Went Home Dilaudid in Pocket

beekee · May 9, 2018

Some BONs require notification if you have been fired. You might want to research if your BON is one of them.

Career Columnist / Author · May 9, 2018

Some BONs require notification if you have been fired. You might want to research if your BON is one of them.

That's interesting, I just visited the Texas BON website and they say terminations for nursing performance issues should be reported, but not employment issues (such as attendance).

I'm wondering how this is enforced as I don't believe the BON has jurisdiction over private employers..?

Also often an employer just wants rid of an employee and is not interested in additional paper work or reporting.

caliotter3 · May 9, 2018

A shame this happened to you. To me, the fact that they refused to test you or the contents of the vial, shows that there was no question about the extent of your involvement and I don't see how they chose to terminate you. Harsh consequences for a human error. Good luck getting your next job.

allnurses Guide · May 9, 2018

When I was a brand new grad I wound up at home with an unopened vial of Dilaudid. I brought it back to the hospital immediately and did a witnessed return. Nothing more was made of it. Didn't occur to me to ask to be tested or to have the fluid tested, but then the vial was still sealed per manufacturer. I wasn't coached, written up, nothing.

I suspect there is more to this story.

Ambersmom, BSN, RN · May 10, 2018

A new night nurse where I work forgot he had a partially used dilaudid in his pocket, he came back the next morning and wasted it with somebody. Nothing happened to him. I suspect that the OP's problem arose when an administrator was brought in. Sorry this happened.

Persephone Paige, ADN · May 11, 2018

People are afraid with the Opiate Crisis. I think it's reasonable to hope that an employer will see it for what it hopefully is: a mistake. But, given the climate and media attention on opiates, it's not out of the realm of possibility that someone may flip out.

This is what I have learned in almost 5 years of being clean and sober ( opiates were my doc, btw ). What I think is no big deal, scares the absolute **** out of most people. We must respect that the majority of people are now ( maybe always, but especially now ) terrified of being associated with anything that can remotely be seen as suspicious, not taking a situation seriously enough, etc... They have to eat. They don't want to let compassion or sentiment interfere with that. Lesson learned...

It's a whole new world out there with regard to opiates. Tape the vial to your nose if you think you might forget.

HalfBoiled, BSN, RN · May 11, 2018

Real world advice: If you weren't alerted/contact for a discrepancy after 48 hours, throw the vial away, and keep your mouth shut.

I have seen similar incidences with my coworkers (whom I trusted and not IVDU) and just discretely throw the leftover vial in the pharm waste bin

Neats, BSN · May 11, 2018

As an LNHA Administrator I have in the past been brought in to many situations. This unfortunately somewhat of a common occurrence, with pxysis now in most SNF facilities and Pharmacists oversight this issue is becoming less common.

I would not terminate an employee who did this the first time, they would have to teach a inservice to all licensed staff though and help me with the F tag we would more than likely get (this is my corrective behavior plan when staff need to be reigned in so to speak), since you say you were terminated I have to pause and think maybe there is 2 sides to every story and we only heard a small part of yours.

I would thank my lucky starts this was not reported and they let you go not sure what is meant by "severe performance issues" but you should be thankful you are not reported to the BON.

Learn from this and always when you are counting narcotics make sure the count is correct and NEVER pre-sign that you gave a medication when you clearly did not, it is bad practice just to save a few mins of time...it is not worth it.

Wisco50 · May 12, 2018

An unsealed vial or premeasured syringe is vastly different from a sealed one. I got the impression the poster had a partially used amount of it in her (accidental) possession. Why else would she have immediately asked for herself and the med contents to be tested?

Mavrick, BSN, RN · May 13, 2018

Dear Nurse Beth,

I accidentally left work with a 0.5 ml vial of Dilaudid. Found it in my scrub pocket on my way home. Immediately notified charge nurse who in turn notified an administrator. Received text from administrator stating to return vial immediately to the workplace. Did as directed. Dilaudid was signed in as returned but not wasted until the administrator was to find out what to do.

Asked to have drug test upon me immediately. Request denied. Asked to have fluid in vial tested. Request denied. Two weeks later I was terminated for severe performance deficiency. Is this an incident that requires notification to the state board of nursing?
Dear Terminated,
I am really sorry you lost your job. It goes without saying you did not follow procedure. The 0.5 mL of Dilaudid should have been wasted and not saved in your pocket for future use.
and yours is a perfect example of why. As nurses, we are constantly distracted.
Did anything else contribute to the termination besides this one incident? In and of itself, it is serious, but doesn't rise to the level of being fired.
I take it you do not have a union. Is this a fireable offense for all nurses in your organization, or were they targeting you? It's notable that you asked for a drug test. That would not be the first response of many nurses in your situation, but perhaps you anticipated your job was in jeopardy.
The organization can choose to report this incident to the BON, but it's unlikely unless they had some evidence of diversion.
Best wishes,
Nurse Beth

At my work we can't return opened vials, we waste them. We can credit it back to the patient so they aren't charged for the unused medication but we can only return meds that can be used for another patient.

There is so much more to this story that OP is not telling. I don't believe a nurse was fired for bringing an unopened vial of Dilaudid back into work.

Wisco50 · May 14, 2018

I understand where you are coming from. I was a staff RN for most of my hospital career but did have 4 years in position of unit director. Most drug users are either caught or highly suspected of use. I had two of the latter situations occur. Frustrated c one as she actually had a "viable" reason to start using, said for pure lack of another way to explain it, NOT as an excuse to divert and use. Had joint surgery, ended up c post op case of RSD (as it was then called). Pre-PYXIS, could see she was removing more drug than needed for patient/s. She refused to admit she had a problem and insisted she had actually given patients more than was ordered because "they needed it". Well, of course, THAT was against nursing practice, so she was then terminated. She could have admitted, taken leave, gone to Rehab and her job back eventually. (This was a long time ago. I feel things have become very punitive minded.) The other nurse was someone I had several concerns about but never anything I could put my finger on. Long story, just trust my gut on this one....anyway she eventually had performance issues (late, call-ins) and I was able to terminate her because of those issues.

Long as I am opining here, let me also say sometimes staff gets upset when you terminate someone (my first example) but because of confidentiality, I could not explain my reasoning for my action. Sometimes staff gets upset that someone is NOT being "dealt with" (my second example) but don't realize I am 1) aware of situations i.e. lates, absences, etc. yet just am waiting 2) to follow protocols etc. in order to terminate someone rightfully - if done incorrectly the person can file a grievance and possibly win if they can show that procedures were not exactly followed.