When wasting narcotics...

Published

Do you always watch to make sure they're actually, uhm, wasted?

I find people never do.

I also witness.

Although, how do I really know what they are squirting into the sink is really the narcotic?

I don't. That is where the trust comes in.

that's a great point.

actually, what is the sense of witnessing if the nurse could be wasting ns?:chuckle

wow.

leslie

Up Vote Up Vote ×
Specializes in Med/Surg. for now.

i always watch, and i always make the other nurse watch me. i never want there to ever be a doubt if something comes up. by making sure that i follow the rules on this then this gives no one reason to doubt me, and i also don't have to doubt them. long story short...i worked in a unit several years ago that an md was diverting. he was the "sweet, wonderful" doc that everyone loved, so the entire unit was lax. i think that he "fooled" every nurse on the floor at one time or another. i had to write myself up :banghead:because i gave a drug that had left my sight for a split second...he switched the syringe and gave me normal saline:no:...that was probably one of the best lessons that i ever learned.

Up Vote Up Vote ×
Specializes in OB.

We just recently had a meeting with pharmacy about this - they reviewed the policy and we were told that we MUST have the witness watch us, which makes sense anyway. The wasted narc has to be wasted (squirted out) in the sink or trash, not put in the sharps container. I guess they have had some associates actually get in the sharps container to get the narcs out - Ouch!

Up Vote Up Vote ×
i am by the book when it comes to witnessing and wasting.

even if a nurse waves me off, letting me waste by myself, i insist on being witnessed.

always, ALWAYS.

leslie

Same here.

I'm also a bit paranoid because several years ago when I was off work for an injury my manager accused me of overusing Vicodin (it was prescribed, I was acutely injured, and she was dead wrong). She didn't accuse me of diverting, but when I returned I didn't want to give her any reason to accuse me of such.

Up Vote Up Vote ×

Unless you see the seal broken, and the med go down the drain, it's not a witnessed wasted. It is a witnessed disposal of some random amount of some fluid.

While I whould, in the 6 differen work environments I have been in, nobody has used proprer waste techniques.

hherrn

Up Vote Up Vote ×
Specializes in ICU, telemetry, LTAC.

My first job with the fancy pharmacy, required that whole doses be returned to them for waste; two, three or ever how many nurses just wasn't enough. So many times I made the trek down 4 floors to hand over a syringe of "random fluid" with the claim of what it was. I don't know if they ever tested what I brought them, but I do know they did not dispose of it in my presence so we had to think we'd be busted if ever someone bebopped down there with a syringe of NS.

Edit: I didn't work IN the fancy pharmacy. They just happened to have one there. Fancy = staffed round the clock.

Once I had to return a white, wet lump in a cup. Lortab, that got dropped in the sink when I walked in the room d/t patient coded. They were lucky I found it at all.

Where I am now, we can put a full dose of something (seal broken, whatever form you have it in) right in a mailbox looking container in the omnicell with a nurse to witness. I will not go into the specific details of how our diverter managed to get her drugs, but she was pretty smart. As good of a nurse as she was, if she'd just stuck to lower amounts of diverting, she'd probably still be there.

Up Vote Up Vote ×
Specializes in Med Surg, ER, OR.

I always watch a waste! and make sure someone watches me waste...

Up Vote Up Vote ×
Specializes in Cardiac/Tele/CVICU.

What's a diverting RN?

Up Vote Up Vote ×
Specializes in ER, PACU, Med-Surg, Hospice, LTC.
My first job with the fancy pharmacy, required that whole doses be returned to them for waste; two, three or ever how many nurses just wasn't enough. So many times I made the trek down 4 floors to hand over a syringe of "random fluid" with the claim of what it was. I don't know if they ever tested what I brought them, but I do know they did not dispose of it in my presence so we had to think we'd be busted if ever someone bebopped down there with a syringe of NS.

LOL! Who watched the Pharmacist waste the "random fluid"? Hmmmm.....Kind of sad to think that the Hospital trusts the Pharmacist more than the Nurses. It's ok that they waste, but not you. Plus, they make you run all over the hospital to hand deliver the medication? Geez....jerks.

Up Vote Up Vote ×
Specializes in ER, PACU, Med-Surg, Hospice, LTC.
What's a diverting RN?

A Nurse that is stealing medication. Diverting (in Nursing) is a term usually used when referring to Scheduled drugs though.

It does not mean that a Nurse is not giving their patient their Scheduled meds. That seems to be what a lot of people think. Sure, that can happen, but a smart Diverting Nurse will make sure that their patients do not draw attention to their Nursing care.

One of the most cunning diverters I have ever worked with always had well medicated patients. Meaning, he made sure his pts were given the medication prescribed/ordered. He also rarely, if ever, gave PRN meds (drew too much attention).

He was skimming off the top and stock-piling.

Up Vote Up Vote ×
Specializes in Med/Surg, Telemetry, Ortho.

The first couple of times with each nurse I watch very close. Nurses I trust I don't really watch after that. I did work with an impaired nurse and I watched her like a hawk. She was caught and fired but not on a day I was working.

Up Vote Up Vote ×
+ Join the Discussion