Recently, during narc count, I caught 2 mistakes made by the off going nurse. One mistake involved a narc given at the wrong time - the medication was due to be given on my shift, but for whatever reason, it was given on that nurses shift. The second mistake involved giving the wrong dosage of a narc.
The nurse admitted the mistakes to me, and reassured me that they would fill out an incident report and "write it up." However, I'm becoming concerned that they never followed through on that. When I looked back at the narc record, this nurse has since crossed out the time that the narc was actually given and listed the prescribed time - a time during my shift! Which makes no sense...how do you sign off on a drug that you weren't there to give?
For the record, I did not sign off on the drug for a second time since it was a once a day dose. I documented in MAR that it was given earlier in the day by the previous shift.
I really don't want to anger this nurse since their personality makes me a little weary of them anyway - they're quick to anger, impatient and seem pretty insecure at times - but I'm concerned that this was never mentioned to a supervisor. I don't want their mistake to fall back in my lap, for many reasons, but especially since this nurse signed off that the med was given on my shift, when it wasn't.
I also don't want to paint a target on my back at my job, since I'm still new and I can't do my job if I don't have people at work I can ask questions, work with, etc. But at the same time, I have to protect my license and the people I take care of.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Not to be accusing but that is how people steal narcotics. "I'll give that dilaudid for you..."
You didn't use the quote button, so I'm not positive you're responding to me, but I'll assume you are.
In an ICU, we work as a team. When a patient comes back from the OR writhing or screaming with pain, someone else may get the Fentanyl while the admitting nurse is quickly assessing the patient, receiving report, applying the wrist restraints to prevent self-extubation or something equally vital. It happens frequently. The alternative would be checking the Fentanyl out of the Pyxis in anticipation of the admission -- before we even have the patient -- or letting the patient suffer until things calm down and the patient's assigned nurse can get away from the bedside to grab pain medicine. Either is poor practice.
I will be quite honest here. I have made similar mistakes when I was new and more experienced nurses showed me how to balance things out without drawing attention to it. To be clear, there was no risk of patient harm and no diversion, just an honest mistake. Just last week, a new RN made the exact some mistake I had made a year before, but twice during her shift. She was agonizing over her error, as I had the year before. I jumped in and showed her how to clean it up/cover her tracks with no undue attention being drawn to it. Another experienced RN jumped in to double-check our work to make sure we did it right so that nothing would be flagged in an audit or by the pharmacy. It took about 15 minutes for all three of us to straighten it out, working together. Neither that RN nor I will ever make that mistake again.
It sounds like the OP was describing a pattern of sloppiness or worse, but sometimes you just work together to minimize the disruption and move on. We work hard and we learn from our mistakes. We are only human.
What concerns me about this situation is that the nurse promised to follow up on the situation & then never did. Then they changed the time to reflect giving it on my shift. If they had self reported, then I likely wouldn't have reported it. As it is, they left me no choice but to report it - otherwise it looks very suspicious that a nurse made two errors involving narcs & the reporting nurse (who knew about them) said and did nothing. It would have looked like I was covering for them or assisting them to divert narcs.
As far as med errors are concerned, I can't think of any reason why I would ask another nurse to help me cover my tracks, electronically or otherwise. I've made them before & I'm sure I'll continue to make them. Reporting errors has the benefit of finding a problem in the system & fixing it. If you cover up your honest mistakes, then how will they ever get fixed? How can you be assured that another nurse won't make the same mistake as you later on down the road?
I hate your question but because I hate to tell you something is up. In my opinion you should be straight up honest and say "I'm really concerned about you as a person" " if you do have a situation with fam etc whatever it is please take time off and maybe speak to someone" then you say because i care about u and the patients you will hate what i will say now" Next descripency on narcs no matter how dumb it will not be ok" suggest she may just need time off.
Unfortunately, addiction is a situation that can happen to the best, nicesest and greatest nurse. As long as when you report is not coming from a bad place in your heart. Sometimes reporting someone may just be the right thing. Its not your job to fix it, or do more then just alert the right person. A supervisor. They'll take it from there. Never feel guilty!!! You care enough to post so to me you are more concerned or seen other things that make you feel this way. A way the erson acts etc. only u know.
My first thought was the drug was being diverted possibly by an addicted colleague or worse. Report it and make sure the patient is not being left without pain coverage. No excuse to falsify MRI.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
What concerns me about this situation is that the nurse promised to follow up on the situation & then never did. Then they changed the time to reflect giving it on my shift. If they had self reported, then I likely wouldn't have reported it. As it is, they left me no choice but to report it - otherwise it looks very suspicious that a nurse made two errors involving narcs & the reporting nurse (who knew about them) said and did nothing. It would have looked like I was covering for them or assisting them to divert narcs.
As far as med errors are concerned, I can't think of any reason why I would ask another nurse to help me cover my tracks, electronically or otherwise. I've made them before & I'm sure I'll continue to make them. Reporting errors has the benefit of finding a problem in the system & fixing it. If you cover up your honest mistakes, then how will they ever get fixed? How can you be assured that another nurse won't make the same mistake as you later on down the road?
I would have filled out an incident report after the first incident -- and if it had been an honest mistake and the nurse involved had self reported, the incident report could have been appended.
As far as med errors, we commonly make them and just as commonly ask our colleagues to help us reconcile the narcotic count. Or is my workplace the only one where someone mistakenly grabs one Percocet and hits "enter" when the default value is two? The nurse standing in line to use the Pyxis next then witnesses when you open up the Percocet drawer to get the second tab and then corrects the narcotic count to reflect that you only took one in the first place. Or when you've dropped the Percocet on the floor, and then have to go get another to give the patient. Am I the only one who has colleagues to witness the "waste" of the first tab and the removal of the second?
Report it and if she says anything to you, just act nice and say you 'reported it for her because you thought she forgot' all stays nice in the work environment!
Lamharr
12 Posts
You owe it to yourself as a true nurse to follow through and report it.