotic, pharmacy will think I'm constipated and too cheap to spring for my own Docusate Sodium.

If it were a narcotic I would be turning around and going straight back. But, otherwise would put anything else back when I was scheduled to work next.

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On 4/9/2019 at 3:57 PM, thoughtful21 said:

Just an extra perspective... I have trouble NOT carrying meds in my pocket.

We are required to discard all partially used vials and pill halves in the black box in the med room. They don't have these boxes in patient rooms, because it wouldn't be safe.

I don't like this, but the alternative is keeping the pill in my hand, and running back to the med room to discard the med right after every med pass, and sometimes I'm just too busy. Patient needs the bathroom before I go, the alarm in the next room is going off... So I end up with half a vial of Zofran or half a metoprolol pill, and I've come close to taking them home sometimes.

(From a money/resources perspective, these are completely useless - that patient is only charged for what was administered to them, and pharmacy considers the rest waste and doesn't monitor it.)

If it's an unused vial that needs to be returned, or a controlled med, then I'm a lot more antsy about it and take it back ASAP.

It makes me uncomfortable to carry ANY meds in my pocket, but it's hard not to. Anyone else have this problem?

It takes 2 seconds to drop it in the sharps container...unless you keep having level 2 suicide precaution patients every shift...

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6 hours ago, drkshadez said:

It takes 2 seconds to drop it in the sharps container...unless you keep having level 2 suicide precaution patients every shift...

They will no longer allow us to discard meds in the sharps container. The regulations for our facility changed. But yes, we used to do that, and it was very quick and easy!

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I accidentally walked out with a 2mg vial of Dilaudid once upon a time. When I brought it back and asked what to do with it, the nurse educator said, "I'm going to pretend that you never said anything about this." and walked off. I don't remember what I ended up doing with it, but I did start checking my pockets before leaving after that.

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On 4/9/2019 at 3:57 PM, thoughtful21 said:

Just an extra perspective... I have trouble NOT carrying meds in my pocket.

We are required to discard all partially used vials and pill halves in the black box in the med room. They don't have these boxes in patient rooms, because it wouldn't be safe.

I don't like this, but the alternative is keeping the pill in my hand, and running back to the med room to discard the med right after every med pass, and sometimes I'm just too busy. Patient needs the bathroom before I go, the alarm in the next room is going off... So I end up with half a vial of Zofran or half a metoprolol pill, and I've come close to taking them home sometimes.

(From a money/resources perspective, these are completely useless - that patient is only charged for what was administered to them, and pharmacy considers the rest waste and doesn't monitor it.)

If it's an unused vial that needs to be returned, or a controlled med, then I'm a lot more antsy about it and take it back ASAP.

It makes me uncomfortable to carry ANY meds in my pocket, but it's hard not to. Anyone else have this problem?

Just another situation where what sounds great on paper does not always pan out in real live nursing. Yes, the proper thing is to return everything not used and so on and so forth. I have to prioritize my work. The safety and needs of my patients come first. I must be as efficient as possible to get everything done. This means unfortunately packing meds around. If there are three patients needing certain things out of the pyxis, then most organized nurses will get them at all at the same time. They don't have time to run that long, long, long, hall three different times, then going back again and putting away when there are a dozen other things that are calling for their attention. This is where the higher ups need to make changes. Nurses are forced to work with the systems that are given to them.

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5 hours ago, Forest2 said:

If there are three patients needing certain things out of the pyxis, then most organized nurses will get them at all at the same time. They don't have time to run that long, long, long, hall three different times, then going back again and putting away when there are a dozen other things that are calling for their attention. This is where the higher ups need to make changes. Nurses are forced to work with the systems that are given to them.

May I kindly disagree.

I can't speak for every setting, but generally speaking dealing with meds for more than one patient at a time is not what organized people do; it is not a generally safe practice. I recommend a different workflow even if it doesn't feel as efficient.

Yes, nurses must work in the system, but we enable some of the worst situations in which we find ourselves. We don't cause them, but too many of us do enable them. Kind of stinks to think about that, but I think it's fair to say it.

If a nurse is working smartly, prudently, safely, in a caring manner, and as efficiently as the situation allows - - why would s/he ever think it's imperative to somehow make sure no one waits (for example)?

Running around as if our hair is on fire due to what I now call "fake emergencies" - is generally dangerous.

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