nurse use of controlled substances

[mittels]

Where does the responsibility lie?

I worked with this nurse, who was training me to a new position.

After the first few hours, I knew something was not right with her and her thinking. By the second night, I found three abx hung on the wrong pt's and a manitol IV that should have been stopped at 250cc, but instead the pt received double the dose. With all the pt's no adverse reactions occured. Thank God. No allergies to the pt's were noted with the abx. I confronted this nurse about her discrepencies (SP). She should have filled out an incident report but did not. I kept a mental note of these pt's. Later on the second night, she admitted that she is prescribed MS contin and Kaden I eventually spoke with the nurse manager the next morning about what took place and her comments about being on controlled substances. Nurse manager filled out the incident reports, and showed me where they were located. She also said that she and higher management were aware that things were not right with her but did not have substantial proff of her problems, that is why they had her orient me. OMG. Least to say I quit after day three. Its been less than a week and I would like input as to where my responsibilty lies. She is dangerous!! Any suggestions would be helpful. Thanks.

[LilRedRN1973]

I don't have any suggestions for you but agree this nurse should NOT be working while taking these medications. I'm prescribed Lortab (hydrocodone) and take it for my cramps a few days out of the month. But I'm also aware once I begin working with patients, I need to find an alternative should I have to work on these days. I will not go to work after taking this med, even though I take half a pill at at time. I did used to go to my other job as a waitress while taking them, but it never affected my work. However, I didn't have to worry about KILLING someone while giving them their food!! I have never taken MS contin but imagine it would affect your way of thinking. She should not be allowed to work under the influence of this medication, IMHO. But I'm just a lowly nursing student and don't really know the policy on all this. :chair:

[nurseygrrl, LPN]

If ANYTHING interferes with your ability to properly care for your patients, you should not be allowed to work. You could have a fever and be slightly delirious, a hangover, under the influence of narcotics and/or alcohol, didn't get enough sleep...any of the above that causes you to be less than aware, not just narcotics. That's my 2 cents! :)

[BarbPick]

You did what you are supposed to do. legally perscribed narcotics are still that, narcotics. She is impared and you did what you were supposed to do.

The Nurse manager can get to the next level. Administration can contact her physician. Just because she is given them by her doctor doesn't me she is normal on them.

You did what your Nurse Practice want you to do, you reported it.

Let the pros do the rest. You were brave and smart. Good for you!

[Tweety, BSN, RN]

I'm fairly sure that here in Fl one can't work while taking narcs. If the condition is that severe, they should be at home. I had oral surgery yesterday and am taking motrin, saving my percocets until I get home.

This person is at risk for causing harm. Obviously with those meds she's in significant pain. Probably needs to work. It's like being between a rock and a hard place.

Check your nurse practice act.

[angelbear]

I recently had this discussion with my DON as I have fibro and take narcotics on a regular basis. However I do not take them when I have to work I take 800 mg of motrin. She informed me that nurses with chronic illnesses cannot be discriminated against regardless of their need for pain meds. She explained that once the body becomes accustomed to the drug that is your normal state. The reason we had this discussion is because my md was considering a duragesic patch and I was afraid I would not be allowed to work. She assured me that this is not the case. I reported it to her and as far as I know she reported it to BON. The only thing different is that if I give a narc I have a coworker witness and cosign. I dont know all this to be fact but this is what I am told. I have not yet consented to the patch and continue to work with motrin my prefrence.