Need Advice... Nurse stealing non-narcotic medication

Published

I am a new nurse and I am not sure exactly what to do regarding this issue. I am about 4 weeks into my first job as an RN and yesterday my preceptor asked me to see if any of my patients had PO Zofran. I asked why and she said that one of the nurses was feeling nauseous. She stated that the nurse she was asking for had asked for PO Phenergan but that she felt better giving her Zofran. I replied by saying "no, none of my patients have PO Zofran". I'm sure I had a funny expression on my face because she followed up with the fact that she frequently took medication like Mucinex or any over the counter medication from patients, reasoning with me by saying "you can get them from the store. So it's okay." And I responded by saying "you can't get Zofran from the store and even if you could the patients are still having to pay for the medication that you're taking from them."

I'm at a loss and I can't get this off my mind. I feel like taking any medication out of the pixis under a patients name is stealing from that patient. I've already had issues with this preceptor and next week I'm going to finish my orientation with another nurse. (This preceptor frequently leaves the floor to talk on other floors or to go outside and smoke. There was one instance when a patient was going into ARF and we had to call a rapid response. She was outside smoking and wouldn't answer her phone when called. Another instance just recently was that one of my patients was having chest pain and I was having to make all of the decisions and call the doctors all by myself. Being new and never having to deal with those things alone are VERY SCARY!)

Anyways... I know what the rules are regarding a nurse stealing/diverting narcotics from a patient. But I don't know what the rules are if it's non-narcotic medication. Also, I did not see this nurse take anything. It was merely a conversation. I don't want to cause a stink over this since I've already had issues with this nurse. But, I just can't get it off my mind. Is this something that I should take to my manager. Or is it something I should file an anonymous incident report over? Or should I just ignore it all together? I don't know what to do and if she does end up in trouble she's going to know it was me that ratted her out. Any advice?

Up Vote Up Vote ×

Report her!

Up Vote Up Vote ×
Specializes in Pediatrics, Emergency, Trauma.

Since you did not see her take the medication, unfortunately you have no proof to report her; if reported, she may pass the suspicion to YOU.

I think you handled the situation appropriately from the conversation. At this point, unless you have proof, is best to continue with another preceptor and keep honing your nursing practice; you know what to do...and you have an idea on how to handle the gray areas of nursing from this experience; pick your battles. :yes:

Up Vote Up Vote ×

You made the right call here. You knew that asking you to take anything out of the pxysis was wrong if it was not directly for your patient. Additionally, machines like a pxysis track your medication. So if there's no documentation to back up why you took the zofran out, then that could cause an issue.

Unfortunetely, it is a he said/she said as you can not "prove" that the conversation ever took place. Ultimately, you did the correct thing. In the future, be really mindful of logging out of the pxysis each and every tiime. Be really mindful of wastes and you should NOT co-sign on a waste you do not actually witness. And for now, I also not be the first to witness an over-ride.

Seems like this nurse is feeling you out to see if you--being new--would take medications out under your name for uses not for a patient. And that stinks, as you are trying to learn, and don't need the drama, nor to be put in a bind over this.

At the same time, to cover yourself, and any potential issues down the road, I would have a conversation with someone about this. For informational purposes only. NOT that you are looking to "get anyone in trouble", but to avoid your own trouble. Maybe that person is your union rep, who can take it from there. Maybe that person is the pharmacist. Maybe the risk management person.

OR ask to have a meeting with your NM regarding how you are doing in your orientation, what you should focus on with your new preceptor, and just generally mention that you are curious what the policy is on being asked to obtain non-narcotic medication for employee use ie: Tylenol, Ibuprofen, etc.

If you don't feel comfortable doing any of that, then there should be an ethics hotline that is part of your parent company. You can go that route as opposed to an incident report.

Up Vote Up Vote ×
Specializes in Hospital Education Coordinator.

in my state if you fail to report you have culpabibity. The BON expects you to protect the public. How can she work??

Up Vote Up Vote ×
Specializes in ICU.
in my state if you fail to report you have culpabibity. The BON expects you to protect the public. How can she work??

Report what? It's a matter of stealing, whether from the pt or the hospital. Zofran is not going to impair you cognitively, although its true that it is not an over the counter medication. I don't see why the BON would care about this, though.

Up Vote Up Vote ×

Personally, I would stay out of it UNLESS you catch her red handed with electronic documentation (such as from the dispensing cabinet) that backs you up. You are not going to get anywhere with a she said/she said.

Up Vote Up Vote ×
Specializes in LTC, med/surg, hospice.

I would just make sure I'm logged out when done and don't leave meds out. I don't think that just because someone would take a mucinex or zofran that they would divert narcs but still be cautious.

I also agree it could be a set up to feel you out or get you in trouble.

It is stealing just like taking kerlix, abd pads or other supplies from the unit.

Up Vote Up Vote ×

I think you hit the nail on the head that the patient is probably being charged for the medication. THAT is the biggest issue here, to me.

Up Vote Up Vote ×
I would just make sure I'm logged out when done and don't leave meds out. I don't think that just because someone would take a mucinex or zofran that they would divert narcs but still be cautious.

I also agree it could be a set up to feel you out or get you in trouble.

It is stealing just like taking kerlix, abd pads or other supplies from the unit.

This I think is worse. The patient is paying for the medication the nurse is taking. They trust us to charge them correctly. When you steal supplies it is from your employer - Still wrong, but to me it's different. To the OP ensure you sign out of the pixis as soon as you are done.

Up Vote Up Vote ×

I would report her. This is still redirecting meds even if they are otc. Still a violation.

Up Vote Up Vote ×
Specializes in ICU.

The patient is only charged with whatever medication that you documented was actually given to them. Just because it is in their med drawer, pyxis, or somehow available for them, does not mean they are charged for it. They can only be charged with what was actually administered to them, otherwise, that would be fraud. (This is not to condone stealing, but it is stealing from the facility, not the patient.)

Up Vote Up Vote ×
+ Join the Discussion