Should she be suspended?

[desro1986]

Hello. I work in a nursing home on a subacute rehab unit. I work with another RN on the same unit. Our DON did a narcotic inventory on her med cart and there were some discrepancies between the narcotic meds and the narcotic book. I have gotten to know this RN well and know she would not steal narcotics. She simply did not document the narcotics immediately after giving it, something which I'm sure many nurses have done at some point. Anyways, she was suspended and there is an invenstigation going on. My question is what are the guidelines for documenting narcotics? Is it a LAW that narcotics be documented immediately after giving them? Or is there an acceptable time span? Does it vary by State and facility? Thanks

[UCF2009]

It varies by state to state, but during clinicals from what I say was the new nurse coming on the shift, and the outgoing nurse from the previous shift would do a count of the narcotics. They had a binder that they would document this information, but I have seen many nurses in the hospital go ahead and get all the meds, and sign for them, and then go give the patient there meds. Well in your friends case I hope it has just been an error.

[NC29mom, ASN, LPN, RN]

whether or not they were signed out immediately after giving shouldn't have been an issue - unless they were prn medications - they should be documentated immediately after administering.

she should not have been suspended if she could account for the narcotics - (scheduled)

maybe you didn't get the whole story.............(not to judge, but you never know, ya know??)

[leslie :-D]

i'm thinking the count must have been off, and was reported to the don...

hence, the reason why s/he checked it out personally.

as stated, no one knows the whole story but yes, during an investigation, the nurse in question is usually suspended.

afterall, it would be a major offense and definitely reportable to the bon.

leslie

[RNperdiem, RN]

Are narcotic inventories a standard procedure, or is something going on at your workplace that you have not been told about?

How serious is the discrepancy? If the discrepancy is big, then an investigation is warranted.

Sadly, narcotic theft does happen.

I hope your friend comes through okay.

[Penelope_Pitstop, BSN, RN]

I have gotten to know this RN well and know she would not steal narcotics.

I hope you're right, but sadly, a lot of times it's not the nurse you'd suspect.

[PostOpPrincess, BSN, RN]

Unfortunately for her, without documentation....

They asked for a urine sample I am sure.

YOU HAVE TO DOCUMENT..DOCUMENT....DOCUMENT!!!!

[dream'n, BSN, RN]

I worked with a nurse once that I NEVER would have suspected of diverting narcs. Never in a million years, but she was diverting and admitted to it when caught. Could have blown me over with a feather, I went to school and worked closely with this nurse for quite awhile and never suspected anything.

[CNL2B]

Many nurses use/abuse/divert medications from jobs. Often, they are not who you think, and often, they go a long time before they are caught.

I think it's pretty unlikely that most companies would suspend an employee for a first or single offense (we all make mistakes documenting sometimes) and agreed, I think if an issue came up, the nurse in question would at least have been questioned before she was suspended.

My co-worker does random narcotic audits where I work (e.g. checks and makes sure that if only 6 of the 10 mg of morphine was given, the 4 of morphine was wasted per procedure) and things do come up sometimes. We all forget to document additional wastes at times, but if it is a repeating event, most facilities investigate. My co-worker found some discrepancies and reported it to my nurse manager (it was a float nurse.) Her narc administration history was pulled from the pharmacy department and there were repeated, multiple discrepancies from multiple patient care areas. That nurse was called into her managers office and she resigned on the spot. She entered rehab that month and is still doing well from what I hear. She never did get her old job back though (I don't think she wanted it back -- the rumor mill and all.) From what I understand, she was diverting and injecting drugs on a regular basis. She worked a ton of OT which can be a hallmark of a drug user -- gotta be near your supply and all.

I always liked her and thought she was an expert practicing nurse. I, to this day, don't think she ever used on the job, but what do I know? Some people are very functional while they are using. I think it is probably the rare few that nod out at work.

Health care facilities and their HR departments generally have pretty well-laid out policies as far as what to do when this event occurs. It is unlikely your manager would have been able to suspend her without a very, very good reason (unless she was in a probationary period.)

[jerenemarie]

Always document narcs immediately in the log book, never let another shift talk out you of not counting due to "lack of time" & always have another licensed nurse with you when destroying any narcs & document, document, document! And, document HOW you destoyed any narcs!

Jerenemarie

[Neveranurseagain, RN]

You should ALWAYS document that was given as soon as you pull the narcotic. I found this out the hard way. Many years ago, on my FIRST day of being an LVN, I was on the med cart for 50 med surg pts (after a 2 day orientation!). It was crazy-at 7:20am a request for a prn Demerol. I checked the med sheet, pulled the Demerol and recorded it, then administered it. Well, 40 min later, it was discovered that the pt got 2 doses of Demerol. The aide had gone to the floor supervisor first because she couldn't find me, and the floor super thought she would "help" me out as she knew it was my first day and went ahead and gave it--but got side tracked and didn't record it right away. I knew she had asked for the narcotic keys, but didn't realize she was going to medicate a pt. The floor supervisor ended up getting fired (doc made a BIG stink!) It was my first week at that hospital, and I ended up getting the cold shoulder as everyone was ticked at ME for getting the floor super fired...

[wooh, BSN, RN]

I always liked her and thought she was an expert practicing nurse. I, to this day, don't think she ever used on the job, but what do I know? Some people are very functional while they are using. I think it is probably the rare few that nod out at work.

I'd heard rumors about a nurse I used to work with, people would think they smelled booze on her. I ignored it because well, I never noticed anything, and I loved to work with her. She was an amazing nurse. Took great care of her patients, knew so much about the patho of disease processes. Loved when she was charge, she kept everything calm and orderly.

She ended up getting fired, admitted to a mutual friend that she had been drinking before coming in to work. I was shocked. Quite honestly, with ETOH in her system, she was still way more competent than most of the sober nurses there.