Did you know that most automatic medication dispensing systems track discrepancies?  All discrepancies should be resolved by the end of the shift.

They also report when controlled substances are taken and can compare the medications vended versus the medications charted.  Then, someone needs to check whether the waste was properly documented.  Was there an order for the medication?  How often did the nurse remove the medication for a particular patient?  Is the effectiveness of the medication documented?  And, was the medication properly wasted or was the controlled substance removed from the machine or were returns properly documented and were overruns properly documented?

So, the answer is … YES … Big Brother is really watching you.

I say that it puts you at odds with patient care and that is because your pain management practices should be aligned with others on your unit.  If you are one who is always staying on top of pain and giving pain medications liberally, make sure that your co-workers are doing the same.  You may not want to give pain medication until a patient asks because you don’t want to be the highest dispenser of controlled substances.  This puts us at odds with patient care.

If they are not, you will stand out as an outlier.

You may also want to talk to your manager about the differences in medication administration as you don’t stand out as an outlier.  Once these reports are printed, they can show that you didn’t have a co-worker document the waste or removing medications without an order or frequently overriding the system, it does cause concern for diversion.

It is better to talk about these things and be on the same page rather than be surprised with an audit that says you are giving much more medication than your co-workers and not properly identifying wastes.

It is much easier to protect your license by having an open and honest conversation up front and getting everyone on the same page.

How would you argue a report saying that you are the highest dispenser of controlled substances?

Also, if your automated medication dispensing machine does not have fingerprint capability, I would strongly suggest that you discuss concerns with management regarding the security of your password.

Lastly, if you do have a substance abuse problem, get help.  Your license is too important just as your health and well-being are too important.  Substance abuse is a slippery slope and the disease becomes progressively worse.  The sooner you get treatment, the better the outcome for your health and well-being.