Should I self report?

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I work on a very busy heart/ stroke floor. I got a write up but not terminated for pulling too many Lopressor 25mg on a patient one day! We scan our meds so it shows the pt only received the correct dose! I honestly do not remember if I pulled a partial sheet in a hurry and forgot to return the rest and left them in my cart or if I didn't log out correctly and someone else went in but why would someone take Lopressor and not narcotics if that was the case??? I am just lost here! My question is should I self report this to the board? Any help is appreciated!

Sunny

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Specializes in Infusion Nursing, Home Health Infusion.

Absolutely not! You did not steal any medication.Just be extra careful going forward so you are not taking out any extra medication.

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Thank you! I am freaking out and over LOPRESSOR??? They ask if I gave it to someone??? I don't even know anyone that couldn't afford a generic b/p drug! They can still report it though!

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Specializes in Psych, Addictions, SOL (Student of Life).

They are not likely to report this to the board - modern electronic medication systems like Pixis and Omnicel - generate Anomaly reports and facilities use these to track med errors and possible diversion. Just breath and move forward being extra careful in the future. Definitely do not Self Report. If you are reported for this do not go before the BON without a lawyer experienced in professional practice issues. If you have you can get a lawyer. If you don't have Malpractice insurance get some - every nurse should carry their own insurance.

Hppy

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Specializes in Critical care.

Definitely do not self-report. Some things that you didn't share here, but perhaps they covered when they contacted you was if a prior user had miscounted, meds found in another bin and this didn't get accounted for, etc. They need to display they did their due-diligence before following through with this corrective action.

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Specializes in Healthcare risk management and liability.
hppygr8ful said:
They are not likely to report this to the board - modern electronic medication systems like Pixis and Omnicel - generate Anomaly reports and facilities use these to track med errors and possible diversion. Just breath and move forward being extra careful in the future. Definitely do not Self Report. If you are reported for this do not go before the BON without a lawyer experienced in professional practice issues. If you have malpractice insurance you can get a lawyer. If you don't have Malpractice insurance get some - every nurse should carry their own insurance.

Hppy

If one of my nursing staff asked me this question, I would advise them to not self-report. A slight correction to the sentence in bold above: if the BON files an actual complaint against your license, and you retain counsel to represent you, the 'license defense' coverage of the CNA policy should provide you with up to $ 25,000 in reimbursement. In this sort of scenario, I would advise my nursing staff to retain counsel regardless of any possible reimbursement. I am usually able to lean on my defense counsel to provide representation to my nursing staff at a reduced rate.

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Thanks Willie! No prior issues! We have a new manager that seems to be wreaking havock but I have had no issues! This hit me upside the head and with us carrying 5 to 6 patients a day with about 3 psych one to ones on the floor everyday it has been nuts! Since this incident occured 2 to 3 weeks ago it was hard for me to even remember exactly the patient or what happened! They said they have been having discrepancies! Lopressor is not a med that is counted but pharmacy said we ran out too quick! Well how do I know they dispensed the right amount??? I know this all sounds ridiculous over a b/p med but it is what I am dealing with! They say it is reportable...but anything is! Idk but if I was going to report someone to the board I would term them also but they did not! WTH am I missing?

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Specializes in Critical care.

I'm gonna go ahead and read faaar into what you've shared, but has there been any recent big leadership changes you're aware of? Any recent conflicts? No need to answer either way, just putting it out there.

BTW, you hit exactly on one of the questions they needed to answer before pointing fingers at you. We've all likely found errors created by the pharmacy tech filling the machine.

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Specializes in retired LTC.
Wile E Coyote said:
... BTW, you hit exactly on one of the questions they needed to answer before pointing fingers at you. We've all likely found errors created by the pharmacy tech filling the machine.

What?!?!?

Tell me it ain't so!

Pharmacy NEVER makes mistakes!

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Specializes in Critical Care, Education.

Excellent observation by Wile E Coyote.... medication administration is a multi-step process with many people involved 'upstream' before it even gets to the nurse. Something could have happened at any step along the way to cause the discrepancy. Hopefully, they are looking at the entire process rather than just landing on a convenient nurse scapegoat. I know many nurses who take the time to do a 'beginning of shift' check on their pt meds even though they are using an automated dispensing system... mostly because they have been unjustifiably blamed for errors in the past.

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Specializes in IMC, school nursing.
amoLucia said:
What?!?!?

Tell me it ain't so!

Pharmacy NEVER makes mistakes!

I thought I was the only one upset that nursing requires witnesses to do anything with a narcotic, but pharmacy techs can escort returns back to pharmacy unwitnessed. One of my coworkers had her Dilaudid return questioned, thankfully I watched it deposit into the bin and verified. It also irritates me that we need to be more responsible than pharmacists who make 50% more than we do.

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Specializes in Psych ICU, addictions.
Sunnywd said:
Thank you! I am freaking out and over LOPRESSOR??? They ask if I gave it to someone??? I don't even know anyone that couldn't afford a generic b/p drug! They can still report it though!

You're right: they can still report it to the BON. Will they? Most likely not. After all, you still have your job, so I doubt it'll go any further than the write-up you received. If they were going to report you, then why would they still have you on the payroll?

Unless, of course, it happens again.

I'd consider it a learning experience and be more diligent in the future. I agree that you should not self-report either. Self-reporting is for nurses who are impaired and who want to save their licenses by entering treatment, not for nurses who lost track of some Lopressor.

But in the very unlikely instance that you find they did report it and the BON comes calling, DO NOT face them without legal counsel at your side. BONs are not your friend, and don't fall into the trap that if you could just explain to the BON that it was an innocent mistake that they would be understanding and drop the case.

And you'd be surprised what drugs are diverted besides narcotics and benzos.

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