RN job in jeopardy please help

Nurses General Nursing

Published

Shell shocked. Worked last night, they called today and asked me to come in today early. Administrator there plus managers, still befuddled. I gave an Ambien to a patient at 2100, I remember pulling them out, snapping one off, shutting the drawer. Apparently the rest of the pack is missing now, drawer is empty. We have the Pyxis system with fingerprints, they say I was the last one to access, no other nurse, no techs, they've searched everywhere, floor, trash, shredder.

They were nice about it but I'm placed on leave and they're "going to call me" it's implied that if the 8 Ambien don't turn up I'm fired. I would think someone diverting meds wouldn't pull out all the meds, leave the drawer empty and carry them around for the whole shift and expect to come back the next night. But since I don't have any answers for them and the drugs aren't able to be found, I see their point. What can I do or say? I have no idea on earth what happened, I've worked there several years and I've never had a problem, this is my first nursing job. :o

I'm scared not only will I get fire I'll lose my license, what should I do?

Specializes in Geriatrics, Cardiac, ICU.
I would tell them I would want their apology in writing because they should understand my position. Then I would give my two weeks notice. ;)

ITA.

Specializes in Neuro ICU.

Ok, Congrats on finding the med. I am glad they called you and offered somewhat of an apology, but understanding their position and policies that is how it may be done.

Which brings me to policies. I would double check policies or manuals on hospital standing about drug discrepancy to address a few concerns. (and to CYA, in case it ever happens again)

1) Why were you not called immediately upon the discrepancy being found. What is policy on this. Lack of timely notification, whether you are sleeping or not, shows ill faith on their part. Plenty of time for your future credibility to be torn apart by co-workers. Additionally, the call may trigger you to remember something or an accidental placement in wrong drawer etc and save EVERYBODY trouble.

2) You should have been able to come in and assist with the search and observe counts upon the discrepancy being found and you being immediately notified. What is policy on this? Even if your were sleeping, how many of us wouldn't run in to assist. provide drug screen, search, review MAR's etc to save our license and livelihood. Also, if their search of the Pyxis was so thorough, why did parm come in and open it and wah lah there it is....You may insist on a more thorough search if you could have been there. Why wasn't pharm notified initially to come "open".

3) Back to being notifed...if you are being investigated or questioned you should have a right to know if you are being reviewed. What is hospital policy on this. They were investigating you without notification, they should have notified you immediately and advised of your Admin leave pending the results of the investigation (CYA for them). They caused you undue stress hmmm...

The hospital I work at does these things along with Drug screens for anybody with access to the Pyxis within so many hours. Including those that have already gone home. Once notified you have 2h to screen.

For future for all of us...

Upon notification, request to be present to assist with search, MAR reviews and counting. In the very least, you should be allowed to observe. If you can, contact union or lawyer to fight for your rights for this.

We all stress and our minds may be blown but we are trained to work under these conditions... Think, my life, my license, my livelihood are under attack what do I need to do. Go into the mode you have been trained to do. only now it is to protect yourself, be your own best advocate. Insist on drug screen, insist on prescence. Insist on Pyxis inventory and access review. Review MAR's of all patients in Pyxis and patient's with need for same drug and nurse for pt.

We have been taught...legalities...documentation, documentation. Begin your own paper trail and write down everyone you contact or who contacts you reference the situation and what they say or advise. Right down times and note time spaces. Ask when was this noticed as a discrepancy and document what the person says and ask why was I not notified sooner etc.

Then begin a memory recall and write down everyhing you can remember in the time frame of suspected incident. Who was there, what was going on, who you had for patients, acuity level, staffing level, housekeeping, techs etc. keep reading it and reviewing and adding what this triggers for memory.

Basically do your own "self charting" to protect yourself. In this way you will begin to feel you have some control of the situation instead of letting the situation control you. Use your critical thinking skills to approach the situation with a methodical plan to direct your focus.

Again, I am glad you were cleared and happy safe nursing to all!

What a relief for you! Similar situation happened to an LPN at our facility except she was reported to state before pharmacy finding the med stuck between drawers. She had been an LPN there for more than 20 yrs. She no longer works there.

Good luck with your next decision. Let time take care of the feelings surrounding this issue. Focus on established experience and career goals.

Yes!! Ive been reading your post and felt sick for you. I am so glad. I have not worked witha Pyxis much, so I couldnt really say anything about that.

You may not get an appology ever. They were following their protocol, and probably think they dont have to apologize, though they should say something.... you went through alot of stress...

Anyways, I am happy for you!

What a relief! I am so glad that you were vindicated in this manner. Be careful about the rumors that have no doubt begun swirling around, it may take a while for them to die down. I would insist that my supervisor notify my coworkers of the discovery if she has not done so already...

I was called immediately but I had worked the night before and was sleeping. They called again and this time someone else was home to wake me because I turn my phone off and wear earplugs but by then the day was nearly over. I will be sure to check policies. They told me they already searched Pyxis thoroughly but the pharmacy apparently knew other places to look inside the Pyxis and there it was. I have been documenting everything and will from now on and always have witnesses as well. In this case, I did nothing wrong, this could have happened to anyone, the med packet apparently caught when I closed the door and somehow got stuck inside but I think rumors are swirling anyway.

Ok, Congrats on finding the med. I am glad they called you and offered somewhat of an apology, but understanding their position and policies that is how it may be done.

Which brings me to policies. I would double check policies or manuals on hospital standing about drug discrepancy to address a few concerns. (and to CYA, in case it ever happens again)

1) Why were you not called immediately upon the discrepancy being found. What is policy on this. Lack of timely notification, whether you are sleeping or not, shows ill faith on their part. Plenty of time for your future credibility to be torn apart by co-workers. Additionally, the call may trigger you to remember something or an accidental placement in wrong drawer etc and save EVERYBODY trouble.

2) You should have been able to come in and assist with the search and observe counts upon the discrepancy being found and you being immediately notified. What is policy on this? Even if your were sleeping, how many of us wouldn't run in to assist. provide drug screen, search, review MAR's etc to save our license and livelihood. Also, if their search of the Pyxis was so thorough, why did parm come in and open it and wah lah there it is....You may insist on a more thorough search if you could have been there. Why wasn't pharm notified initially to come "open".

3) Back to being notifed...if you are being investigated or questioned you should have a right to know if you are being reviewed. What is hospital policy on this. They were investigating you without notification, they should have notified you immediately and advised of your Admin leave pending the results of the investigation (CYA for them). They caused you undue stress hmmm...

The hospital I work at does these things along with Drug screens for anybody with access to the Pyxis within so many hours. Including those that have already gone home. Once notified you have 2h to screen.

For future for all of us...

Upon notification, request to be present to assist with search, MAR reviews and counting. In the very least, you should be allowed to observe. If you can, contact union or lawyer to fight for your rights for this.

We all stress and our minds may be blown but we are trained to work under these conditions... Think, my life, my license, my livelihood are under attack what do I need to do. Go into the mode you have been trained to do. only now it is to protect yourself, be your own best advocate. Insist on drug screen, insist on prescence. Insist on Pyxis inventory and access review. Review MAR's of all patients in Pyxis and patient's with need for same drug and nurse for pt.

We have been taught...legalities...documentation, documentation. Begin your own paper trail and write down everyone you contact or who contacts you reference the situation and what they say or advise. Right down times and note time spaces. Ask when was this noticed as a discrepancy and document what the person says and ask why was I not notified sooner etc.

Then begin a memory recall and write down everyhing you can remember in the time frame of suspected incident. Who was there, what was going on, who you had for patients, acuity level, staffing level, housekeeping, techs etc. keep reading it and reviewing and adding what this triggers for memory.

Basically do your own "self charting" to protect yourself. In this way you will begin to feel you have some control of the situation instead of letting the situation control you. Use your critical thinking skills to approach the situation with a methodical plan to direct your focus.

Again, I am glad you were cleared and happy safe nursing to all!

Specializes in Case Management.
I find it difficult to believe anyone dusted for fingerprints AND got a match in that short of time.

Wha??????:confused: :no:

I am so sorry this is happening to you, and angry too. Our jobs require so much of us, yet we are always vulnerable to accusations even without proof, from patients, staff and management. I wish I had more practical advice to offer but all I can say is try to hang in there. Good luck now and in the future.

Specializes in Med Surg.
Why not just put a camera in the med room, then you wouldn't have to guess as to what happens to meds?

I thought you were innocent until proven guilty.

Glad they got it straightened out though.

I see I need to pray before every shift when I graduate.

If they put cameras in the med room, how are we going to pull up our bra straps or fix wedgies without getting seen? I can't count on always being alone in the elevator:p .

Seriously. Shortly before you give report, pull up your Pyxis activity for the day. This for 2 reasons; you can review it to make sure no one pulled anything out behind you if you spaced and walked away without exiting or didn't push the exit button hard enough; and so you can double check your med sheets against the record and ensure all your prns are signed out. I have been SO guilty of giving someone pain meds and then getting called away before I could get to the med sheets. And that helps with the appearance of diverting drugs. I've never been suspected, but had to witness an LVN being investigated.

By the way, LVNs...in CA there is no drug rehabilitation to save your license. One strike and you're out. This needs to be addressed to the LVN board.

Specializes in nursing homes, home health..
If they put cameras in the med room, how are we going to pull up our bra straps or fix wedgies without getting seen? I can't count on always being alone in the elevator:p .

Seriously. Shortly before you give report, pull up your Pyxis activity for the day. This for 2 reasons; you can review it to make sure no one pulled anything out behind you if you spaced and walked away without exiting or didn't push the exit button hard enough; and so you can double check your med sheets against the record and ensure all your prns are signed out. I have been SO guilty of giving someone pain meds and then getting called away before I could get to the med sheets. And that helps with the appearance of diverting drugs. I've never been suspected, but had to witness an LVN being investigated.

By the way, LVNs...in CA there is no drug rehabilitation to save your license. One strike and you're out. This needs to be addressed to the LVN board.

icon14.gif Wow way to go CA. they must have all of the nurses they need and then some. Seriously tho how in the world can they afford to be so strict.icon5.gif
By the way, LVNs...in CA there is no drug rehabilitation to save your license. One strike and you're out. This needs to be addressed to the LVN board.

Not true. There is no diversion program that keeps the recovery off your license record, but there is a disciplinary process in place similar to that of RNs who go through the BON's program rather than Diversion.

Specializes in cardiac.
I find it difficult to believe anyone dusted for fingerprints AND got a match in that short of time.

Possibly someone who doesn't understand how the PIXIS works. Not all facilities use them. You need a fingerprint in order to access the PIXIS system. When you punch in your id number, it will ask for a fingerprint scan before you can punch in any type of drug you are trying to retrieve.

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