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?
okay you guys are quoting quotes that were quoted.....and im getting a little confused ;P
and where is OP ? i bet she took the the majorities advice and ran and told her supervisor that the nurse kinda sorta attempted to maybe conspire to steal some zofran that she didn't even have on her cart....and now she's probably out of a job:x3:
I still say that just because a medication is available in the pyxis, under a patient's name, doesn't mean the patient is charged for it. It must actually be given to the patient; if you charge a patient for a med he didn't receive, that is fraud. Insurance companies go over everything before they pay. Meds not in a pyxis or medsense type machine, but loose in a med drawer, should be returned to the pharmacy for credit; otherwise, that is stealing and/or possibly fraud. Another thing~ I am curious about the Phenergan comment, that it potentiates opiates. I was taught in nursing school that it does not potentiate opiates, that it was proven not to be true. I tried to look it up, but the studies I found were actually from the 70's. Are some schools still teaching that it does?
All you have to do is waste it, and no patient charge. Oops, fell on the floor, and bounced into someone's mouth. Then hospital pays for it, like all the other bills that don't get paid.
All you have to do is waste it and no patient charge. Oops, fell on the floor, and bounced into someone's mouth. Then hospital pays for it, like all the other bills that don't get paid.[/quote']
Actually, I do keep a box of band-aids in my truck. I'm a knitter with two sons.
I made that remark because the general attitude seemed to be that if it's not a narcotic, then it's not theft/diversion/whatever. Theft is indeed theft :)
So, if a CNA comes to me and asks for a Tylenol because her back is killing her, I'm STEALING if I give her a pill out of the 500 ct bottle?? We're talking pennies here.
Would the more "moral" action be to tell the painful aide she's SOL because she should have brought her own tylenol?
There's nothing virtous about being so black and white.
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....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 patient's name
You have a headache, a backache then have at it....take a Tylenol from the 500 count bottle. Or ask your supervisor for YOURSELF if you can have an Ibuprofen. But to ask the new nurse to potetially do it for someone else is really fishy.
There's an interesting debate on what constitutes stealing. However, to see the forrest through the trees, you are asking a new nurse to do something most would find ethically questionable. I am not sure that there's a 500 multi dose vial of zofran lying about. And the "just waste it" or whatever other way you can divert is again, ethically questionable.
If the preceptor RN would like to take the responsibility of obtaining the medication, of documenting same (and as we all know, chart audits are always an issue) then put your OWN signature on it and by all means. Does that make it right? HECK no. But that is just my opinion. Honestly, there's a huge difference between a couple of Tylenol from the large multi-use bottle, and getting zofran from a specific patient which, in acute care, shows a handy-dandy record.
We ARE all too busy to be involved in the drama of the nausea nurse. So why put the new nurse in this position to begin with?
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
MODERATOR NOTE:
Several post have been edited.
Allnurses promotes the idea of lively debate. This means you are free to disagree with anyone on any type of subject matter as long the idea of lively debate.
Our first priority is to the members that have come here because of the flame-free atmosphere we provide. There is a zero-tolerance policy here against personal attacks.
We will not tolerate anyone insulting other's opinion nor name calling.
Our call is to be supportive, not divisive.
We can agree to disagree and voice our opinions professionally.
So, if a CNA comes to me and asks for a Tylenol because her back is killing her, I'm STEALING if I give her a pill out of the 500 ct bottle?? We're talking pennies here.
Would the more "moral" action be to tell the painful aide she's SOL because she should have brought her own tylenol?
There's nothing virtous about being so black and white.
I've just posted what the definition of stealing is. I leave the moral and ethical issues of one's actions to each person to figure out for him or herself.
I've been in the realm of gray. But I don't delude myself about what it is or isn't.
Our facility has a pharmacy policy for OTC meds given to the staff, the staff receiving and nursing giving them have to sign them out. I get Ibuprofen frequently for headaches.
I would talk to your instructor about the incident first and then maybe the two of you could talk to the DON for the unit. Tell her that you did not observe anything but maybe they could monitor that nurse specifically for a period of time and see if they are able to catch her.
You did the right thing by saying no and explaining that you were uncomfortable with it. Hopefully it will never be an issue for you again now that you've made your position clear. Since it was just a conversation and you have no other proof that nurses are "borrowing" from the pyxes the easiest thing to do is to let it go and move on. Unfortunately, the "right" thing to do would be to report your concern. I can tell you from experience that the right thing is not easy and will cause you a lot of grief, but if the situation devolves into a worst case scenario it might save your license. If the conversation gets reported it will not be hard to pull up the records and see who's taken what out of the pyxes or which drug counts are off and when that happens someone will probably lose their job.
Do I think taking meds from the pyxes is wrong? Yes. Do I think doing it makes you a bad person? Not necessarily, but I don't want to know anything about it either because it puts me in a really bad situation since I can get into trouble for not reporting it. If you can't walk over and openly take that Tylenol while other people are watching then it's a pretty safe bet you shouldn't be doing it.
You can't compare taking medications to taking band aids. Band aids aren't locked up and anyone can get one. Nurses can get into the pyxes and take out medications but a housekeeper can't. Taking a band aid doesn't have the potential to cause side effects and as far as I know you can't "abuse" band aids like you can medications. Years ago, there was a VA nurse who started diverting epinephrine. It turned out she was using it to murder patients. She was convicted of 5 counts of first degree murder but was suspected of dozens more (yes literally dozens). Her coworkers became very suspicious but didn't speak up right away because they couldn't prove it. I have yet to see someone commit murder with a band aid. Obviously that's a very extreme case but stuff like that really happens and you can't be too careful.
That isn't always true. It depends on what kind of system you're on. If your facility is still charting on paper (like ours) the pt gets charged as soon as a med gets pulled from pyxis, NOT when it is charted as given epic or another med charting system. So yes, the mere act of pulling a med would charge a pt.
So, if this RN is puling the med under the pt, that pt is getting charged, and that is theft. If she is also charting that it is being given, not only I that fraud, but it is also tampering with a medical record, which is an entirely different matter. Either way, management should be notified, because diversion of medication any medication from a pt can cause you to lose your license. Not a risk I would want for mucinex!
youngheartoldhead
50 Posts
okay you guys are quoting quotes that were quoted.....and im getting a little confused ;P
and where is OP ? i bet she took the the majorities advice and ran and told her supervisor that the nurse kinda sorta attempted to maybe conspire to steal some zofran that she didn't even have on her cart....and now she's probably out of a job:x3: