Who's got their hand in the Demerol cookie JAR?

[CaLLaCoDe, BSN, RN]

at work 3 weeks ago some (6 syringes!) of demerol were missing from the controlled med cabinets and last week our night shift crew (including myself) had to be tested because a demerol pca was missing when the count was done at 0300 since someone was leaving at that hour. everyone passed the drug test!

now we're having to be crash private eye detectives, everyone is held as suspect. something i really don't want to spend my time worrying about when i became a nurse, i've got peoples lives on the line.

so, if you have experienced narcotic drug theft at your work. what happened and how did you deal with it?

[EmmaG, RN]

It was Ativan, and it turned out to be the pharmacy tech delivering the drugs.

[gonzo1, ASN, RN]

Sorry you are going through this. If you see anything out of line you could bring it up with your charge. But you are not a law enforcement person, your first job at work is caring for your patients, not looking for a drug user. Just keep taking care of your patients and the problem will sort itself out. It might have been an outside person and this will never happen again.

Congrats on passing the pee test

[BabyRN2Be]

This happened recently at the clinic my brother goes to for ADD. Of course, the doctors scripts are signed before hand. They just sit in the desk until the doc is ready to write a prescription. I believe there were two problems: the office staff was coming in and taking prescriptions and writing controlled substances (meds like Ritalin) for themselves. The main person who was suspected of doing this was led out of the doctor's office in handcuffs.

The other problem occurred when patients who did not use their prescriptions would turn the unused script back into the office. I have ADD but I don't use Ritalin anymore. My PA would write out prescriptions for three months at a time, and if for some reason I wouldn't use a script (there were times I'd be sick or something and I wouldn't need to take a full dose), I'd bring the script back into my PA so it wouldn't fall into the wrong hands. Some patients presented the script to the upfront office people and the script wouldn't find it's way back to the chart. FTR: I also gave my unused scripts directly to the PA. Now, I'm glad that I did because I'd be pretty upset if I learned that someone was using my unused scripts to obtain medication illegally. :angryfire

Hope your situation is solved soon. I didn't think that there were that many hospitals using Demerol anymore.

[Balder_LPN, LPN]

My PA would write out prescriptions for three months at a time, and if for some reason I wouldn't use a script (there were times I'd be sick or something and I wouldn't need to take a full dose), I'd bring the script back into my PA so it wouldn't fall into the wrong hands. Some patients presented the script to the upfront office people and the script wouldn't find it's way back to the chart. FTR: I also gave my unused scripts directly to the PA. Now, I'm glad that I did because I'd be pretty upset if I learned that someone was using my unused scripts to obtain medication illegally. :angryfire

??? Am I worng that scrips for amphetamines can only be given 30 days at a time and the doctor must actually see the pt to write more scrips? 3 30 scrips at a time seems to be illegal to me, is there something I dont understand here?

[BabyRN2Be]

From what I understand, it depends on office policy. Some offices will write for 3 months, some won't. At the end of 3 months, I'd go in and see her for med checks.

Sometimes it will vary state by state, and as I said, offices within the states.

[TazziRN, RN]

We've actually had it be a misload from the pharmacist, but that excuse only works if the amount that the count is off by is a container of meds, which is usually 10.

[HopeItWorksDNP]

It started out with missing hydrocodone from our med cart. Then a vial of Ativan, here and there. Then the drug carts on the m/s floor would be missing a Demerol injectable here, a morphine there. This started out happening very occasionally, but increased rapidly until there was no denying there was a serious issue somewhere. The problem was identifying who the culprit was? Meds were missing from every cart in the hospital at different times: ER, CCU, M/S, etc. Never the same cart twice in a row. Then one night 3 vials of Dilaudid went missing and this one nurse was so stoned she was drooling thru report. It was our night shift house supervisor. A great nurse with 25+ years with our company.

Management was able to match up the missing drugs with her schedule. She was the only person in the hospital every night a med was missing. And the only one with access to every cart. She was given a choice betwn termination and rehab. She chose termination. I still hate myself for not noticing she was in trouble. She was a dear friend and I let her down. But I learned a valuable lesson. Anyone is vulnerable when the access is there and personal stress is high. If you suspect a friend has a problem, get them help before it is too late.

[jojotoo, RN]

My PA would write out prescriptions for three months at a time, and if for some reason I wouldn't use a script (there were times I'd be sick or something and I wouldn't need to take a full dose), I'd bring the script back into my PA so it wouldn't fall into the wrong hands. Some patients presented the script to the upfront office people and the script wouldn't find it's way back to the chart. FTR: I also gave my unused scripts directly to the PA. Now, I'm glad that I did because I'd be pretty upset if I learned that someone was using my unused scripts to obtain medication illegally. :angryfire

Why didn't you just tear the script up?

[icie rn, ADN, RN]

I agree with the poster who stated the first job of the nurse is take care of the patient. We have had this happen on several occasions, I personally attempt to keep a running check on narcs during my shift, usually have another nurse close at hand to verify what I get and that I have signed out for it and the count is correct. One red flag I see is when a patient has been taking po pain meds and then goes back to injection one night. Unless there is some change in the patients activity, or a doctor has done a new procedure to patient, then this needs explained. If nurses notes bear out a change then OK, but if not, it is a red flag. Our problems was a nurse, a pharmacist, and then a doctor. You can never tell who has their hands in the cookie jar.

[jetscreamer101]

For many years, the facility I was in only kept schedule II narcs under double lock. Being as I always worked the same unit, I started to notice vicodin being used frequently on someone who had only ever asked me for tylenol. I asked her about her pain, PRN use. She said she only took tylenol. I reported it, and eventually through cart checks, schedule monitoring, and the local police, we found the culprit- staff nurse.

(Diverters sometimes take for someone elses use.)

[CaLLaCoDe, BSN, RN]

i have learned a lot from posting this thread. i have gained insight regarding culprits that may not be nurses (ie pharmacy techs) --- and why weren't they tested along side all of us nurses who tested negative?!!

i remember when i was just an aide and the icu nurse b stated one morning while we were walking up to the step down unit that he could only tolerate coffee as his illicit drug while at work, if he thought otherwise, he had the insight to know that his career would be finished!

one time i suspected someone diverting medication from the medicine count when her six patients in a row were requesting vicodin, how very odd is that! i thought to myself and in addition it was her last night working at our hospital!