I work at a hospital that uses pyxis for narcs and bar code med administration for giving meds. I had a pt that was hurting, I had him for 6 hrs and knew I didnt give him ivp morphine so I went to the pyxis to get it so I could scan it. I noticed another nurse took out the med but did not scan it in. pt was not her pt. I had to call the MD and say the dose was not effective and needed a different order so I did take care of the pt's pain. I have noticed this nurse taking meds out for multiple pts that were not hers, at times I have asked my alert and oriented pt's if they got anything for pain and they have stated no. in a shift most of us get into the pyxis 5-6 times to get things out, either routine or prn meds. I noticed this nurse takes 20-25 out per shift, at first I thought maybe she was just really aggressive with pain management. occasionally if we have a pt in pain on the ward and the nurse is in a procedure one of us will give the pt a prn but we would of course talk to the pt's nurse prior to giving anything. this nurse does not and the only way some of us found out they "got" a prn is by seeing the med taken out of the pyxis.
I had a pt friday that used to be a medic, she had a stress test and it was negative, that was around noon, and she was back at the ward at 2pm, when I went to dc the pt I noticed she had taken out her IV already, (pt stated she was an emt and wanted it out) no problems there. I saw on the pyxis that this nurse took out 2 2mg vials of morphine at 4:01pm and 4:27pm, her ride came about 4pm and she left about that time, the pt declined any pain at dc, the nurse didnt scan the med in the barcode system. how did she give the ivp med if there was no IV? I noticed a pattern before any of the pt's get discharged she is in the pyxis getting meds out for the dc'd pt even if it isnt hers. some pts do have long drives home and with some conditions if certainly is appropriate.
however if the pt's chest pain has been resolved why is she getting meds out for a pt she isnt even discharging.
Other nurses are noticing this as well. the nurse that is doing this is a msn nurse, she is married to a dead beat dad that works sporadically so she has to pay the child support on his 5 kids. She is vested with this employer, I generally like her. She actually got promoted to another job, she will be in charge of the hospitals palliative care program. From what I understand she will not have access to drugs in that job and they will supposedly take her out of the pyxis system it is supposed to be an administrative job. (she wanted to do overtime on the ward but they wouldnt let her because the job will be funded under a different account and she wouldnt have access to the barcode system or the pyxis. )
I guess her last day on the ward is this weekend (which I am off) and her new job starts next week.
I have noticed the discrepancies in the meds for several months (i,e, pts that are not hers getting pain meds from her and they deny getting them or say they are ineffective) in the past week the discrepancies have been massive. she has been taking out narcs based on the max prn frequency but when I go into the computer none or very few of these are documented as given.
She is a big girl (300 lbs) she did break her leg last year, she is about 50 yrs old, a good and educated nurse, the work on out ward is physically demanding and there is a lot of walking and lifting. She might just be having a lot of pain, maybe this is why she went to the desk job, or maybe she is stocking up because she wont have access any more. She wont be on my ward any more so it really isnt my problem anymore
I cant believe the powers that be havent seen where she took out so many drugs and were never documented as given. I talked with a co-worker (and a nurse) that I went to college with and we have been friends 25 years and she thinks she is just hurting because the job is too demanding physically. since she wont have access to drugs anymore she thinks we should just blow it off
what should I do with the information that I have? It can all be verified in the computer.
YOU need to report this in a way that you can CONFIRM that the person you're reporting it to received the message. You can't with a text message. And honestly, if I got an ANONYMOUS report from a fake email address, then I would probably ignore it. It sucks to do it, but it doesn't give you a pass to pansy out on the report.
CPTLUCIEJENSEN I think it is very sad that nurses can know another nurse is diverting narcotics from patients and pretend as if it is not even happening. I am not sure as to what state you are practicing but in GA you can lose your license for not reporting incidents like that. And to be honest although you have anonymity in this forum with us. You need to understand that there may be a nurses married to a FBI or DEA agent that can track you down, find this nurse and hold you accountable by your computer's IP address. You just confessed to the world that you know this nurse is stealing narcotics and you and others have chosen to ignore FEDERAL drug laws and not report it. SHAME.
I recently started a contract with a hospital and on my second day of work the charge RN tricked me into witnessing multiple doses of narcotic waste with her. I was repeatedly prompted to enter my password and user ID and thought it was not accepting me because I was agency. When I asked the nurse where was the waste for what I thought was 1 dose of narc she stated that she had already wasted it. In observing her behavior and noticeable absences I got really suspicious and went back to look at the patient's medicine and noticed that she had actually had me witnessing about 5 or so waste and the repeated prompts were in fact additional doses. I immediately reported the incident to overhouse RN and my agency. I also emailed all nurse managers including CNO and pharmacy. There was no way I was going to ignore her actions. I was so offended that she had the nerve to involve me in her addiction that I was tempted to report her to the BON myself. The managers asked me to let the hospital do their investigations first and allow them to handle it. I am waiting to see what happens. I still may very well report her to the board.
In reply to zimsaint, I would say that while we are obligated to report diversion of narcotics when we witness it, there is no need to create a culture of blame and paranoia in the workplace. We should report these things because we know they are wrong and harmful, not because we are living in fear of FBI or DEA agents lurking about. The op said she had strong suspicions, not proof, and that she was asking for help in what action to take in what she called a "dilemma" - and since this is a serious charge to make against a co-worker, she was using her head by giving it a lot of thought.
I beg to differ with you as to what is suspicion vs proof. You don't have to see a nurse literally shoot up to have PROOF that they are diverting narcs. This nurse she said routinely took out narcotics for other nurses patients some of whom were alert and said they got no pain med. Others have no IVs and had even left the hospital discharged. DENIAL is contagious. As for FBI or DEA's "lurking" around the internet. They have divisions and employees who's sole
I beg to differ with you as to what is suspicion vs proof. You don't have to see a nurse literally shoot up to have PROOF that they are diverting narcs. This nurse she said routinely took out narcotics for other nurses patients some of whom were alert and said they got no pain med. Others have no IVs and had even left the hospital discharged. DENIAL is contagious. As for FBI or DEA's "lurking" around the internet. They have divisions and employees who's sole
purpose is to do just that. BELIEVE IT OR NOT!! W
Without an official investigation, there is no proof. The OP's subjective recall of events--while likely indicating narc diversion--is not enough evidence to "prove" anything. "Proof" has to include significant details that collectively illustrate--beyond a shadow of a doubt--the guilt or innocence of a person. Tox screen, multiple eye witnesses, MAR/Pyxis audits (including pt response to allegedly given medication), criminal record or relevant behavioral histories of the nurse in question, direct confessions, etc--these are all pieces of evidence. But none of these stands on its own to prove guilt or innocence. AND, I think the OP has shown wisdom in her/his approach to this discussion. S/he knows what s/he saw, understands the gravity of the situation (including the repercussions to the nurse in question if she were accused), and s/he is sensitive to the fact that there are always multiple sides to every story, no matter how convinced she is by what she saw.
And while I don't disagree that privacy is definitely not a certainty when posting anything on the internet, I am...skeptical (to say the least) that any government agent has the OP on a watch list because of this story. It is a dramatic theory though.
all we know at this point is that, according to the pyxis, this nurse appears to have taken out and not given, multiple doses of controlled substances......what about the other nurse who doesnt want to report, what if SHE has obtained the other nurses access code/pass word?...you need to report to NM or whomever, and DONT mention it to anyone else in your hospital again....!
2 nurses came to me with the same suspicions, we got together and told him (our manager) our concerns, he will check the pyxis and computerized meds and will go from there.
I didn't even take the time to read the responses here.
YOU MUST REPORT THE FACTS TO YOUR SUPERVISOR IMMEDIATELY.
It is not your place to feel bad for her. Your supervisor should be investigating this, and the patients should NOT BE DENIED their pain medications because another nurse took out their pain meds and didn't give it.
Document this and give it to your supervisor. Never EVER EVER deny your patient their pain med if it was not scanned and given. Ask her if she gave it, then taker her to the patient's room and ask them in front of her. Do not assume anything and DO NOT FEEL SORRY FOR HER. If she is taking these meds, she has a serious problem and she needs help, she doesn't need your sympathy right now. Trust me.
Even though she is going to another position, you still need to report this. It is your duty as a licensed nurse.
I have a lot more to say, but I will leave it at that.
wooh, BSN, RN
1 Article; 4,383 Posts
YOU need to report this in a way that you can CONFIRM that the person you're reporting it to received the message. You can't with a text message. And honestly, if I got an ANONYMOUS report from a fake email address, then I would probably ignore it. It sucks to do it, but it doesn't give you a pass to pansy out on the report.