narc waste a little long

[ohmeowzer]

.. we had a nurse at the hospital where i work have a pt who had diluaded 1mg scheduled every 6 hours.. well instead of wasting the dose of diluaded , she put in her pocket and saved it for the next dose .. she was written up for it and was just told not to do it again.. she said our policy at the hospital stated that she didn't have to waste it with 2 nurses .. i always thought we did have to waste a narc with 2 nurses and never heard it was okay to stick it in your pocket and save it for the next dose.... she told the nurse coming on shift ..." it didn't make sense for her to waste it because she had to give it again"... she was in the army and she said this is what they do there... this is the weirdest thing i have ever heard... she wasn't fired either just made a level 2 ... i work in a large hospital chain in a big city... what is your policy regarding narc wastes? this happened at the end of shift and i didn't get a chance to check the policy .... has anyone ever heard of a hospital tolerating this??? i've been a nurse for 26 years and never heard of this happening and then getting a slap on the wrist .... thank you for listening to my vent......

[subee, MSN, CRNA]

Wasting drugs is a stupid exercise. Unless it's propofol, how do you know what people are squirting out that needle. No addict EVER got caught because of that useless exercise. Resesearchers are working a "litmus" strip where drugs can be tested on the spot so ensure that is in, indeed, Fentanyl that is being wasted and not saline. I never heard of 2 nurses having to witness a waste. That just makes it TWICE as dumb.

[psu_213, BSN, RN]

Wasting drugs is a stupid exercise. Unless it's propofol, how do you know what people are squirting out that needle. No addict EVER got caught because of that useless exercise. Resesearchers are working a "litmus" strip where drugs can be tested on the spot so ensure that is in, indeed, Fentanyl that is being wasted and not saline. I never heard of 2 nurses having to witness a waste. That just makes it TWICE as dumb.

I do tend to agree with you about it being useless. Many cases nurses will say, "can you waste this with me...oh, I just squirted it in the garbage can." Most nurses will still 'witness' the waste in the Pyxis. Part of the required wasting ritual might have to do with legal reasons--for example if nurse dirverts narcs and then uses them at work, then causes harm to pt because the nurse is high...the hospital would have to answer for why it does not have a policy in place to try and prevent that. Yeah, stupid reason, but I can imagine it being part of the reason.

[subee, MSN, CRNA]

PSU_13. Of cours, you are right about a hospital needing to have somthing in place but witnessed wasting doesn't address the problem. Education, education, education. That slow and expensive stuff. Nurses have little or no didactics in addictions and yet, at least half of the patients in the hospitals are there because of excessive eating, eating crap, cigarettes, lack of exercise, prescription meds abuse....you get the picture. Yet staff addicts usually don't get detected until very late in the disease when they're really unable to think anymore and do something radically stupid, unless they're in anesthesia where death is sometimes the first presentation of a problem. Unused drugs should be returned to the pharmacy where they could be randomly tested

[oncnurse1997]

Where I've worked, we have saved narcs to use for the next dose, as long as it's the same nurse giving it. We label and date the vial and put it in the med cart in a lock box. We waste what's left at end of shift. We do always waste with 2 nurses. I know of some nurses who do keep it in their pocket if they are giving it frequently. Nobody I know has ever been written up for it. The narc isn't wasted every time because it's expensive. The facility trusts the nurses unless there is cause not to. It's nice to be trusted, but I think that is not the norm in this day and age.

We always saved it labeled in a lock box of the medcart and anything that wasn't used was wasted with 1 nurse witness. We used to put them in our pockets but they frowned upon that later on when they were having so much problem with narcs being taken by nurses and patients getting saline instead of pain meds.