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You are here: Home / Archives for pyxis

Top 10 Blogs Of 2019

January 2, 2020 by LORIE A BROWN, R.N., M.N., J.D. Leave a Comment

This is one of my favorite things with each New Year.  I look at my top 10 blogs to see which ones you really enjoyed.  In 2018, the favorite ones were based on license protection so in 2019, I chose to do more articles on that same subject.

Just like with the New Year’s Eve countdown, let’s go down the list starting with number 10 and head to number 1.  By the way, you can read the original blog by clicking on the bolded number for each one.

NUMBER 10:  PYXIS AND YOUR NURSING LICENSE – Probably among the most important of my videos because day after day I see where nurses are not properly following policy with medication management which is of concern to administration due to our opiate crisis.

NUMBER 9:  THE PERILS OF TRAVEL NURSING – This blog discussed the top 8 ways travel nurses can get into trouble and advises how they can protect themselves.

NUMBER 8:  WILL NURSES BECOME OBSOLETE – Is new and advancing technology creating a more automated world that is taking the place of nurses?

NUMBER 7:  MED ERRORS AND CRIMINAL CHARGES – Tennessee nurse RaDonda Vaught accidentally gave a patient vecuronium instead of Versed resulting in the patient’s death.  Vecuronium is used to intubate patients by repressing respiration.  While in a PET scan, the patient arrested and died. The issue was not identified until an audit by the Center for Medicaid and Medicare Services (CMS) was done over a year after the incident.  After the investigation, nurse Vaught was charged criminally in this matter.  While she did commit malpractice, it is my opinion that it should not have risen to the level of a crime albeit for making a horrible mistake.

NUMBER 6:  REFUSAL TO DRAW BLOOD – Jonathan Moore was involved in an auto crash killing a former city council woman and her daughter.  When Moore was hospitalized, police wanted the nurse to draw blood without an order and without patient consent.  The nurse told the officer that a warrant would be needed to make the draw.  Crystal clear policies should be in place so nurses know when they can do certain activities.

NUMBER 5:  FATAL MEDICATION ERROR UPDATE – This was another article dealing with of nurse RaDonda Vaught who accidentally administered vecuronium to a patient [See NUMBER 7].  Criminal charges were filed against nurse Vaught and the Tennessee Board had initially excused her actions but then decided to take action against her license.

NUMBER 4:  NURSES IN TROUBLE WHEN PHYSICIAN OVERPRESCRIBES – A physician was actually practicing “end of life” measures by prescribing 20 times the normal dosages of fentanyl.  Nurses who carried out those orders were all fired and reported to the Board.  There was one wrongful death lawsuit that settled for $4,500,000.

NUMBER 3:  NURSES WITH ADDERALL – This item discusses a Louisiana Board’s concerns about nurses who take the controlled substance Adderall.  In fact, it shows a statement by the Board about how Adderall is the most widely abused prescription drug in America and how Boards can take action if a nurse takes any controlled substance.

NUMBER 2:  UNUSUAL NURSING BOARD CASE – A nurse received an unfavorable decision by the Delaware Division of Professional Regulations to the Supreme Court which overturned the Delaware agency’s ruling.  Two nurses were on duty and required to count medications just as if they were controlled substances.  During the count, the supply of hepatitis C medication, costing $1,000.00 per pill, was accidentally spilled to the floor.  The nurse put the 12 pills in the sharps container, but the pharmacy ordered them to be retrieved for later distribution to this patient/prisoner.  The nurse’s license was placed on probation for 90 days and required her to take continuing education.  But she disagreed with the decision and took the matter to the Delaware Supreme Court … and WON!  It is unusual for nurses to appeal a case, let alone be successful.

NUMBER 1:  PATIENT KILLS NURSE – A nurse accosted by a patient who, before others could restrain him, violently slammed the nurse’s head onto a desk.  Lynne Truxillo subsequently succumbed to blood clots in her leg leading to a pulmonary emboli.  Though the patient was charged with manslaughter, the obvious truth was that the charge could never bring back nurse Truxillo.

MY PERSONAL FAVORITE:  My personal favorite blog was an interview with nurse Yolene Lofton who lost her license simply for recording the wrong date on some documents.  It was sad that she lost her license over that error.  But it does show just how important your license is and how even a minor error could result in loss of your license and livelihood.

My hope is that you can learn from these blogs and do everything you can to protect your most valuable asset: your license.

What was your favorite blog in 2019?  Was it any of the above or perhaps a different one?  Let me know in the comments below.

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Filed Under: License Protection, Newsletter Tagged With: 2019, adderall, blogs, board of nursing, criminal charges, lawsuit, license defense, license protection, medication errors, nurses, nursing, nursing board, nursing license, overprescribes, Patient kills nurse, pyxis, revocation, Top 10, travel nursing, violence, wrongful death, Yolene Lofton

Nurses, Cameras and Privacy

April 4, 2019 by LORIE A BROWN, R.N., M.N., J.D. 5 Comments

These days cameras are everywhere.  In fact, in the United Kingdom, any person can be seen on camera at least 300 times every day as the devices are everywhere.  Every time you’re on the street, every time you enter a store, restaurant or bank, drive into a public garage … anywhere and everywhere the chances are likely that a camera is looking at you.  And now they are making their way into hospitals around the world.

A recent case in San Diego against Sharp Hospital, Administration put 3 motion detector cameras on their anesthesia medication cart because someone was stealing propofol.  However, the cameras did not shut off when there was no motion and it happened to be in an OB surgical suite where women were having babies by C-section and GYN type surgeries where the patients’ genitalia were exposed.  These patients, some of whom where unconscious, were being videotaped without their knowledge or consent.  The hospital no longer has 3 of the servers with the videos and is unsure if the hard drives were properly erased.  This is scary and a true invasion of privacy as well as a violation of HIPAA. 

There are also ICUs where patients consent to be monitored on video tape called E ICU.  Video cameras are sometimes located in public areas of hospitals and health care facilities.

I think cameras can help … and they can hurt.

The idea of having cameras at the Pyxis is to see who takes medication and whether medication is properly wasted.  This can be helpful to show your properly wasted medication with a witness or it can hurt if you forgot to sign out that you administered the medication.  If your facility does have a camera at the Pyxis, I would recommend that you administer the ordered medication to the patient right away, document that on the MAR and then immediately waste the medication in front of the camera with a witness so there can be no question about you properly deposing of the medication.

Cameras also can be a disservice because they capture images at only one angle and you cannot get the true 3-D picture.  If you go to break up an altercation with patients in a hall, what the video shows will depend at which the camera views the scene.  Or, if you are providing care to a patient on video, it may be misconstrued that you are being rough with a patient.  Things aren’t always as they seem at one angle.  Sometimes you need multiple angles.

I do have concerns about patients’ privacy on video.  I think sometimes facilities will give you a paper and ask you to sign it and most will do as they are told but not bother to read it.

In some respects, cameras can be a blessing and help a person if the footage is kept and sometimes it can be a curse.

What are your thoughts on being videotaped doing your job?

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Filed Under: Employment, License Protection, Newsletter, Workplace Issues Tagged With: cameras, HIPAA, motion detector, nurse, nurses, patient privacy, Privacy, pyxis, Sharp Hospital, videotaping c-sections, wasting medication

The Pyxis and Your Nursing License

March 14, 2019 by LORIE A BROWN, R.N., M.N., J.D. 2 Comments

Lorie Brown, Nurse Attorney, discusses problems that are the result of a Pyxis audit and how to protect your Nursing License. This includes how it may look like a nurse is diverting medications and making sure you are administering and wasting medication properly so you protect your license.

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Filed Under: Employment, License Protection, Newsletter, Workplace Issues Tagged With: administrering medication, diverting medication, license protection, nurse, nurses, nursing, nursing license, outlier, protect license, pyxis, witnessing waste

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