I charted something I shouldn't have and I'm terrified I'll lose my nursing license

Sour Lemon · Feb 7, 2019

16 minutes ago, newbie2018 said:
Hi all,
So I'm a new nurse (been a RN for only 2 weeks, was a LPN for about 11 months prior). Last week I received a telephone order from a doctor to give a one time dose of Norco, but my patient didn't have any, so after asking another nurse what to do, I gave my patient another patient's Norco, against my better judgement. I charted in my patients medical record that I gave my patient the medication from patient's XYZ supply. I am TERRIFIED that I will lose my RN license because our annual is open for the state to come in. My boss said I wasn't losing my job, but we went over my reprocussions. Any words of advice or thoughts would be greatly appreciated, because I am losing sleep and I can't even eat because my stomach is in constant knots.

Look on your state's BON site (or another state's). You can usually see disciplinary actions, and you will see that this is not something you will lose your license over.
When I was a new graduate, we pulled meds under one patient and gave them to another all the time. Now it's super-mega not allowed ...so don't do it anymore and definitely don't write a note saying that you did it.

Advanced Practice Columnist / Guide · Feb 7, 2019

You observed the 5 rights except for the fact that the medication was from another patient’s supply. If anything, you are guilty of cheating the other patient from a pill that they were charged for and you gave your patient a free dose. Just learn from it and next time, pause and think before you act and document. I don’t think you’re going to lose your license over this.

Long Term Care Columnist / Guide · Feb 8, 2019

You won't lose your license. I think almost everybody has done this at one time or another when things weren't as strict as they are now. (I never did it with narcotics, though, just maintenance meds like Lasix and vitamins.) Like Juan said above, this "cheats" another patient who has already paid, or whose insurance has paid, for that drug so you don't want to do it again. Always make sure you have enough meds on hand and if you don't, get hold of the pharmacy right away so they can supply the drugs ASAP.

JBMmom, MSN, NP · Feb 8, 2019

Giving the med from someone else's stock was the problem, not the charting (although that wouldn't really go in a medical record either, because you shouldn't have another patient's identifying information in your patient's charting). Doesn't your facility have a pyxis system of medications that can be pulled before the pharmacy supplies the doses? There should never be a reason to take another patient's medications, and that's the real problem because I think it can be pursued as medicare fraud because the other patient's coverage paid for the dose. Will anything happen? Probably not, but it's a good point to learn the lesson about what to do in your facility in the future so it doesn't happen again.

guest1048932 · Feb 10, 2019

I don't think this is something you'll lose your licence over, but learn from this experience. Remember your rights of medication administration, and that you don't pull other patients meds from another patient (right patient). As other posts here have said, you don't pull meds from another patient, chart about it, and chart other patient names in the record. Own up to it, learn from it, and chalk it up to experience! You will be a better nurse for it. You've already talked to your boss, and YOU WILL NOT LOSE YOUR JOB! To me, that says your licence is safe.

DVB, BSN, RN · Feb 10, 2019

You won't lose your license. If it is found, your facility may get dinged during survey for passing a med from someone else's supply. It is cheating the other patient out of a dose though. Suggestion: If you work in a NH or SNF, you would have the MD, order you a replacement dose after explaining to the MD what happened. Then there would be no "theft" of a medication. Then I would chart replacement dose was ordered and obtained. If they have Medicaid, they can't order early, so it would really be cheating a patient if it was not replaced.

allnurses Guide · Feb 11, 2019

I agree with all of the above. It isn't good but it isn't fatal. In your review, after you calm a bit, examine what was going on in your shift and in your thinking that made you feel that was the best course of action in the moment. Identify the factors that influenced you (fatigue, overwhelmed, afraid to perform differently than the experienced nurse/peer pressure, self criticism for needing to ask more questions, unsure how to order the med from pharmacy and get it quickly, rushing, patient badgering you for the med, etc). Identify how you could have done better. It may be helpful to debrief the situation with a trusted experienced nurse. Then, next time, you will do better.

CoffeeRTC, BSN, RN · Feb 11, 2019

22 hours ago, DVB said:
You won't lose your license. If it is found, your facility may get dinged during survey for passing a med from someone else's supply. It is cheating the other patient out of a dose though. Suggestion: If you work in a NH or SNF, you would have the MD, order you a replacement dose after explaining to the MD what happened. Then there would be no "theft" of a medication. Then I would chart replacement dose was ordered and obtained. If they have Medicaid, they can't order early, so it would really be cheating a patient if it was not replaced.

Agreed! This would be a good item to take to Qapi and do a PIP about this.