Narcotic Diversion vs. Forgery

[mrskh2u]

So I am an LPN in North Carolina and came on the 3-11 shift. While counting the med cart with the nurse I was relieving, I discovered that 1 Xanax was missing. I stopped the count and informed the nurse I was relieving that I will not take possession of the cart until this is resolved. She then took the bottle of Xanax and the narcotic sheet and we both found the ADON as the DON was unavailable. Her direction was, "give me the narcotic sheet and Xanax and I will take care of it. You two can continue counting the cart." She later came back and stated, "A nurse that worked a week ago forgot to sign." So the ADON put the nurse's initials on the line to make the count correct. I recounted the Xanax before I would put it back into my cart AND I should mention, this ADON has been previously restricted for drug abuse. I called out the next day because I needed time to process this and see what needed to be done. The DON and ADON are big buddies so this would not be addressed correctly. What should I do? I'm nervous about this situation. HELP

[wanderlustnurse88, RN]

One concern I have from your post is the timeline. If the ADOC said that it was last week that this nurse forgot to sign it, why has it been an entire week before it was discovered. Does you ADOC have access to the med cart? My managers don't have access to the cart and it would look funny for them to be in our med room as they have no real need to. I'm just also putting it out there that maybe she compared the record to the MAR and as that there was a missing signature. I'm not sure the best way to address this as I've never been in that situation but just trying to help you see other options.

[abobbett]

Can the ADON even put another nurses signature on there like that? That kinda seems like forgery to me and should be reported because what if that other nurse gets in trouble...This is definitely a tough spot though being that they are friends. At my hospital there is a "hotline" that you can use to report things like this and then there would be an investigation to see if someone was actually taking the medications.

[OCNRN63, RN]

How do you know the ADON had her license restricted for drug abuse? Did you read it in your BSON newsletter? Did she tell you herself? What would your reaction have beefing you didn't have this piece of information?

[wanderlustnurse88, RN]

That nurse still needs to sign the sheet. We usually leave a sticky note on it asking to sign it next time they are in. But no, the ADOC cannot sign for that nurse.

[caliotter3]

Based upon the info in your post I would start looking for a new employer and get away from there as soon as possible. You have to look out for yourself.

[crazin01]

I think I would have questioned the whole week long counts and nobody caught it before. That would've really irked me and the fact that you saw her sign another nurses' name is forgery/falsification. Also, how did you all continue to count the cart, if the ADON had the med sheet & Xanax with her?

Seems fishy to me... I understand why you called out the next day, but that might look suspicious to someone if there is an investigation and I would certainly push for one. There is no one above your DON, correct? (Sorry, everywhere is different). What about your floor nurse manager? Would you trust going to her/him with this, along with the nurse you relieved so your story is able to be verified? I would also most definitely contact that relieved nurse ASAP to write out the event & you both sign it.

Sorry, I've just seen too much crap go down

good luck...please let us know what happens.