Nurse stealing narcs advice

Nurses General Nursing

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I have a dilemma I have been facing at work for sometime now. There is one nurse who gives out WAY more pain medication then any other nurse. It has always seemed weird to me but now alert and oriented patient are telling me they are not getting their pain medication when she is saying she is given them. Also this nurse will give more than what's prescribed if it's one every 8 hours PRN she will give one at 715 and 245 (shift is from 7-3). I have went to my DON multiple times about this and she said she did an investigation but nothing has happened no days off or anything. At the very least she making regular med errors (literally everyday she works) with giving them to frequently. But I know she is always taking them as well. I don't know what I should do. Should I go above my DON so something gets done about it? If so who do I report it to and is there anyway to do it anonymously?

Specializes in ICU.
citations, please,

and it defeats the purpose of the order...

i have not in all the places i have worked run across such

What citations are you wanting? Any hospital institution I've ever been in, it's not been a med error unless it's out of that time frame. PRNs included. Maybe your institutions are different, but as long as we were in that time frame, it was not a reportable med error. I'm not sure what citations you need for that.

Plus, in the OP there was a 15 minute difference. Give me your JHACO citations where that is not allowed.

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Other than patients stating they are not getting their meds, I don't see an issue here. It isn't a med error for the PRN. I think before we judge another nurse, we try and make sure we have all the facts and a full understanding of med errors.

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I think before we judge another nurse, we try and make sure we have all the facts and a full understanding of med errors.

Which in this case we have neither. LOL. I would hate to be OP's co-worker. But I love it when people run into versions of themselves. I see that happen a lot.

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Where is OP?

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What citations are you wanting? Any hospital institution I've ever been in, it's not been a med error unless it's out of that time frame. PRNs included. Maybe your institutions are different, but as long as we were in that time frame, it was not a reportable med error. I'm not sure what citations you need for that.

Plus, in the OP there was a 15 minute difference. Give me your JHACO citations where that is not allowed.[/quote

it is a half hour, not 15 minutes... if a doc wanted that flexiblity in the order he/she would have written it that way.. you are the one that stated JHACO says it is ok, so you site.

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Specializes in Pediatrics, Emergency, Trauma.
What citations are you wanting? Any hospital institution I've ever been in, it's not been a med error unless it's out of that time frame. PRNs included. Maybe your institutions are different, but as long as we were in that time frame, it was not a reportable med error. I'm not sure what citations you need for that.

Plus, in the OP there was a 15 minute difference. Give me your JHACO citations where that is not allowed.[/quote

it is a half hour, not 15 minutes... if a doc wanted that flexiblity in the order he/she would have written it that way.. you are the one that stated JHACO says it is ok, so you site.

i'm not the person whom you are replying to, HOWEVER, I have a link that explains the processes of medication administration, including PRNs:

http://www.dhhs.nh.gov/dcbcs/bds/nurses/documents/sectionIII.pdf

Section 4 suggests only "enough time lapse" to give meds; Joint Comission is only concerned about clear use of said PRN per Joint Comission website; there is also the Institute for Safe Medication Practice that can also weigh in as a resource per the Joint Comission site through my Google search.

15 minutes, in my experience, is not a "red flag" in terms of PRN administration; nurses need to be prudent on understanding pharmacodynamics for PRN meds prescribed.

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i'm not the person whom you are replying to, HOWEVER, I have a link that explains the processes of medication administration, including PRNs:

http://www.dhhs.nh.gov/dcbcs/bds/nurses/documents/sectionIII.pdf

Section 4 suggests only "enough time lapse" to give meds; Joint Comission is only concerned about clear use of said PRN per Joint Comission website; there is also the Institute for Safe Medication Practice that can also weigh in as a resource per the Joint Comission site through my Google search.

15 minutes, in my experience, is not a "red flag" in terms of PRN administration; nurses need to be prudent on understanding pharmacodynamics for PRN meds prescribed.

Mary has a medication order and a PRN protocol for Tylenol, 650 mg bymouth every four hours as needed for pain or fever.Mary has a headache. You have checked the medication log to see thatMary has not received any Tylenol within the past 4 hours.According to the PRN protocol, the specific symptoms that Mary can havethe Tylenol for are "pain” and "fever".This means that you can give Mary Tylenol for her headache.

that section clearly states the issue. the other is related to having had instead of not having. so "enough time" in this case, is 4 hours.

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Specializes in critical care.
Excuse me. I thought more might be discussed on here than how much our feet hurt, or what we wish we could say to our patients. How deep!

800,000 members.

Millions of threads.

Ironically, this thread has nothing to do with feet, or what we wish we could say, or anything that might be considered shallow at all.

The responses frustrate you. I get that. The situation itself is frustrating. Unfortunately, we get in situations frequently when our nurse instinct tells us something, we act, but then we are never allowed the catharsis of knowing the outcomes, or the details leading to them.

We should also always try to remember that, while we might feel strongly that something is happening, empirical evidence trumps all. If the OP's colleague had good documentation, maybe it really is legit. Heck, maybe the colleague even submitted a clean urine specimen.

The point is, no one but management and the employee know the depth of the investigation, and it may very well have turned up no evidence. Just because OP believes his/her hunch, that does not make it true. None of us knows.

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Specializes in critical care.
Where is OP?

I'm thinking this thread was a stop, drop and roll. Abbreviations in the OP make me think maybe the OP is not a nurse.

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I'm thinking this thread was a stop, drop and roll. Abbreviations in the OP make me think maybe the OP is not a nurse.

What abbreviations are you referring to in OP? I went back and reread and I don't see anything that would make me think OP is not a nurse?

To OP if you are still reading: I do not think the "proof" you think you have is enough to say a nurse is diverting. You reported your suspicions and it should be left to management to handle at this point.

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Specializes in HH, Peds, Rehab, Clinical.

Seriously? Text speak is against TOS...

If the pts are complaining they did not receive there pain medication u did right by reporting it.

Also if pts are asking and not receiving from this nurse and the pt is telling u this. U can have the pt talk to supervisor that it is happening. Have the pt report it. I remember when my dad was in a rehab for a hip fx even though he was 90 years old he also was SHARP. AAO*4. He was in pain. He also was the type to not take pain meds unless he really was In terrible pain Tough guy. BUT in this rehab when I went to visit him he said he was in so much pain while sitting up in a w/c. Also he was very diaphoretic. He said he hurt so much. I asked him if he received his Percocet 5 mg he said no. So I went to the nurse and asked about it. She said he took it an hour ago. I think she was full of it. It is scary what we see as a nurse when on the other side. [emoji17]

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Specializes in critical care.
What abbreviations are you referring to in OP? I went back and reread and I don't see anything that would make me think OP is not a nurse?

To OP if you are still reading: I do not think the "proof" you think you have is enough to say a nurse is diverting. You reported your suspicions and it should be left to management to handle at this point.

Whoops! I think I got this thread mixed up with another one. You are right!

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