Need feedback

As a manager I feel obligated to be as fair as possible. I cannot justify not doing a full investigation because I might miss something or be accused of bias. You need to confirm with Pharmacy how charges are done, but in our facility, if they leave the drawer the patient is charged. Someone has to be be. We do not give away anything.

Need more feedback, please

All I can think is that maybe there has been a problem with drugs being diverted from the Pyxis. Narcotics are not the only drugs that have value; many prescription drugs are expensive and may have resale value on the black market.

Only management and pharmacy would know the details, and they would not share them with the staff nurses if an investigation is going on.

There is a record of how many drugs go into a pyxis.

In any hospital where I have worked and drugs were pulled from pyxis they are charged, period. If meds are not given then it needs to be documented as to the reason and it needs to be documented that the physician was informed. This nurse not only left meds out but left strips as well. She does not recall leaving the meds out but admits to the strips and stated the reason for leaving the strips out. If these strips were truly extra then they need to be disposed of appropriately in the shredder. Narcs are not the only drug that need to be secured. All medications need to be secured. That is the reason they are kept either in a secure dispenser such as pyxis or a locked area. In this case the drugs were not secured.

Even though the public did not have access to the areas where these items were found they are accessable to hospital personell. Only licensed nurse should have access to meds. As for the strips this is a violation of HIPPA. Only those persons directly involved in THAT pt's care should have access.

Who knows what could have become of these items (pills, strips) had they not been reported. Yes it is more probable that no one would have misused them. But the laws are clear and are there for a reason.

It may seem extreem and excessive. Yet, if you have seen what happens when a surveyer comes in and finds these kinds of things you would not say that any longer. The hospital would be cited and possible fined. The reasons are irrelevant to the surveyers. State surveyers are law enforcement.

I am just a staff nurse but I would be concerned if I had done this and there was no investigation. These investigations go on every day in every hospital they are to protect the patient, the hospital and the nurse.

It sounds like she was asked about them. You did not say she was jumped on, yelled at, accused, etc. She was asked about this and allowed to give her version. I do not see anything unfair about this.

We do make very human mistakes like this every day. Nurses are expected to be perfect. Unfortunately the seriousness of our responsibilities and the vast expanse of that same responsibility demands perfection. Some times a system failure can be identified by these investigations. We can not repair these system failures without investigating. Often it is the nurse involved who is able to identify where the system failed.

Some times we are just over worked, stressed, in a rush etc that causes the error. Bringing it to our attention in this way reminds us to slow down and pay attention. Sometimes a nurse being stressed in a particular situation is a system failure and can be fixed.

I do not care how many years I have been practicing or what positions I have held or how good or popular I am. I make mistakes. Calling it unfair because of my personal qualities or history dose not reduce the error. I made it I must own it.

I speak from experience. lately I have taken twice very recently 2 vicodin or other narcs and administered them when one was ordered and one was charted. In every case it was absentmindedness on my part because we are always working stressed, and multitasking, so in a hurry. It has been a reminded to stop and regroup when I am pulling and giving meds.

If you think your friend is in trouble think about how I feel when I get a call at home on monday or tue about this error that occures on a friday night or saturday. (each time) I can not remember yesterday let alone several days ago. And we are talking about narcs in this case.

It sounds like you are a good friend but do not have the full picture of what might be going on with your friend, we seldom do, particularly when things are out of wack.

If indeed something "fishy" is going on this nurse needs to cover herself better and not be making these kinds of mistakes. Sometimes employers to attempt to get rid of higher paid nurses in favor of new nurses who do not make as much. Once a nurse starts to feed into the victim mindset this can create she often does not realize that she herself is adding fuel to the situation because she then becomes (or continues) to be less dilligent than she should.

The fact you have always done something and perhaps it has been over looked in the past does not make it right and this kind of action will get you fired if that is their intent.

So really more dilligence is called for not less, and not business as usual.

Are they trying to clean house and get rid of higher paid nurses with more time in to replace with new nurses who could be paid much less?