New Nurse, morality question.

meanmaryjean, DNP, RN · Oct 1, 2018

I am a new nurse. By 'new' I mean I passed NCLEX 2 weeks ago. After I passed I sent out my resume and the place I wanted to work for gave me an interview. The interview went well, and afterwards my interviewer asked me if I wanted to shadow one of the nurses to see what the floor was like. I agreed and shadowed another nurse whom I got along with quite well. She was nice and seemed to really care about her patients, but near the end of my time there she went and got some morphine. She didn't need all of it, and needed to waste some. She called out to another nurse "what was your number again?" as she was leaving, and that nurse told her w/o ever looking at her and walked out. The nurse I was shadowing than put the number in, squirted the extra that she didn't need into the sink.
I am not going to say what I did. But what do you think I should have done?

Nothing. You were a guest- and while the two nurses were not following policy, it is ZERO none of your business.

car48 · Oct 1, 2018

Nothing. You were a guest- and while the two nurses were not following policy, it is ZERO none of your business.

Ok, I agree with that. But than where do you draw the line? Had the nurse pocketed the morphine I doubt anyone would say "it is none of your business". And, if I am going to work there does it become my business?

Edited to add. I made sure to post that I just passed NCLEX. Much of what I know about nursing comes mostly from school and Ivory Tower types of protocol that, some of which, I have already not seen followed in clinical. I am not naive enough to think that everything I learned in nursing school is the way it is done in the real world, which is why I made the post.

meanmaryjean, DNP, RN · Oct 1, 2018

Yes, when you are en employee it becomes your business.

kaylee. · Oct 2, 2018

If you were wondering about what is common: yes many protocols slow us down and may be altered or omitted but I have never seen this in wasting meds. No one gives their password. It is not uncommon, however, to do a waste and the other nurse will leave before actually witnessing. I'm not saying it's right but it happens...

Accolay · Oct 2, 2018

It's against their policy and I think it's a bad idea to waste that way, but I don't think you have to get involved. That's their deal, not yours. If they had pocketed the waste, then you should have reported it, but I assume that those stealing narcs are a little more sneaky than that. When you start your first job, wherever that may be, I'd advise to not incorporate that wasting technique into your practice.

This does happen though and I am uncomfortable with those who don't care about actually seeing me dump my drugs. Be savvy to this because your coworkers will sometimes forget why we are being forced to do this extra step and that it's easy to get fired for stupid stuff.

The only thing that could possibly be a problem working there is if narcotic control has somehow gotten sloppy with a work culture that has developed such that your future coworkers would actually have a problem with you doing your whole job as the waste observer. It could get a little awkward as The New Guy for sure, but better than getting canned. But probably not and everything will be alright.

Trauma Columnist · Oct 2, 2018

Hmmm...most Pyxis systems now require a thumb or finger print to waste, not just a number or password.

Like others have said, I would leave it alone as you are not an employee.

Emergent, RN · Oct 2, 2018

I work in an ER. Our custom is to stay and actually witness the waste. It's slipshod to not take the 5 extra seconds to do that. Giving out passwords? That is beyond the pale, imo. I don't think you want to work at a place with this culture.

JKL33 · Oct 2, 2018

Hello car48 -

Good on you for recognizing that this is not proper procedure. I agree with all of those who have responded that in your position you were not obligated to concern yourself with it.

People (including nurse people) get into bad habits for a variety of reasons (quite legitimate ones, often enough) that you are about to find out. While this particular example (wasting meds) is not something I compromise on, the hard truth is that there are myriad compromises (often categorized as "prioritizing") that must happen in nursing. There is no other way. Often they are very simple things like "I had to delay getting so-and-so's vital signs..." (because something else was the priority), but sometimes people compromise when they really shouldn't.

You aren't obligated to pick up those bad habits or to routinely compromise on important issues. But you will learn very quickly that many things won't be able to be done just as you've been taught. Big principles are important and you will have to keep them in proper perspective.

If you are going to work at this place, your first priority will be manning your own backyard while doing the hard work of learning how to prioritize (what kinds of compromises are necessary as a matter of correct prioritization, and which are just wrong/unacceptable).

Best wishes ~

:up:

inthecosmos, BSN, MSN, RN, APRN · Oct 3, 2018

I am an anomaly on this post, but I think you should have reported it. Narcotics and wasting aren't things I take lightly. Giving out your password is dangerous and a breach of contract for most places of employment. Just my two cents.

Cowboyardee · Oct 4, 2018

I am an anomaly on this post, but I think you should have reported it. Narcotics and wasting aren't things I take lightly. Giving out your password is dangerous and a breach of contract for most places of employment. Just my two cents.

Strongly disagree. The OP knows nothing yet of the workflow on the unit they're shadowing. They know nothing of the character of the nurses involved or the kinds of priorities they have to juggle. They know nothing of the administration at the hospital and whether the administrators they might report to would refuse him the position as a risk to their staff and facility for reporting, or possibly see an opportunity to hire a naive hatchet man to report and go after the staff they disfavor before being driven off by the hostile environment that they foster.

All he actually knows is that a couple nurses broke protocol, a patient got their medicine, and nobody diverted narcotics. File it away and learn the lay of the land please. Maybe it's something he can change, report, or challenge once he gets hired. But right now, he really doesn't have any idea of either the nature of the problem or how to actually fix it.

TriciaJ, RN · Oct 5, 2018

And this is why you shadow. To see up close how they do things and decide whether it's somewhere you want to work. If you do take the job, you know the right way to do things and you can tell your new coworkers you're just being persnickety as a new grad. They'll razz you for awhile then they'll just accept that you're persnickety. You might even be able to gradually change the culture, but not as a new hire, and not as a shadow.

If your first action as a shadow is to find fault, then you'll either not be offered the position, or you'll be hired to be the narc and your work life will be unlivable.