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 stated "The Asian nurse" because this is what the patient said, verbatim. In front of four staff members. Each wrote a statement of what they heard. Two evening shift RNs have reported patients ask for meds that aren't ordered, and when they are told they cannot have them, they say something along the lines of 'ill just wait for the night nurse, she'll give it to me.'
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.
Based on your concerns about her questionable nursing practice, I would personally NOT witness wastes with her. I agree with you-- all of this does sound shady. Add to that, the fact that she would not give you details about to who she was giving the ativan? Definitely sketchy. I would not want my name/license associated with hers by witnessing any wastes.
I agree with other posters-- since you've written her up with each occurrence, the higher ups may be working on their investigation which could be the reason why you have not seen any immediate action. Just stay alert and keep writing things down.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
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.
If you have questions about this nurses practice I would not be witnessing wastes with him/her.
We are not trying to be harsh. Remember this is an anonymous site and we give "advice" carefully. There should be policies that you are to follow if you suspect a co worker of diversion.....you need to not talk about something that may be legal on o a social media site.....and follow your policies regarding diversion ie: notify supervision/management.
Definitely do not witness for wastes that you have questions on. That is the purpose of having a second signature.
A nurse witnessing the waste is signing for exactly that, they are witnessing that the other nurse actually wasted the unneeded amount of drug from the pyxis. In no way, shape, or form is the witnessing nurse liable for what the initial nurse does with that dose. Of course, unless they actually tell you that they're not going to give it to the intended patient, they are stealing it, etc... In that case I could see the witnessing nurse being held liable for something since they had knowledge of the initial nurses intent to deceive.
In this case, I wouldn't witness waste with that nurse just because you have a bad gut feeling about her honesty and integrity.
You'd think these things would be *somewhat* simply resolved, but I guess they're often not. A nurse on my unit told me he was nearly 100% sure that a med tech was not only stealing some pain narcs but was snorting them in patient bathrooms (!) ... and he told mgt., but she was never fired - left on her own later.
I hate to say it, but sometimes a place may even keep a problematic person on a night shift just because it's hard to find someone to replace them ... but let's hope an investigation shows this person to be doing what you're saying they're doing, and action is taken.
For your own protection keep an extremely detailed log of every single little thing that happens, who said what, witnesses, names, the whole shebang. You may desperately need this information at some point.
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.
If you are cosigning her wastes, and suspicious, you had every right to observe her. Did you report this through a Radar/Incident Report, or just by talking to your manager? Make sure everything is done through official documented channels. Your manager may have a conflict of interest with the employee (drinking buddies/lovers/whatever). Your hospital should also have a compliance hotline available. Be aware that once reported, the most your manager will be able to tell you is that it is being investigated, due to employee confidentiality. Your state BON will also be very interested in this, or in the conclusion of the investigation.
For your own protection keep an extremely detailed log of every single little thing that happens, who said what, witnesses, names, the whole shebang. You may desperately need this information at some point.
Document and keep notes as though the DEA is coming to do an audit of reported diversion.
It is not in the best interests of the investigation to discuss the nurse's behaviour on a public forum, the nurse in question may recognize herself from the unique identifiers provided in this thread and that may influence the outcome of the investigation to her benefit.
Big-RN
23 Posts
I have no vendetta.
Crazy? No, but thank you for the kind words.
I stated "The Asian nurse" because this is what the patient said, verbatim. In front of four staff members. Each wrote a statement of what they heard. Two evening shift RNs have reported patients ask for meds that aren't ordered, and when they are told they cannot have them, they say something along the lines of 'ill just wait for the night nurse, she'll give it to me.'
I know I did the right thing.