sprchpmnk LPN

[sprchpmnk]

I have a problem. My first job was at a local hospital and I was taught that when you pull your meds you pull all of you scheduled narcs as well. I worked there for 1.5 years and everyone did this. I didn't think a thing about it. A girl got mad at me because I was well liked. She went to her friend who was the floor director and got me into trouble. I was reported to the state board. I took a volentary drug test. My drug screen was negative. I had two meds in my locked cart that I need to find someone to waste with but no one could at that time. I even hired an attorney who took $3000.00 of my money just to tell me that the board did not have to answer to the law and I would have to take what they gave me. I did and I had to pay $1500.00 to a rehab center prove to them I was not an addict. Then pay $275.00 for renewal of my license and $250.00 for a fine to them. I am now on probation for 12mths. The board would not even listen to the people who said they would testify that the hospital does pull their meds in that manner. Anyway I have not worked since my last job fired me when they found out I was going to be put on probation. Does anyone have any suggestions as to how I can get a job with me being on probation? So far I have been looked at like I was scum or a trouble maker and incompitent. I promise I am not any of those bad things. But I am quilty of trusting too much. I have to get a job in order to fulfill my probation. I don't know how they expect me to do that since most places won't hire someone on probation. I am scared, embarrassed and I don't know where to turn.

help

sprchpmnk:o

[TheCommuter, BSN, RN]

It is difficult to answer your question because there are simply too many holes in your story. Were you placed on probation as the result of a urine screen that tested positive for illicit substances or metabolites of pain pills?

[sprchpmnk]

Sorry, no my drug screen was negative. what are the other holes I will try to fill them in.

thanks

sprchpmnk LPN

[TheCommuter, BSN, RN]

My only advice is to be totally honest and upfront about the probation at interviews. It should be the first thing you discuss. It will look really bad if the interviewer ends up asking about the probation first.

[Antikigirl, ASN, RN]

Okay..at my facility it is in our house protocols that the narcotic scheduled meds can be passed with other routine meds.

What I do is put them in a separate cup from the other routines...I learned this in case I spilled a cup and wasn't sure if the narc was in there afterwards...so I found two cups were a great idea, and if someone questioned me about it...I could show them right away and not have to rifle through a cup load of pills. Also, people tend to remember having two cups instead of one and can be a witness :).

I had no idea this would be considered wrong? Maybe it is per facility.

I know I am not alone in being terrified of what you are going through! At our facility, if they suspect you...they have a drug screen done, their cost unless you pop positive then it is on your dime. If you are found negative, then no further charges are brought, and hopefully the facility just doesn't find another reason to fire you.

I just never knew you could pop neg and still be in trouble! That is SCARY!

I am glad I have a pixis that helps to keep track (and helps cover nurses by only allowing certain amounts to be taken out over a said period of time), and if there is a miscount...nurses aren't blamed alone, pharamacy is also investigated to make sure there was no error on count on their part either (since they fill the pixis several times a day). Also, if there is even a sign of trouble, a nurse can volunteer that moment for a drug screen and subsequent ones as well to prove their innocence (one is covered, others are on the nurses dime).

I will be watching your story hon, keep us posted. I really want to know more about this so I can keep myself and others safe from wrongful accusations. Learning about what your lawyer said about the BON...I think inside I assumed that...but seeing it said again in type...I got the shivers! Guilty until proven innocent in healthcare huh (and some other professional fields too).

[ktwlpn, LPN]

I have a problem. My first job was at a local hospital and I was taught that when you pull your meds you pull all of you scheduled narcs as well. I worked there for 1.5 years and everyone did this.:

I have a question-do you mean that you would pull meds for several patients at a time including their narcs? What exactly are the terms of your probation? Are you on probation for pre-pouring meds? I know many nurses do this-some see it as a way to cut corners but I've also seen pretty serious med errors made.I don't do it because I really can't keep track of too many cups of meds floating around and I have nightmares of someone opening up the med cart in the morning and finding that I poured but passed none of them...I've worked acute care and know how crazed it can be-but it only takes seconds to witness a waste.....I think I'm missing something......

[CaseManager1947]

I do know that this pra ctice is frowned upon by JCAHO and state reviewers as well. A nurse got dinged and the facility received a type 1 error whe narcs were found pulled in advance. That may be why the fallout has been so stiff

[Antikigirl, ASN, RN]

Oh wow whew...I only pull out medications for ONE patient at a time!!! With how many meds my pts typically have, and the fact I do assessements and some general ADL's while passing meds...one at a time works!

I never prepour, that is asking for trouble or error! OR presign because knowing me I will get busy, forget..and just see my initials and forget I didn't do it!

I follow my med admin rules, and since I taught them they are as natural to me as anything...however, when I pass meds, I do it as uninterupted as possible...and for one pt only for the meds at that time only...do basically a triple check...then administer (checking pt name and such and assessment before giving for things like swallow, congition changes, if they know their meds and educate PRN, and personal preferences on taking pills like do you like to take all at once, or one at a time...).

With all that work, how could you safely give meds to more than one person at a time? I know I wouldn't or can't!

If it was a case of pre pouring...oops, that is a no no.

[sprchpmnk]

nope your not missing anything. Yes it was to cut corners but the narcs were pulled but not taken out of the bubble pack and were put in the drawer for that pt. keeping them in the drawer specifically for htat pt. it cuts way down on errors. Besides I had just got my license and didn't know any better because they all do it. The only thing the board got me on was misshandling meds. Yes it only takes a minute to waste meds but getting that other person to just take that minute to do it. Where I worked it was a dog eat dog world and I was wearing milkbone underwear and I was on my 50th pair. My attorney said they just wanted to make an example out of me. And because I wouldn't say I did something wrong and new it was wrong to do it. I just did what I was taught.

thanks

sprchpmnk

[sprchpmnk]

I didn't have any idea it was wrong until it happened to me either. The pixis system is a lot better. I guess I just made the wrong one mad. Another thing I found out or at least one of the counselors at the drug eval clinic I had to go to. She said that even if I had a script for myself if it was more than six mths old I had no right to take it. I haven't verified this with the board yet. I am just a country girl if I don't take all my meds I keep them until I need them later. Too poor to waste anything. The funny thing with it was my drug screen was neg and no meds missing. All was accounted for. I guess just my luck I just don't know what I am going to do about getting a job to fulfill my probation. No one wants to hire someone on probation. thanks for your support. I'll keep you posted

Sprchpmnk

[Antikigirl, ASN, RN]

That is horrid and I feel very sad for you! I taught med pass to CNA's at an ALF, and I taught the importance of doing it properly by what the BON says. I would even sneek up and find things wrong and scare the heck out of them by telling them..."we need to talk". I didn't ball them out or anything..but took the opportunity to teach and not scare tactic bullying. I would let them know..what if I was the BON? That was enough to question things if they didn't understand what they were doing wrong..and I would go over it with them and tell them stories I have heard about what happens when it isn't done correctly.

BUT I never made an example of anyone because they never made any serious errors, or cause harm to patients (there were huge investigations into this that I had to do, so I knew if there was a probelm sustained). I would also hold meetings where people could discuss med pass, questions, things that had happened that can teach us all something...etc. In fact, these were so benificial that people actually SHOWED UP for them! Well...I had a tendency to make it fun and informative...

I am so sorry you didn't know, and got it! I would certainly be pointing a finger at who taught you this and say that this is how you learned it, and that you are now aware that this isn't the correct method and will not be made again! If I taught someone incorrectly...I would want to know, and I feel personally responsible for these things.

[Antikigirl, ASN, RN]

WHAT??? Not take a script you had for 6 months? WRONG in my book. Heck, the facility I worked for was dinged by the BON for D/C'ing narcotics that were over 6 months old without being taken because the pt paid for them, were prescribed to them, and could easily get an order from their MD to use them again at any time (and if we disposed of them...a new cost!)! Why would that be different for anyone else???? That just doesn't fly with me!

That is why I always make sure that I have a PRN on my narcotics (and routine if necessary) for pts. That way I have parameters for the med, even 6 months to expiration date, for them to use since they did pay for them and are their property!

That just sounds like bull pucky!