With the opioid epidemic raging right now, hospitals are even more cautious of anything that could be considered abuse. You need to protect yourself and your license so I have some tips to not only keep from endangering your license, but maybe help you avoid criminal charges as well.
1. Do not take controlled substances. If you are asked for a drug test, many facilities will excuse a positive result if you have a prescription. But the Board is concerned about nurses working with controlled substances in their systems. Even if you took something in your off time. Whatever you do, do not take someone else’s prescription even if you are out or have taken that medication before. This is called diversion.
2. Make sure when you take a medication out of the Pyxis that you administer it right away followed by scanning and documenting that the drug was given. Facilities are very leery about lag time between the withdrawal of the medication and its administration. You should not be carrying narcotics in your pockets for any length of time.
3. Be prompt at wasting medications. Again, do not carry any medications in your pocket for any long period of time while trying to find someone to verify your wasting. Make sure that the witness to the wasting actually sees you waste the medication and then immediately signs that the medication was properly wasted. Facilities also do not want to see lag time between the administration of a medicine and witnessing its wasting.
4. If you have an emergency drug kit, make sure that there are policies and procedures in place to count the medication so that if any medication comes up missing, there will be no question that it can be accounted for during that shift.
5. Don’t be the outlier. This means that if you give more narcotics than anyone else, that raises a red flag. There is software in the Pyxis that shows each time a nurse accessed the Pyxis.
There are a lot of time-consuming policies and procedures in place that seem to make your job harder. The truth is that the policies do make it harder but they also protect you. When you do things properly according to the policies and procedures, you can better protect your license. If you are in a position where the proper policies are not carried out, don’t just settle
I work in Assisted Living when I first came on board 1 year and 9 months ago. The nurses(LVNs) would count their Narc box by themselves then the on coming nurse would sign like they witness the count. I immediate let each nurse I relieve I would not accept the med cart unless we counted together and if they had a problem then we could call our supervisor who was also a LVN. Long story short we function as the appropriately skilled professionals that we are. There is not enough money in the world to put aside my license for a short cut.
LORIE A BROWN, R.N., M.N., J.D. says
I am glad you did not tolerate this practice and spoke up.
Jeff Obrien says
1. Do not give narcs for another nurse
2. Do not give narcs another nurse signed out or wasted a partial dose of.
3. Waste on camera if possible
4. ALWAYS document a pain score at narc administration and 1hr later.
5. Always make sure you are signed out before you walk away from the omnicell
Nancy Ramirez says
I work in a hospital and we just volunteer a finger but we are shunned away andexpected to sign. I work in a unit culture where there are no repercussions and cliques stick to one another but there any many things that do not seem right. I’m new to the unit and I’m over the culture, it’s non functioning but there is no change
The software also keeps track of if you click on a patients name that is not yours and what drawers were opened.
the order was placed by nurse or Dr but was not verified by the pharmacist. So the nurse went into see who else had it ordered and took from them , but hit ‘cancel’ , so no charge was made. but forgot to go back and charge the right patient .
so 1)hippa) 2) the next dose could be given right away by oncoming shift, because it shows not given, in pyxis. While this could be handled w/in the hospital if they are looking for an out for you, they will turn this over to the BON, in this case the nurse is on probation so basically out of work . And will not get off probation because the stipulation is work 36 hours, catch 22. OF course this is AZ. Their most egregious cases are ones that have nothing to do with nursing (or breaking the law or drugs) . License protection !
LORIE A BROWN, R.N., M.N., J.D. says
Nancy thanks for sharing. You can always get another job but you cant get another license. There are better cultures out there.