I caught one of the night nurses at our psych unit using the Pyxis as a resource and dispensing medications to patients as she sees fit. This nurse primarily works as the only RN on the unit. The nurse in question charted in MAK that she gave two IM injections to a patient. I watched the nurse and she did not give this particular patient any medication. I then woke him up and asked if he had gotten an injection and he said no, he's been sleeping all night.
This nurse then went to another patients room told the patient she was going to give him something for the voices. I checked what she had charted, and what was charted was ambien and vistaril. She then went back into the room an hour later and checked on the patient. A mental health counselor asked the nurse what she gave him. The nurse's response was, "the cocktail". This particular patient just got back from the ICU with a very high cpk and in addition to not having "the cocktail" ordered, he didn't have any IMs ordered.
It has been suspected for some time that this nurse has been doing this, as evidenced by patients coming to the nurses station asking for medications that are not ordered for them, then saying well the nurse on night shift gives them to me.
I wrote her up, told supervisor and my manager, but it seems this is getting swept under the rug. The nurse has not been suspended and continues to work as the only RN on the unit at night.
I also paid very close attention to her, for this reason....
She asked me to witness Ativan waste so she could pull it from the Pyxis. I asked, who are you giving Ativan to? She didn't answer. I then looked at the Pyxis and said your giving Ativan to this particular patient? She still stayed quiet. I then consigned and paid close attention to her every move.
The patient who came back from ICU for possible or actual neuroleptic malignant syndrome may be in imminent danger of a
reoccurence. I would ask for a private meeting with the medical director, explain that the pt is at risk for NMS please check for IM needlemarks and suggest a tox and cpk be done if he develops fever stupor or rigidity.
Are you working with her on the unit? You say she's the only RN, yet your user name says you're an RN. If she's working the floor alone, you clearly aren't witnessing the things you're accusing her of, right? I'm all for correcting a wrong, but I also believe in treading lightly unless you are WITNESSING these things..
Hello,
I caught one of the night nurses at our psych unit using the Pyxis as a resource and dispensing medications to patients as she sees fit. This nurse primarily works as the only RN on the unit. The nurse in question charted in MAK that she gave two IM injections to a patient. I watched the nurse and she did not give this particular patient any medication. I then woke him up and asked if he had gotten an injection and he said no, he's been sleeping all night.
This nurse then went to another patients room told the patient she was going to give him something for the voices. I checked what she had charted, and what was charted was ambien and vistaril. She then went back into the room an hour later and checked on the patient. A mental health counselor asked the nurse what she gave him. The nurse's response was, "the cocktail". This particular patient just got back from the ICU with a very high cpk and in addition to not having "the cocktail" ordered, he didn't have any IMs ordered.
It has been suspected for some time that this nurse has been doing this, as evidenced by patients coming to the nurses station asking for medications that are not ordered for them, then saying well the nurse on night shift gives them to me.
I wrote her up, told supervisor and my manager, but it seems this is getting swept under the rug. The nurse has not been suspended and continues to work as the only RN on the unit at night.
I explained earlier in the thread I have picked up extra shifts and a few nights a weeks there are two RNs working night shift. Not sure why this is being question again.
So if you were there, and her actions caused you to be concerned enough for patient welfare that you actually woke up a sleeping patient to interrogate them, why wouldn't you simply ask the nurse "Hey, what's going on?".
You seem hell bent on getting this nurse suspended or fired. I don't understand that, especially when you were on the spot and had an opportunity to seek clarifications for actions you perceived at the time were detrimental to patient care, not to mention criminal. If you were so concerned, why did you allow this to happen? You seem to be more concerned with documenting it than resolving it. Makes me wonder whether this isn't a personal "thing" you have with this nurse. I certainly wouldn't stand by and watch something like this happen, on multiple occasions, and not challenge what was going on and seek clarification/explanation. You chose to just passively observe patients being endangered and I think that is why people are having a hard time with this. I cannot imagine watching all this and not intervening at the time to protect the patients on that unit.
If you think that we are skeptical and unsupportive, just wait until you encounter an official investigation into your co-worker's alleged activities. We have done you a favor by alerting you to the fact that you simply cannot make accusations without documented facts. Whether WE believe you or not is completely irrelevant.
You yourself would be wise to watch your step in making accusations without foundation.
You know, it's very possible he's working with a nut-job, but how much evidence does one need? How long did people suspect the likes of Jeanine Jones, and how long was she able to get away with it, because no one spoke up for whatever reason.
I know we don't want to accuse anyone wrongly, but it sounds like others have witnessed things that are off about this nurse.
1) She pulled IMs for a patient and it did not appear she gave it to the pt. The pt denies he got any IMs.
2) She told the MHC she gave the other pt a "cocktail" and this pt had nothing like that ordered d/t (what sounds like) neuroleptic malignant syndrome.
3) She said she was giving this pt something for "the voices". Obviously, Vistaril and Ambien would in no way do squat for voices. Something like Haldol would, though, and it's part of the cocktail... which would be the last thing this pt should have.
4) Pts are stating this nurse is giving them meds they don't have ordered.
I agree, this sounds really shady. It sounds to me like you've already reported your observations using the chain of command at your facility, but are not seeing evidence of any remediation, and you've attempted to confront her about the Ativan waste, but she was evasive.
I think the next step would probably be your state's BON.
For more info on this, check out this article. Maybe it will help you find some clarity.
I worked IP psych for a few years and until you have worked with that population as a nurse it is hard to understand their level of manipulation, lies, and genuine forgetfulness/confusion caused by their meds and disease processes. Not to mention the common presence of drug and alcohol addiction amongst this group. It can add up to real trouble for the nurse who doesn't handle things "just so."
You can write up each instance you witness individually and turn it in. Otherwise, you have to let this go. You don't know what may be going on behind the scenes. You asked why she can't be suspended during the investigation--it could be they don't feel they have enough evidence and are watching her, waiting for more. I take it on faith that you're just concerned for the patients, but I'll tell you honestly that reading through this thread, you start to sound like a crazy person with a vendetta. (Especially when you repeat the comment about "the Asian nurse"--probably innocuous, but sounds racist. Not the patient, but you, for repeating it.) Don't accidentally discredit yourself as a witness.
Big-RN
23 Posts
I also paid very close attention to her, for this reason....
She asked me to witness Ativan waste so she could pull it from the Pyxis. I asked, who are you giving Ativan to? She didn't answer. I then looked at the Pyxis and said your giving Ativan to this particular patient? She still stayed quiet. I then consigned and paid close attention to her every move.