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Discussion

Is my supervisor trying to set me up?

I work in a nursing home and follow the 8 hour 7-3, 3-11, 11-7 schedule. I work 3-11. I'm also a relatively new nurse. One of the patients that would've been on my assignment discharged on the 7-3 shift. By the time I came on by the 3-11 shift the patient in question was already long gone. However, my supervisor comes to me at 8pm and starts saying we have a problem. I ask why? My supervisor says the patient's wife is freaking out because she doesn't have a full day's medication and the pharmacy is closed. I say what am I expected to do? He left before my shift even started, I wasn't responsible for the discharge. 

My supervisor tells me we still need to give her the meds for the patient, and I say well we get it from a Pyxis and he's officially discharged so he's no longer in the system. How can I pull meds for a discharged patient. So my supervisor tells me to pull the meds from patients who share his medication. My supervisor tells me I should be the one searching for his medication since I know him better since he was my patient two nights ago. My supervisor tells me to search the system for patients who share the meds and she watches me as I do so before watching me go to the Pyxis to pull the meds and then I give it to my supervisor. The supervisor tells me to label the envelope where the meds are held in and write down everything in it. 

 The supervisor then calls the patient's wife and she comes to pick it up. My supervisor then rings me and tells me that the patient's wife came and my supervisor tells the patient's wife that it was me who collected the meds for her husband, and stated my name. 

I'm super irritated as I can plainly see that my supervisor is setting me up to be the fall girl in case of any liability or issue arises. I feel dumb for complying. What was the right thing to do in that scenario?

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    • Featured Replies

    • Admin

    I would be extremely concerned that this would be considered dispensing medications, which is not within the scope of practice of nursing - administration is, but not dispensing. It could also be considered theft of the other patients' medications. Also, how is this not high risk for making an error in what dosage is given to the patient?

    This would have been a hill I would have chosen to die on. There's a reason your supervisor made you do this and gave the wife your name and didn't just handle it herself.

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    Rose_Queen said:

    [...]

    This would have been a hill I would have chosen to die on. There's a reason your supervisor made you do this and gave the wife your name and didn't just handle it herself.

    Absolutely.

    OP, if you haven't already done so, you should email your manager as soon as possible.

    Best wishes.

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    A good rule of thumb is to avoid breaking rules simply because someone pressures you to do it.  

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    am I outa the ball park to think this is a controlled medication?

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    Quote

    My supervisor tells me we still need to give her the meds for the patient, and I say well we get it from a Pyxis and he's officially discharged 

    Stop right there

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    • Columnist

    Write everything down and keep a record. Hopefully, if anything comes of it, it will be clear that this supervisor targeted and manipulated you.

    If there's an investigation, I would guess that this supervisor has been involved in other such shenanigans, if not diversion.

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    • Author
    londonflo said:

    am I outa the ball park to think this is a controlled medication?

    No it wasn't anything controlled like a narcotic. It was basic things standard meds like Lipitor and eliquis. Nothing narcotic or controlled. 

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    • Columnist
    Revolutionaryroad said:

    No it wasn't anything controlled like a narcotic. It was basic things standard meds like Lipitor and eliquis. Nothing narcotic or controlled. 

    It's really interesting your supervisor took such risks. Something strongly motivated them. What do you think?

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    Everything about this is wrong. As a nurse, you cannot dispense medication, nor can your supervisor. It violates your scope of practice and your nurse practice act. Taking other patient's meds could be considered theft. CMS would not be happy at all with this practice and could consider it Medicare fraud. Who contacted pharmacy to let them know to replace the other patients meds? I imagine the pharmacy was not happy.

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    • Experts

    40 years ago faced in this situation, I was instructed to give place ONE dose of meds in envelope to give to spouse --but from clients meds not yet returned to pharmacy.  SNF had only outpatient pharmacy; most  drug stores were private with 9A-5P hours, no 24hrs in those days. "Borrowing" from other patients meds never appropriate.

    Your SUPERVISOR should have handled this situation.  Please report this to your DON asking guidance "how this type situation can best be handled after hours" as a "learning experience".   

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    Years ago when all the meds in the SNF worked for came in bubble packs from an outside pharmacy meds "borrowing" meds from another resident was not that unusual, we all knew it was wrong to do so but many nurses had a do what you gotta do attitude and this was not discouraged by management. But then there was no paper trail that you "borrowed" another residents med, as long as the med was not a controlled substance.  Nurses never borrowed a med that needed to be signed for. 

    Creating that paper trail could very well get you in trouble on all sorts of levels, not the least of which is Medicare fraud which could impact not only you but the entire facility. As another poster said bringing this to the DON for guidance on how to handle this situation in the future is appropriate. If it were only your butt on the line management likely wouldn't give a darn, but as there are potentially facility implications the DON might at least have a discussion with your supervisor. But if it was or is caught, don't expect your facility to have your back. They will gladly throw you under the bus and run you over.

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    That is an abuse of power. I agree that you should go over the sup head and  tell the DON what happened. 
     

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