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?
So true, Txredheadnurse. We were advised way back in nursing school that if we gave medications to anyone (without an MD order, and without a nurse-patient relationship) we could be found guilty of either dispensing medications without a license to do so, such as a pharmacist, or prescribing medications without a license, such as a doctor would do. I won't give anyone anything, but tell them to go to the ER if needed, for this precise reason.
First of all, if someone were stealing a roll of toilet paper either they're a kleptomaniac or their economic situation is such that they desperately need it. How would I feel? I would feel sorry for them.
As for the Tylenol, again, we're not talking about meds from the Pyxis, we're talking about a couple pills from a big ol' honkin' bottle of stock meds. The cost to the facility is measured in pennies, not dollars.
Once in a blue moon a CNA will come to me and ask for a Tylenol because her back is killing her. These are women who do back breaking labor for nine bucks an hour. I sleep very well at night knowing I "stole" from the company by giving them fifty cents worth of Tylenol, thank you very much.
You can report anonymously. You should have a corporate compliance hotline, and those reports do not have to have a name attached to them. When I was a new nurse, I became sick on the floor. I left a number of times to vomit and tried to come back to work. When I started having diarrhea, I knew I wasn't going to be able to cover the shift. The charge asked me if I wanted any Zofran. I asked her if she had any, and she replied she would find me some. She took me to the Pyxis and started scrolling through patients. I asked her what she was doing, and she said she was going to "find" me some po Zofran. I said, "This conversation did not happen." and I left the med room. I told her very soon after that I was going to have to go home. She was very angry. She targeted me for months afterward.
If you report her anonymously, chances are the management will start watching her Pyxis pulls and her habits. She has a number of bad habits, so she will call attention to herself on her own. But to ease your guilt (this isn't your fault, by the way), be proactive.
As for the original question--In my mind, you cannot report this nurse unless you actually witnessed her taking the medication. Otherwise, it is just a he/she said, she said situation....as an orientee you are going to lose such a battle to a nurse they (your administration) has enough faith in to make them a preceptor. Maybe this was a set up by the preceptor (to see if the OP would fall into the "trap" of puling out a med for a coworker), but my guess is the preceptor wanted to help out an ill colleague. And, unless it has to do with narcs, anonymous reports don't seem to go anywhere (in my experience anyway).
As for the dreaded grey area...I just cannot buy into the argument that "stealing is stealing...it is always wrong." One time, while working night shift, a fellow nurse called down to the hospital pharmacy asking for a dose of Norvasc, which he had forgot to take before he left home. I realize this is a bit different than the nurse just taking the med for himself, but if it is such a great sin to "take" the hospital's meds, then why did the pharmacist send it up? I mean, stealing is stealing, and this pharmacist is an accomplice to the crime--and he should be reported to the board that sanctions his practice! (insert sarcasm icon here)
Since this discussion now seems to revolve around an employee taking a dose of Tylenol, I will comment on that too. If an employee has a minor HA, backache, etc., I don't see the harm in one dose of Tylenol. Someone made a comment that (and this is not a direct quote, sorry if I butcher it) a person should just buy OTC acetaminophen...it's cheap anyway. I, nor any other comments I have seen, advocate removing a boatload of Tylenol from the unit stock/pyxis. It is a one time dose to get the "over the hump" at work, then after work they can stop by the convenience store and pick up a bottle for at home. I say, give em the dose.
Specializes in Orthopedic, LTC, STR, Med-Surg, Tele.
Zofran's a little different from Tylenol. I keep a bottle of Advil in my handbag for headaches and I always offer some to my coworkers who say they have a headache or backache or cramps or whatever. But if I was feeling nauseous I'd "steal" some ginger ale. I wouldn't go in the Pyxis and pull some Zofran for myself.
You're a new nurse. Don't get yourself into trouble. Stay out of it. This can backfire on you. You don't know who is friends with who, and who might retaliate against you.
Oh, wow. We divert non-narcs at my facility. None belonging to the residents but the facility? Yeah.
What do we give? Tylenol 325mg and 500mg. Ibuprofen 200 mg. Allegra 160 mg. Vit A and C. Ointments like theragesic, vaseline, Eucerin and A/D. Those clear eye drops, as well.
It'll usually be the pain meds. Sparingly. About 3-4 times a month, I'd say. An aide or housekeeping or dietary or office worker will come around with a headache, allergy flare-ups or feeling generally 'under the weather'. We medicate.
If a nurse has 'the crud', they'll just ask the med aide for some OTC (as we don't keep anything but PRN narcs on our carts).
It's been awhile but when the pollen and ragweed levels rise? I've popped an Allegra or two, myself.
Until I read the responses on this thread, I didn't actually consider it 'Fraud, Waste and Abuse' because it's seen as 'not a big deal' when anyone does it. When I worked the Med Aide cart as a GVN, I was instructed to give this or that coworker Tylenol and such by my nurse/preceptor. The charge saw. They do it, too! I suppose it's all 'fraud, waste abuse' when you look at it...but different specialties just have different liberties when it comes to these things? I'll raise the issue when I go back to work, though.
I'd never pull the pt's meds for personal use, though.
I was thinking this, exactly. OTC things like Tylenol or Colace are a no-brainer if someone is complaining of a headache or constipation. Now, I'm in a nursing home, so these medications are part of our "house stock", so they're not even assigned to patient account numbers.
The difference between giving someone 2 tabs of Tylenol 325 mg off of your cart supply and telling a co-worker to "go out to the drugstore and buy your own Tylenol" is just common professional courtesy. I would never advocate for anyone using floor stock or patient medications as common practice or their own personal pharmacy, but there's a difference between OTCs and things like Zofran and other non-narcotics.
When I worked in the state mental hospital, all meds were in bulk bottles of 500 or 1,000. Injectable meds were about the only meds that came in disposable prefilled syringes. The pharmacy was closed at night. We were all encouraged to keep things like Tampax. Tylenol, Kaopectate, Maalox, bandaids, etc. in our lockers. If we had a dose of an Rx med during our shift, we were instructed to let the nursing office know, then to keep a few doses in our lockers.
I suspect the other nurse was testing the younger nurse to see what she'd do and how she'd react. Since she actually witnessed nothing, there was nothing to report other than suspicions, which wouldn't hold up.
I worked 3 12's and kept myself on track with my anticonvulsants by sticking to the same schedule every day. That meant taking Tylenol and Neurontin at 6 pm (about.) I took, in the meds room, by myself for years with no problem whatever. Then, a psych aide
who had been reprimanded by another nurse and hated all RNs, reported me. Because I had made a record of my two meds and could show several others in bottles from my pharmacy, his complaint ended right there. Phew!
Zofran's a little different from Tylenol. I keep a bottle of Advil in my handbag for headaches and I always offer some to my coworkers who say they have a headache or backache or cramps or whatever. But if I was feeling nauseous I'd "steal" some ginger ale. I wouldn't go in the Pyxis and pull some Zofran for myself.
Or ask the new orientee nurse to do it for you.......
None belonging to the residents but the facility? Yeah. 
MadpeysRN
365 Posts
Maybe she was just testing you to see if you'd do it??