Missing narcs returned to med cart...sorry long

Nurses General Nursing

Published

Here is my question for all of you...

A couple of weeks ago, our facility had some narcotic syringes missing from our med cart. This happened on a weekend that I do not work. I was frantic because I knew that I had counted these syringes correctly with the oncoming staff. I was not called or notified that weekend of this. Found out when I reported to work the following week. I am in the Admin office wanting to know if police called, drug testing and trying to get to the bottom of what happened. So come to find out, this is what happened, (after I stated I was going to call police to file a report). The Admin stated that another CMA wanted to "teach" the other CMA's a lesson the importance of counting the narcotic syringes. He/she had taken the narcs out of the locked med box and had given them to the Admin, so the narcs would be "missing". He/she in turn had them in his/her desk drawer and not locked up. He/she showed me that he/she had the missing syringes and he/she left them on him/her desk for at least a week. We kept telling him/her to put these up or waste them, (with witnesses),

due to the fact that many people are in and out of his/her office all the time. Kept telling Admin that syringes could be used and returned to the desk top.

So guess what? Came to work and the syringes are back in the locked narc box and signed off by the CMA that originally took them out! How in the world do I know that the medication is actually in the syringes? I keep signing off the narc count sheet as incorrect d/t to the fact they were missing and now returned. The staff confronted the Admin regarding this and we were told the CMA's needed to be "taught" a lesson by this other CMA. Informed him/her that he/she had put our nursing licenses on the line with this stunt. We were told this action was never directed towards the nurses...huh?

Where do I go from here (besides out the door)? Oh, one other thing...this certain CMA is the "best buddy" of the Admin. and loves to keep the facility "stirred" up to their advantage.

Has this ever happened to you?

i would not use any of those syringes on pts.

the DON should be discarding them w/a witness.

i would also pose this question to the BON, anonymously.

this totally negates any and all professional standards of conduct.

and the admin could be heavily penalized over this, if not lose his/her license.

so many things wrong here.

and, write an incident report noting sequence of events.

keep copy for yourself and give to DON.

dang.

leslie

That is a horrible thing to do to co-workers.

I agree with others on this thread the medications should be destroyed. And your DON needs to take the initiative in making sure this is done and NEVER happens again.

Isn't that CMA under the DON's supervision and not the administrator?

Trying to teach other people a lesson, sometimes, can backfire.

And I also thought that with having CMAs in the medication administration process, that they were NOT to responsible for narcotics!

What is THAT all about now??

Specializes in Advanced Practice, surgery.
Thanks so much...I am really furious about this. But, where do I start reporting this? Their corporate office, state BON, state facility licensing?

Mods, please don't TOS this, as I am not asking for legal advice, I just don't know which way to turn and just need direction. I am so angry that this stunt was pulled and my license placed in jeopardy.

Thanks...

If your DON didn't know about this and she is furious then i think that is your first port of call, write a letter to her stating how concerned you are and asking her how she suggests you proceed as you are not confident the narc count in correct and willnot sign to say they are.

As you quite rightly point our this is not the place for legal or BON advice.

Specializes in OB, MS, Education, Hospice.

"personally, i would waste them the next time i did count. do it by procedure, with another nurse and note that the content is questionable because they were not locked up for a period of time and put the names of those who moved the syringes. why put patients at risk?"

i wouldn't waste the meds--i would turn them in to the pharmacy--the syringes can be sent in for an analysis to determine whether or not the syringes indeed contain the drug. a similar situation happened on our unit when i was a new grad. a nurse was removing the med from the vials and replacing it with saline. the counts were off at odd times, and there were a few other warning signs. the syringes were sent off--sure enough... saline... she had tampered with the morphine, demerol, phenergan, toradol and stadol... what an eye-opening experience that was for me as a newbie! it was really disturbing to me that fresh post-op patients were given saline for pain relief until this nurse was stopped! if your supervisor is on your side--utilize the chain of command to follow this up--and refuse to administer the medications that were left out and unattended.

Specializes in OB.

Contact the dispensing pharmacist/pharmacy and have them tell you the proper procedure for returning these syringes to have them analyzed and disposed of properly. Make sure to have all communication regarding this documented in writing and all handling of these syringes from this point on witnessed by at least 2 licensed people and documented as to chain of possession if returned to the pharmacy.

You want to make sure that this cannot be turned back on you, especially if the administrator is involved or disciplined for this.

Specializes in ER, TRAUMA, MED-SURG.
good, someone needed to be. hopefully they wil be reprimanded for there stunt. never know when state may want to make a surprise visit.

personally, i would waste them the next time i did count. do it by procedure, with another nurse and note that the content is questionable because they were not locked up for a period of time and put the names of those who moved the syringes. why put patients at risk? and having to answer to this might teach those involved "a lesson".

what right does any staff have to teach any peer "a lesson"? i would be livid.:angryfire

my thought exactly!!!!!what right does this staff member have to "' 'teach a peer a lesson?' " sounds like this person needs a little "education"

anne, rnc

Maybe someone should call the police. Why can't administrators be drug tested? I think this one should. It sounds very suspicious.

How did they get access to the narcotic draw, and I agree with all this should be reported and the syringes should not be used.

Specializes in Ortho, Case Management, blabla.
Thanks so much...I am really furious about this. But, where do I start reporting this? Their corporate office, state BON, state facility licensing?

Mods, please don't TOS this, as I am not asking for legal advice, I just don't know which way to turn and just need direction. I am so angry that this stunt was pulled and my license placed in jeopardy.

Thanks...

I would contact the FDA and OSHA as well. They probably wouldn't be too happy that the drugs were being stored against their rules.

Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

Just when I thought I had heard it all......

Am I correct when you say syringes you are talking about the TUBEX/Carpuject type? I know for a fact the little plastic tab can be bypassed by using a long needle into the rubber end. I've seen our clinical specialist show us it could be done. Are the meds usually in a Pyxis or just a drawer in a cart?

The DON is the appropriate one to report it to officially, not just tell verbally IMHO. That's just my opinion, but I'm with you I'd NEVER sign that the count was corrrect if I knew/suspected it wasn't.

Thank you so much for all of your input into this nightmare. Hopefully, I can answer some of your questions. Since I work in an assisted living facility, most medication passes are done by CMA's, especially on the weekends. Our meds are not dispensed with a Pyxis and are stored in a med cart. In my state, CMA's are allowed to administer po narc meds or topical narc meds. The narc syringes are topical and already pre-filled. I am sorry, I guess I didn't make that statement clearer. But, these still must be counted!

I am just so still darned mad about this. But, at least now I am starting to be able to think with a clearer head...

Sounds like you work with a bunch of hulligans. This is about the stupidest thing I have ever heard. How mature is your CMA or Administrative staff? I'm glad I work in a hospital where things like this don't happen. We have a machine called a Deibold machine that dispenses almost all of our narcs. You take and you record your waste with another nurse via this machine that dispenses the med. It is kind of works like a bank machine. You swipe your badge and enter your password to dispense. Then you do the same to return a med if you don't need it. If you need to show your waste for a half dose administered then you log on and your witness has to log on entering her password. You can never be 100% sure that someone may not waste but rather use it and replace the drug with water. You just have to know your staff, co-workers, and do random drug screening when problems arise. As far as I am concerned there is no room for games like the one your facility has performed. Wish you luck.

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