reported a nurse stealing narcs and not giving meds, shes friends with the DON :(

[CynicallyVexed]

HI I'm fairly new at the SNF I'm currently working at.. (Less then two weeks to be exact) and in the past week the nurse I follow (she works days and I work evening shift) she was constantly leaving me in a hot mess and not wanting to count narcs until it was 30 to 40 minutes after the time I had clocked in for my shift. I started noticing medications that are due 4 times a day that I give twice at night and she gives twice during the day where on the same count that I had left it at the night before and she was signing she gave them (this would be blood pressure meds to be exact). On these same patients she was signing out routine narcotics and prn narcotics as soon as she could sign them out. I kept up with her pattern. She had picked out four people who get routine hydrocodone or oxycodone that also have PRN orders to go with it. I pointed this out to the preceptor I had during my orientation and she reported it to the DON immediately. Both her and I found shortly after that she is neighbors/best friends of the DON nothing was done about it and the situation has become worse. 20 PATIENTS are being affected.

The facility I'm at has a corporate number to leave tips anonymously about whats going on there. Both the preceptor and I called the line and the state has been called. We have copied the med cards and are dated and stamped of when the cards came in. There is patients that have been there for a week to two weeks and most hadn't got their blood pressure meds but their narcotics are being signed out. A patient was recently put on antibiotics and out of the past 5 days that patient has only gotten one dose of the medication.

I truly feel my job within the facility is at risk now cause this so called nurse stealing drugs is best friends with DON who is doing nothing about it. Is there anything I can do? Do I fall within the whistleblower act? I'm so lost and astonished of what I'm seeing, but I know I can't continue to work there knowing these patients lives are in jeopardy and possible hurting cause they are not getting their medicine!! Its so bad that the patients that are alert and aware of whats going on are complaining and have went to administration but nothing has been done. We called the ombudsmen for one that is alert enough to explain.

Im just truly astonished and this week has been so stressful.

[sissiesmama, ASN, RN]

I am surprised you haven't been terminated already. You need to get a move-on.

My thoughts exactly! If the nurse is diverting (which it sounds like that's going on) and is good friends with the DON, your days there are prob VERY limited. From the sound of things, that's a good thing. Any evidence, ect u may have I would definetly keep for if/when the poop hits the fan.

It would make me a wreck working somewhere like that - never knowing what would happen - JMO.

Good luck, and and let us know how things turn out.

Anne, RNC

[jadelpn, LPN, EMT-B]

YIKES!! Her yelling at the nurses station that she gives her meds when she clearly doesn't--one would think that they would be under added scrutiny and start giving their meds. So not the brightest bulb in the bunch.

BUT here is a point worth considering--IF a resident doesn't get any medication and you can prove that (ie: antibiotics) what is your obligation to then give the meds? It is a good question to ask, as the last thing you need is to then have the state say "well, CynicallyVexed, you discovered that there were 20 residents that were not getting meds. Did you give them? Did you do an incident report that there were missed med passes?" It is really, really awful that now you have been left holding the bag. So be really careful. If you have malpractice insurance, call and ask for advice.

In any number of facilities, if you catch it, then you need to respond to it accordingly (ie: give the med, sign it off, follow the policy on missed doses in your facility). Ask your preceptor for guidance. It may require daily counts of all medication.

If one of the residents has a stroke due to a uncontrolled BP, you could be called out due to the fact you know that (due to med count) the patient did not receive meds. There are often some policy on timing as well.

What a hot mess. And I am sorry you are left holding the bag. Protect yourself in all of this. Do NOT leave the facility until you are sure you are covered 1000%, all your "t's" crossed, and your "i's" dotted.

Let us know how it goes.

[sissiesmama, ASN, RN]

That's what I was thinking too jade - the scene she caused at the station - wow! Definetly not too sharp - not at least trying to look like she's doing what she's supposed to.

Anne, RNC

[morte, LPN, LVN]

this may be exactly what the DON is planning for the OP, get her tied up on the not giving meds...

YIKES!! Her yelling at the nurses station that she gives her meds when she clearly doesn't--one would think that they would be under added scrutiny and start giving their meds. So not the brightest bulb in the bunch.

BUT here is a point worth considering--IF a resident doesn't get any medication and you can prove that (ie: antibiotics) what is your obligation to then give the meds? It is a good question to ask, as the last thing you need is to then have the state say "well, CynicallyVexed, you discovered that there were 20 residents that were not getting meds. Did you give them? Did you do an incident report that there were missed med passes?" It is really, really awful that now you have been left holding the bag. So be really careful. If you have malpractice insurance, call and ask for advice.

In any number of facilities, if you catch it, then you need to respond to it accordingly (ie: give the med, sign it off, follow the policy on missed doses in your facility). Ask your preceptor for guidance. It may require daily counts of all medication.

If one of the residents has a stroke due to a uncontrolled BP, you could be called out due to the fact you know that (due to med count) the patient did not receive meds. There are often some policy on timing as well.

What a hot mess. And I am sorry you are left holding the bag. Protect yourself in all of this. Do NOT leave the facility until you are sure you are covered 1000%, all your "t's" crossed, and your "i's" dotted.

Let us know how it goes.

[itsmejuli]

Yup, I'd be out of there in fear of being thrown under the bus and the one to blame for everything.

[monkeyhq]

One question: Did they whiz quiz everyone? In most places (in my area anyway), if a med is missed & frequent errors are happening, everyone in the building is peeing in a cup, including the DON, period. If they try to fire you for making a report, or attempt to frame you, or retaliate against you in any way, I would challenge them with mandatory urinalysis for all involved (at minimum).

Even if corporate protects you from these two (when all the truth comes out), you may still be considered a litigation 'risk' for the company. They may try to find a way to subtly get rid of you (poor performance reviews, etc.).

I agree with many of the above, it might be time to consider a new employer before your license is at risk (due to retaliation actions). In the meantime, honesty is always the best policy and I believe you did the right thing...patients should not suffer due to missed pain medication.

[lpncharlie]

Put your initial and date next to the blister on the meds you administer.

[RN_rescue_ninja]

If she's diverting the narcs, just wondering why she's failing to give the BP meds? What do the non-narc meds have to Do with it? I'm tired, lack of sleep at the moment; may e I'm missing something.

[monkeyhq]

The implication is that she is there for the narcs and is very diligent in signing off on them (as in CYA).

The issue has come to light because daily non-narc medications have been missed, but never PRN narc meds. There is perfect documentation when it comes to the narcs, and missed doses when it comes to the non-narcs. Why would a nurse repeatedly neglect to give a patient something they should have everyday, but be diligent about giving something that is PRN? Big warning sign for diversion, in my opinion.

[canoehead, BSN, RN]

Once you've notified your employer and nothing was done, my next choice would be to ask the BON what to do. Give them the hypothetical situation, and ask them who needs to be notified, and in what order. At what point do the police get involved? Who calls the police? And what to do about the missed medications?

[RN_rescue_ninja]

The implication is that she is there for the narcs and is very diligent in signing off on them (as in CYA).

The issue has come to light because daily non-narc medications have been missed, but never PRN narc meds. There is perfect documentation when it comes to the narcs, and missed doses when it comes to the non-narcs. Why would a nurse repeatedly neglect to give a patient something they should have everyday, but be diligent about giving something that is PRN? Big warning sign for diversion, in my opinion.

Right, right. I understand that. But someone who is so diligent at making sure they properly sign out the PRN meds...should be better at something so obvious as making sure they are giving the other regular meds? Idk, maybe she's missing them because she's high all the time?

[monkeyhq]

Idk, maybe she's missing them because she's high all the time?

That is my interpretation of what the OP meant, but I think perhaps the OP should weigh in for clarification? Maybe the missed daily meds were just a few times and that sent off the warning?