Narcotic Descrepency!!!

Nurses General Nursing

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Hello all,

I am a new grad and recently just finished up my 3-month orientation. This is my first week on my own, and up until today I had yet to create a decrepency in the Pyxis. Well today, instead of counting 20 pills, there were only 8. I was so busy at the time, that even though I made a joke about it to one of my co workers as it happened, I forgot to report it to the charge nurse. Now the night charge just called me asking what happened and why we are short 12 pills, and while she is going to try to fix the descrepency herself, she does need to report it to the nursing supervisor. Has anything like this ever happened to anyone else??? I am so shaken up and scared of what is going to happen to me! I know descrepencies do happen from time to time, but usually it's only by 1 or 2 pills, and the nurse has the sense to report it IMMEDIATELY. I've tried so hard to do everything right since day one, and right now I'm really upset and worried that my word isn't going to be good enough :-( Also, I can't believe that I joked about it and then forgot to report it-- does at least making someone else aware of it somewhat help my case (what I mean is that at least I told someone, so it's not like I tried to hide anything???) Please help!!

If this is a major problem then the police would have already been called, and you would have been called at home. You would have already been asked to pee in a cup in one of those special bathrooms.

As someone else said, that many pills don't usually fit in a pyxis area.

You will be councelled on appropriate procedures to follow in the future. But the descrepancy has probably been dealt with already, and you are most likely not the focus of the investigation.

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Specializes in ER, progressive care.

Wow that's a big difference...that should have been reported, but it happens. A lot of times discrepancies are related to miscounts and you just happen to be the person who catches the error.

I created a discrepancy the other day...a patient was supposed to receive 2 oxycodone, but I wasn't paying attention and only pulled out 1. Since there were only 2 remaining in the Pyxis, the medication was already grayed out. So I returned the 1. Someone from pharmacy was there and I explained what happened and she said "no problem, it happens" and fixed it for me, but there was still a discrepancy. My manager called the next day wondering about it, so I explained what happened, filled out a variance form and that was it. My manager said if they still don't believe me they'll just give me a drug test, and I said if that's the case then bring it lol. I got nothing to hide, I just accidentally took out 1 instead of 2 and it created this discrepancy!

Don't beat yourself up, OP!

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Specializes in Med Surg.

Our pyxis prints out discrepancy reports, so it should be easy to figure out who first miscounted. Yes, you should have reported it, but the error should be simple to spot.

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I made so many mistakes when I was a new grad. It was just last yr. They reported because that have to. Just know you are human. This too shall pass. It is very scary as a new nurse. No matter what happens after this, it is now a lesson learned. As you will hear over and over again, it's a 24 hr job. You can only do so much in one shift. Slow down just a little bit. Everything seems like a priority but safety is the biggest. Breathe and get some sleep!! I know exactly how you feel!!

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Specializes in Gerontology, Med surg, Home Health.

If our narcotic count was off by 12 anything, no one would be allowed to leave the building. The police and the DEA would be notified. We don't have Pyxis machines. Just locked drawers in our med carts.

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I do feel much better about it this morning. I'm obviously humiliated at the fact that I didn't report it, but I know I've done nothing wrong besides that. I'm also fortunate to have a PCM that stands up for her nurses. I know I will get some sort of punishment for not following through with the descrepency, but I am confidently hoping that I will not face termination. The bad thing is that it can't technically be fully straightened out until Monday, however I have some fun things planned for the weekend so I am hoping to not stress too much. Thank you everyone who has posted here with advice, support, suggestions. You are all amazing, God bless.

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Pills I'm ok with but liquids I hate because the pharmacy send more then what's labled in the bottle so it makes the count off everytime

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I do feel much better about it this morning. I'm obviously humiliated at the fact that I didn't report it, but I know I've done nothing wrong besides that. I'm also fortunate to have a PCM that stands up for her nurses. I know I will get some sort of punishment for not following through with the discrepancy, but I am confidently hoping that I will not face termination. The bad thing is that it can't technically be fully straightened out until Monday, however I have some fun things planned for the weekend so I am hoping to not stress too much. Thank you everyone who has posted here with advice, support, suggestions. You are all amazing, God bless.

First...... the Pyxis can be made to any size including towers for IV meds and large bottles and packaged meds. The drawers are custom so that certain high volume meds in a large facility will fit in the machine with varying sized drawers that are also custom ordered.

Although 12 missing narcs is usually an error in who checked in the drugs or with pharmacy when they delivered. The Pyxis should have flagged the discrepancy immediately. I am having trouble understanding how anyone was allowed to leave without resolving the discrepancy or the supervisor being notified. As a supervisor, I would have actually called in pharmacy to remedy the discrepancy if I couldn't do it myself. As well as, notifying administration of the issue. I am having trouble perceiving it being left until Monday unless they have identified where the discrepancy has occurred and are waiting to change it in the computer. Are you in Acute care or LTAC as you mention your specialty is telemetry? because there is always someone on call for these things. The shift would not have been allowed to leave until it was resolved. 12 missing narcs is a lot of narcs. It's a big deal....They need to be accounted for to the DEA. Proper documentation of narcotics is a big deal with most facilities and BOB's.

Your punishment will probably depend on the policy and procedure's as well and how policy was or was not followed. I empathize with your situation. I am sorry you are having to go through this :hug:......although your aren't going to like what I'm going to say........ I have to tell you that it is serious and really can lead to termination. One thing that EVERY facility takes VERY seriously are narcotics. It can even affect your license. I have seen nurses licenses disciplined, suspended, or placed on probation for "Improper documentation of a controlled substance". If you have (and I am a firm believer that every nurse should) I would give them a call and let them know there has been a compromising situation involving you. In case you need to protect your license. It is human to make mistakes but there are sometime consequences to our mistakes we can't avoid.

YOU are right there is now nothing else to do right now so don't spoil your weekend. On Monday you need to convey your sincere apologies and convey that your are aware of the seriousness of the situation that you will do everything in your power to never allow this to happen again. I am sure in your BSN program there was a nursing legalities course and nurses legal responsibilities that you can reference to use to learn from this experience.

I wish you luck...I hope everything turns out OK........let us know what they say.:redpinkhe

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Specializes in Home Health.

My questions about this would be, was a count done at the end of the last shift and what did it show? Who was the last person to pull that narcotic for a patient and what should the total have been after pulling it? The pyxis will have stored this information.

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Specializes in Gerontology, Med surg, Home Health.

OK...I just have to say it....it's DISCREPANCY not descrepency or discrepency ...

I feel better now.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
OK...I just have to say it....it's DISCREPANCY not descrepency or discrepency ...

I feel better now.

I thought Crap!!:eek: and had to check my spelling...LOL

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Specializes in cardiac (CCU/Heart Transplant, cath lab).

Wow. Some of you are just really...unhelpful. Talk about beating a dead horse. Give the OP a break for heaven's sake...like you have never made a mistake. OP, you are not going to lose your job over this. Your unit needs a nurse, and they just spent a lot of money on orienting you for 3 months. Everyone knows you did not take the pills. If they did, they would have reported you to pharmacy and you would have taken a drug test. Depending on your NM, don't be suprised by a write up. They just have to document that they took necessary steps to educate you on proper reporting of narotic discrepancy.

Try not to let it ruin your weekend!

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