P&P about missing narcs, How does your facility handle this?

[I<3H2O, BSN, RN]

Example:

You pull a narcotic out of the med station with intention of giving it to a patient. Patient decides they do not want it or order has changed or any other reason that would result in you not giving the pt. the med. Then, you placed the med in the pocket of your jacket, your binder/clipboard, fanny pack or whatever you carry. Shift ends, you forget where it is and are actually unable to locate said medication for days/weeks/etc. When you find it, it is still sealed. What do you think would happen in your facility? Do you have a policy about this?

This recently happened in my facility and there was no actual P&P regarding something along these lines and the nurse was formally written up for it.

[demylenated, BSN, RN]

Oh yeah - def write up!!! We have to IMMEDIATELY discard with 2 nurses... or I tell a nurse I have it and when we have time I need to dispose. "Not finding it" is as good as "taking it." Finding it weeks later could be a new med just taken out and SAID they just found it... no proof...

ALWAYS have a double nurse discard ASAP.

[tyvin, BSN, RN]

As previously said must find another nurse to discard/waste. Never put in your pocket; never.

[Whispera, MSN, RN]

Did pulling it out of the med station record it as given? If not, I'd think that in itself would cause a problem.

Bringing it back and turning it in is what needed to happen, write-up or not. Write-ups are used to correct system errors (such as re-education about what to do when a patient doesn't take a med you've taken out of the med station).

A nurse who doesn't get a write-up is like a day without air....not likely.

[I<3H2O, BSN, RN]

Does your facility have a specific policy on this topic? I was surprised to find that we do not. This nurse was mad about the write up (obviously) but there was no P&P on "missing meds". I had always heard if there were missing meds then everyone was getting a UDS before they left the floor. Found out that wasn't in the policies either. Trying to find out if this is just a discretionary type of write up or does most facilities have a specific plan in place for it.

[merlee]

If a narcotic isn't given after being pulled for any reason it must be wasted and witnessed. That is the policy everywhere I have ever worked.

[IdrilRN, BSN, RN]

If the unused/refused narc is still in the sealed unit dose package we can put it back in the pyxis. If I'm using the LTC bubble packs I make sure I sign it out as soon as I take it out of the pack. If person refused then waste with two nurses.