Narcotic Discrepancies

[KyRN, BSN]

I am looking for advice for a coworker, yes honestly! So, she recently started in the last maybe 7-8 months and has done great on our busy ICU, gives great care etc. However, she just got her 4th narcotic discrepancy since she's started. It seems to be mostly forgetting to scan the med before administration. One time she pulled a med under the wrong patient in the Pyxis but gave the correct med and dose to the intended patient. Her last error she pulled fentanyl for another nurse in a covid room because the patient was bucking the vent. This nurse did not waste the remaining fentanyl so it is under her name. So, her managers told her the next time it happened she would be written up and it would go on her record. It's not consistently the same drug either. Now, we have nurses who have had  10 discrepancies on our floor over time and have been just fine, still work here no issues.

How worried should she be? Tips for error prevention?

[SmilingBluEyes]

My tip is for her to SLOW DOWN and THINK more. I wish her well.

[amoLucia]

If she's making these kinds of errors with MONITORED narcs, what can she be doing with UNmonitored meds?????  Errors will likely catch up with her; hopefully no terrible outcomes.

She needs to SLOW DOWN & THINK like PP SBE commented. It's mgt's job to audit her & mete out any remediation/discipline. NOT YOUR JOB TO COUNSEL HER!  Sadly, I suspect she's likely to err again and then the proverbial hammer will fall.

[Been there,done that, ASN, RN]

She should be very worried, not you. Usually one narc discrepancy write up will get you a foot out of the door. It is up to her to discuss with administration and pharmacy .. as to how she can correct her narcotic  documentation errors.

 

[matthewandrew, NP]

Yeah, seems a bit excessive but I don’t suspect diversion. This nurse needs more reminders and experience. Maybe another in-service. Also review repercussions.