Need advice

beautifulb · Mar 29, 2006

Are there any other colleagues that you could talk to and see what kind of feelings they have for this new nurse? Although it sounds as if you are questioning if this nurse is taking the drugs. Besides you having to clean up after her/him after your shift, do they exhibit any kind of bizarre behavior? Have you ever done narc. count with this person and do they seem "different". I can honestly say that I have never worked with anyone who has diverted drugs but, in the same take it is pretty common. Maybe she goes around to this patients, sees that they're awake and offers them a sleeper. Keep your eyes open and, yes, you may want to talk to your NM about this. Sounds like an icky situation.

CapeCodMermaid, RN · Mar 29, 2006

We had a similar problem where I worked. There was one nurse who would document giving pain medication to EVERYONE who had an order...not Tylenol, but Percocet, Vicodin, T3.....people no one else had medicated for days suddenly developed pain or anxiety or sleeplessness when she was on duty. She was an excellent nurse with good assessment skills so for a while no one thought much. Then our pharmacy consultant saw the narc book. He told us to keep an eye on her because the red flags were being raised and surveyors would question the same thing. She first told the DNS that she was really good at assessing pain and could she help it if the other nurses were "too lazy to medicate properly." Then we thought she just wanted everyone to either sleep or be quiet...she did a lot of 16 hour shifts. We had to investigate and drug test some of the residents for narcotic metabolites. The entire incident was horrid. In the end she was fired for suspected drug diversion. We all felt betrayed by this co-worker. Worst part? In this state, it takes something like 3 years for these issues to get before the board for review. She was hired some place else and probably did the same thing there. I think there is a special place in hell for someone who would steal medicine from an old person who really needs it and who relies on the nurse for everything.

Don't keep quiet about the situation where you work....tell the DNS face to face.

donmomofnine · Mar 29, 2006

I am a DON and I would definitely want to hear from you!

CoffeeRTC, BSN, RN · Mar 29, 2006

Ding Ding Ding....that was all the bells going off. So on the weekends...these residents are "getting" meds that they don't normally get? And this one nurse is always the one giving them? Hello?

I'm actully dealing with this/ reporting this type of thing now... Pt had a surgery (very minor) done a few months ago and for some reason is still getting (or so its signed) Vicodins 2-3 times a shift. At first it was only 2 now its 3 times. This has happened with 2 residents. No on else seems to be medicating them and beleive me these other nurses would assess and medicate if needed.

fuzzball · Mar 30, 2006

Thanks for the FYI thus far. I will update on what happened so far. Pt with ativan: med was DC'd. The rational I was told: maybe (the nurse)they just gives meds to shut them up or to calm them down. UMMMM makes me wonder. The ambien patient- he stated last month that he needed it. I have discussed my concerns with the other 2 nurses who work on the same unit. They are also concerned. They have noticed some strange things too!(Like extra pain pills given on weekends) I don't like the rationale thus far. I am happy for resident who has her ativan dc'd. Does state look at the med usage at all. Do you guys think this would be a red flag? I have done my job on reporting this. I still feel the residents will continue to be cheated. I will continue to voice my concerns. Thanks for all the input.

LoriAlabamaRN · Mar 30, 2006

If you have a PYXIS you could ask your DON to pull a record of the narcs she signs out and compare it with other nurses... I'm willing to bet she will be WAAAAYYYY out there.

Sounds like a diverter to me.

steelcityrn, RN · Mar 30, 2006

I think you did the right thing, only you should not speak about it anymore unless with mng. Let them do the dirty work. Have to be pretty slick to catch them in the act, and it sounds very suspicious.The sad thing is, this agency nurse may only be told she is not wanted back, only to have her start at yet another facility doing the same things. As I have always said, a good nurse has something called a "gut feeling", and Im glad you answered that call!

CapeCodMermaid, RN · Mar 30, 2006

If we have a problem with an agency nurse, I always call and speak to the supervisor at the agency. I tell them what the problem is/was and hope they will deal with it some how.

geriRN1993 · Apr 1, 2006

Greetings to all. I have a desperate need to find out if I did the right thing! I have been struggling in LTC as a nurse for 1 year. MY unit consists of 39 patients so it is quite busy. I know the patients meds like the back of my hand. The question is this.. I work m-f only 2nd shift and on the weekends certain patients who never ask or do not need a medication will receive that med on the weekend. Example Pt z does not have a sleep issue during the week but only on the weekend. Pt B shows no anxiety but receive ativan on weekend. Nortriptline doses come up missing-5 over the weekend. Does this sound normal? I think something is not right. This started 2 months ago with the hire of new baylor. Until then no problems. Tonight I slipped the NM a note and asked her if she could DC these meds. I am concerned for my patients either way. 1-they are not getting the medication 2. they are without proper cause and no documentation of sleep isssue or increased anxiety. Would you guys be concerned. I work after this person and I am tired of cleaning up after her. This person has a habit of not responding to patients needs. Please let me know what you think. Would you say something to management or just slipping a note would do. They will know its me anyway. I am the only one there that will express how they feel. BTW-I did bring issue up with DON concerning the nortriptline loss? Thanks for listening....

Unfortunately I have worked in a situation as an ADON where I received the call from the coroner that one of our nurses was found dead in her own bed. After investigation it was found that she had been diverting medications for a long period of time and stock piling. She was found dead with 3 Duragesic patches on her. I won't say that it was never suspected but never proven and her behavior was normal. I saw this nurse the day before her death and thought something was wrong. She seemed to be swaying. But I didn't put 2 and 2 together until she was dead. The way that this nurse was diverting was giving meds to people who otherwise didn't request or require them and the patches were actually discontinued when the dose changed. We changed many policies after this tragedy. (She left 2 little girls without their mother). My best advice is Always do a count of narcotics at the beginning and end of your shift. Report suspicious behavior to the DON (she is required to investigate) and insist on 2 nurses destroying medications and witness the actual destruction.

Don't let your fears go uninvestigated. It could save a life.