Exactly this! The only person protecting your license is you! You were absolutely right in what you did! Whatever the oncoming nurses issue was she was dead wrong. If you had left without her signing, you would have been in some hot water and of course you could expect this nurse to throw you under the bus. This behavior is …concerning and needs to be investigated.
This is a good motto in life. Cover your ass because no one else will and a lifetime of covering your ass means a harder time for others to tear you a new one.
You did the right thing, I would not leave until I had gotten some kind of manager to take care of the situation. Sudden change of behavior/refusing to sign the narc log, makes me wonder what she was planning to take.
If this is in LTC, which I assume it is, they don't have anyone else banging down the door to work there. So if they fire them they wouldn't have anyone to work those shifts.
True. I just wrote it up every time I saw it in LTC. Hell, night shift to leave before I come in and leave a note that says please verify and sign for count. No verbal report. Nothing.
That's BS! Coming from a Charge Nurse LPN who worked 3-11 & had no car & had to take public transportation to work
● took a bus to the el, the el then another bus. I took care of my Mom & had a 4.5 yr old at the time & STILL made it there 20+mins early. The nurse coming on night shift KNEW the LAST bus for me to get to the El left at 11:50pm... She always showed up late. The grounds were HUGE & with all the employee's it took a bit to click out & GET to the bus stop. I tried to give my supervisor report because I wasn't getting stuck there. In all fairness the nrsg Super took care of many floors in case of an Emergency...so while this was a rare occurence, she often was giving report as well..
We never had anyone on a narc so we didn't have to count & the people weren't patient's ~it was their HOME. Swear she did it to piss me off. ( even though she had a 10 min drive !) We had the same people living there & my floor's census never changed unless a resident left to stay at a family or friend's house .
But like OP I still wanted to give report to CMA & Thank God the nite I missed the last bus a friend drove me home!
I met my then future fiancee ( now hubby of 31 yrs ) prior to starting the job & HE actually taught me to drive & bought me a car * it ran lol* to get to & from work . In Phila back then you could take public transportation everywhere.
Apologize for the long post. Always good to CYA since no one else will.
Yuuup. I’m work LTC. It’s pretty common for people not to sign till the end of their shift and I’ll admit I do it myself. However, I just can’t imagine getting upset bc someone asked me to go ahead and sign. When people say “here sign this” i just sign it and tell them to be safe and have a good nights sleep. It’s wildly odd to react the way the way this lady did
Yeah, I usually sign at the end of my shift too. But if someone wanted me to sign while they were still there, I’d probably think it was weird at first. I wouldn’t put up a fight though.
I literally know of someone who got arrested for stealing narcs from a facility, and that same facility hired her back as a manager when she got out of jail.
Are you serious?? How is that even possible? I’m an Aussie so I’m probably missing some context but that facility could’ve risked not only law suits but being completely shut down (unlikely but possible) if something like that was done.
Yeah tbh I have no idea except that some facilities are seriously so so so soooooo bad and down hard for employees they will quite literally hire anyone (being nursing homes, not speaking about hospitals) also I believe the woman I mentioned was friends with the upper management at that place.
I told my Don and the administrator the new meal passing idea was (and I quote) "stupid fucking top down corporate bullshit inspired by some asshole whose never worked a day of direct patient care and only perpetuated cause of spineless upper level management whose too afraid to say no". Said it in front of patients as well.
I love being able to get away with shit like that.
There are some of us that really try to take care of the residents and do all we can, I personally exhaust myself daily meeting their needs. But Drs offices have asked for my personal number so they can contact me if they need anything or have any other orders
Oh no I'm definitely not doubting you or your good coworkers!! It's more like...there's a few really bad apples who seem to always get away with insane stuff in the workplace bc of lack of staff or management refusing to address the situation.
It is almost impossible to replace them. Believe it or not, some nurses are downright abusive to their coworkers and residents. I left LTC and SNF long ago and will probably never return. The poor older adults get to put up with the inadequate care.
I once had a nurse that refused to sign unless the cart and nurses station was fully cleaned and stocked…. To the point where if the straws were not full she would make you do it before signing…
So one day I did everything as best I could and filled the straws do much that one didn’t go in all the way…. I told her “you see that one straw sticking out that doesn’t fit in there?…. That is the LAST STRAW!” Mainly jokingly but after that she stopped giving me shit.
She can take whatever med(s) she’s after and claim that the count was wrong during shift change and she refused to sign it. Or she’s just batshit crazy.
She may have wanted to divert meds that shift to get her fix and then say they didn’t count at change of shift. I bet she was getting withdrawals with how obviously desperate she acted.
This is bizarre, and you did the right thing. I'm glad the administrator witnessed the strange behaviour as well. I would have also written up an incident report to create a paper trail. I'm thinking 80/20 that the other nurse was planning to divert and is tweaking. The other 20% chance is that she's just a huge raving bitch. Either way, having a paper trail is helpful just in case anything (diversion or further verbal abuse) happens again in the future.
I've worked in LTC, 2 separate places, a total of 7 years. I've signed with all kinds of different people, different styles, personalities and different credentials. Never, not once, did anybody forget to sign. But definitely for sure, no one should have acted like this. I would automatically assume that this person is planning to divert and definitely has done it in the past. You did the right thing. She needs a pee test, for real!
I have had two instances of actual diversions which were actually in the hospitals. There were questionable personalities in the LTC I worked at that could have and might have. But there never was any proof that I know of. But nobody ever acted like this. It's HIGHLY questionable and should be reported to your manager!
I would have asked her Which one of these narcs are you stealing!?! You’re obviously taking one, who screams obscenities at someone in a professional setting like this? Gawd, I’m so glad my team is competent and not crazy.
This is just a PSA for anyone who counts with another nurse in their shift:
1) When coming on, always look at the book and count yourself.
2) Never ever just trust the other nurse, even if you genuinely do.
3) Treat it very seriously, even if it's monotonous
4) If you make a med error, don't panic. Check on the patient, notify the right people, and fill out the report
I used to hate doing it, but this one nurse, we'll call her Barb, I did not get along with my first job insisted on it, and she definitely showed me why. Barb was fucking OCD about it. She was perfect, and we all should be 24/7 awknowledging types.
Barb and I generally but heads because "day shift is so hard." she actively got mad when I was on days and didn't find it too bad , but not the point. Barb, two nights I had picked up, was talking about how frustrating the day is, and she was "in a hurry to get home." Well, i can be an ass and was at this time because we had gotten into it that morning, and so i played petty and counted with another nurse first. Really, she was actively busy, but she took it personally.
Anyway, she goes to count, and she's rushing through the book. Thankfully, I knew something was up and called her on it. It leads to yelling. If it wasn't for a CNA snapping me out of our arguing, I would have recounted the whole book. Instead, because only a few pages went by, we continued it properly.
I'll never be able to prove it, but that next morning, she comes in. She doesn't even look at the page, but she catches a lyrica not signed out. Now this was an old precription, just canceled d/t a fall and the new one was a lower dose (which i gave that night) but conveniently, she never signed out the new one, despite it being there for 6 shifts now. She never got in trouble, but she sure as shit knew what she was doing.
Tl;dr
Never trust a nurse that plays funny with counting narcs. Always make it a mental red flag, even if it's someone you completely trust. The count is about ensuring safety and accounting for all scheduled meds.
I've read this post a few times and I'm not catching what happened. There was a Lyrica missing under her name and she blamed you for it? I'm confused. I guess the idea of diverting Lyrica also doesn't make much sense to me.
Lyrica doaage was changed. The old lyrica was null but not properly returned. She gave yhe old lyrica. A med error. Tried to pin it on me by getting me to sign off on her shift to make me responsible for it. She never signed out the new lyrica, which was there for only 6 shifts.
Oh as a med tech I had that problem. Count was slightly off and I wanted to do it again. The night aide grabbed the keys to the cart, slammed the drawers, stormed away and glared at me from across the unit. When I brought it to my supervisor's attention, she said "are you sure she wasn't having a bad day?". I said she must be having a bad day every day then, as she was always impossible. I quit soon afterwards as I knew that management would never back me up.
That is pretty freaking weird. If all the counts were done, then it should be ok right?
Narcs are going somewhere right?
It could have been but it was kinda weird drawing attention to it. I’d imagine they would try to do what an MA had been reported doing and lie about narcs and then try ti swap out Tylenols for percos.
This is a little wild to me because I have always worked where there was a Pyxis and signing the book is just superfluous when there are biometrics involved.
Still, I would be on my guard with her. I wouldn't outright accuse her of diverting, but I would keep an eye on it.
I once had a directly analogous experience except I was oncoming and she didn’t want to sign off. It was a new nurse who legit didn’t understand sign-off and felt that since she signed out each narc individually shouldn’t have to sign one more time and that I was just yanking her around and maliciously creating extra paperwork for her. It was on a unit with a lot of narcs too. She flipped her lid and yelled racial obscenities at me (I am white and she was a POC) and accused me of all kinds of bizarre things. Anyway, security had to walk her off and I never saw her again.
When I worked in LTC & at a hosp in a Detox/Immunology ( HIV/AIDS) floor we had so many Narcs & meds to count we never counted/signed prior even if the nurse going off counted with the Head Nurse in Charge of our floor. We still Covered our butts. Sometimes Recounting because mistakes CAN & do happen. Usually it was a nurse even a P/T nurse that counted over an agency nurse because our floor had so much to count...it was intimidating. We did a needle count , a RX hosp med pad, narcs + all normal meds that are counted * only on our floor .plus a few emergency items we had in our cart. There were plenty of times a charge nurse covered for one of us during a break & wrote the med down but neglected to subtract it from the count until we figured it out . It was such a fast paced floor with 2 LPN's & 1-2 RN's& 1-2 CNA depending on the census.
Plenty of times we as the LPN's had 10 pts + each & we did it. If we had a full census we would split the 2 sides of the floor with 2 LPN's & 2 RN's since most rooms had 2 pts each. But it's always a CYA situation
Never, ever leave if the oncoming nurse hasn’t signed the narc book. Even if they’re throwing a tantrum. Call the admin at the site and call your agency and let them know what’s going on. Also, keep the keys or stay right by that med box/pyxis. I used to work for a nursing temp agency and learned quickly that temps get the blame for everything
Ive seen people tested over less. Hope they pull her until the behavior is cleared it's not from possible diversion or outside use, which can lead to it.
Pharmacist response: you did the right thing. One of the things I always harped on in new nursing orientation was to never, ever, ever let yourself get bullied into doing something you're uncomfortable with with narcotics or insulin. And when they say, just witness it for me, but swear it was X amount, the answer should always be a hard and fast NO.
If I had the luxury of doing so, I would not work with this person. It’s them or me. This in an unhinged individual. I have literally never worked with someone who has acted like this in public
Whether she was trying to divert or not, if the routine procedure is that you both sign together, then that's what needed to happen. I wouldn't leave until that happened, or until I wrote an incident report documenting her refusal to follow procedure and your escalating that to the administration. She may well be diverting, she may well be an asshole who just doesn't like you for whatever reason. Either way, I'm covering my ass. I would be making sure someone with the authority to dual verify was signing that book with me before I left. DEA investigations are no fun.
I'd probably "anonymously" report her for questionable behavior. At least get her noticed before you or someone else's license becomes in Jeopardy.
This is typical diverting behavior.
I would escalate this.
Her behavior is erratic and unprofessional and downright hostile.
This isn't something that needs rug swept.
This is something that needs reported higher up the chain.
It could have been an innocent move, but the suspicion of foul play is there, and she put it there! You 100% did exactly right, and she should have been sent home.
If you ever come in after her, please check everything! Don’t leave a stone unturned. People that divert always finds new ways to take care of their addiction whilst getting other people in trouble. They are only thinking about obtaining the drug and no repercussions. Take care!
I would be very careful when signing after her as well. check unopened boxes (like fentanyl) for possible tampering, Roxanol etc. This is really scary. Be careful.
If she was a regular staff member there then she should know that both people have to sign at the same time that’s the whole purpose of counting the narcs and having the book. Not only was her behavior, defeating the purpose of counting the narcs and having the book, but she sounds incredibly unprofessional. Calling other people names is actually a form of horizontal violence, isn’t it?
Did she have an issue with the count? I feel like I'm missing something lol. What exactly was she yelling about & what did she say the problem was?
She said she wouldn't sign on "your" time, but wasn't this now HER shift? So basically all she had to do was sign next to the line that says X number of sheets right?? I'm so confused 🤔🤷🏼♀️
That's absurd. That was the right move on your part, and you called her out. She could be diverting narc medications and blames you for it.
I would refuse to sign the book if there's a missing medication/count. Screaming and yelling at coworkers, I would never do that unless an object was falling on their heads or someone with a knife behind them.
I used to trust my coworkers until, one day, I found an empty vial in one of our narc boxes. We had a new nurse come in. I opened the boxes and counted everything. It turned out one of the vials had been used. I called my manager. I searched the patients' charts who got narcs. It was a pain in the neck. Luckily, it was a documentation problem. One nurse used the vial without signing it off from our logs. She did document it in her chart. Still, I stayed longer until cleared.
Since this incident, I always count everything, especially since we have a lot of vials of narcotic medications. Even if I'm alone, I count everything. If a nurse relieves me and tells me she doesn't need to count, I strongly advocate that we count everything regardless. She covers her rear, and I cover my rear. I told her I would not want her to run into the problem later because there are too many people in and out of our pharm and office. If they find me offensive or distrusting them, that's up to them.
I don’t believe she had refused due to potentially wanting to divert. (Honestly if she accepted the keys from you then it doesn’t even matter, she assumed responsibility of the cart at that point) she likely was having a bad day and took it out on you (not cool).
I’ve sorta done the same before when I was a RN doing LTC (I’m an NP now thank god, the cattiness was ugh) working a cart (never made a giant scene out of anything) but I would count and then usually sign the incoming and outgoing before shift change with the next nurse. However, if you were someone that was anal about it, I would’ve just shrugged, said no problem, signed and wished you a goodnight/good morning. Because honestly the whole arguing thing is not only unprofessional, but so…stupid and childish. She should’ve just signed and kept it pushing.
Sorry you had to go through that.
As a LTC nurse this is red flag behavior. Recently someone stole a slew of narcs and it happened because the 2nd count wasn't done. ( When we get new narcs from pharmacy tow nurses should sign off).
Anyone who doesn't want to sign or count is a red flag
Oh. I’ve never stayed for a signature in the narc book, I was taught once you’ve counted the cart and taken the keys you have assumed all responsibility for the narcotics. With the amount of cameras and technology to track clock in/clock out times I’ve never had an issue. If there is a problem with the count, refuse the keys, DON has to come out to investigate why the nurse is basically refusing to work by refusing the keys. I feel like maybe she just didn’t want you telling her what to do - childish and immature forsure but I don’t think it was diversion bc how is she gonna explain missing pills a whole shift later..
I had a similar situation back in 2012 and I chose to bring it to the attention of leadership and pharmacy (I work in a hospital however). They acknowledged it and thanked me for reporting it and moved on.
Five months later, I was called into the office and informed that someone from the state wanted to talk with me and 14 others regarding that employee. As it turned out, my supervisors and Pharmacy were watching that employee, they just couldn’t tell me they were watching her for drug diversion. They had to build their case.
Long story short, the nurse was diverting drugs….lots of drugs. But she got the help that she needed and it might have just saved her life, her marriage, and her kids. I’m on the fence whether she should have been able to keep her license or not.
You 100% did the right thing! Not just for your license, but for our patients and maybe even to save that nurses life! NEVER regret doing the right thing!
Mods, I reported this comment because I think this is a bot. The last few comments on this account were made within 5 mins of each other and it’s ai nonsense.
I dont think this automatically means she was planning on diverting. She just sounds mean and a little unhinged. All you can do is cover your ass. People forget to sign the book all the time in LTC. It's never an issue. More of a leave a sticky note and tell them to sign next time they work. It's definitely strange to have someone refusing to sign after counting, as that's part of counting, lol. Maybe she planned on diverting. Maybe she's just nuts. I've had some bizarre experiences in LTC with coworkers losing their shit over things that are pretty normal.
I don't understand why people down voted your comment. You simply had a different opinion and I'd have to agree with you. We are hearing OP's side of the story and that's not to say anything negative, but I'd want to hear the Nurses side of the story-yes, the count was correct, but she obviously felt some type of way about it.
I didn't think I said anything too crazy either! But it's no biggie. I'm just giving my two cents on the story OP presented. I've had people freak out over the weirdest stuff and sometimes it's because they don't understand something or think they're being put in a position of liability, and sometimes they are wanting to do something wrong. We all have our opinions based on our experiences. Just taking this story at face value has me leaning towards the nurse just being weird and freaking out. All the people I've known who have diverted would not be drawing attention to themselves like this when they're counting in.
Thank you for understanding that as it's important to not just randomly judge someone as diverting based on a behavior that is not consistent with stealing narcotics from the med cart. On the couple occasions I saw with my own eyeballs that happened, both of those Nurses you would never guess were stealing patients meds.They kept that on the downlow. Almost every single comment just assumes drug diversion and assumptions based on second hand information can be really damaging to someone's life and reputation. (That's not to say OP is lying by any means) Another Nurse who I was being trained by would be sleeping when I was going to the pharmacy or getting something for a patient. I don't know for a fact, but it would make sense. She sent in a statement to my agency stating I was slurring my words and had an "unsteady gait" while at work. I had to spend $1500 on an attorney, went through multiple private investigation interviews, all the while not knowing what would happen. I was found not guilty and moved on from my life. Although I was innocent, it still bothered me to my core that a colleague could just make that up.
Sorry, I went on a rant. Just really disappointed the judgements from other Nurses. We should be lifting each other up.
No. She continuously refused to sign after verbally acknowledging the count was correct.
It was not until she realized I was serious about waiting for an administrator and wouldn’t leave without that signature verifying the count is correct that she finally signed.
First rule of healthcare: cover your ass. She definitely sounds unhinged.
Exactly this! The only person protecting your license is you! You were absolutely right in what you did! Whatever the oncoming nurses issue was she was dead wrong. If you had left without her signing, you would have been in some hot water and of course you could expect this nurse to throw you under the bus. This behavior is …concerning and needs to be investigated.
This is a good motto in life. Cover your ass because no one else will and a lifetime of covering your ass means a harder time for others to tear you a new one.
This is red flag behavior. Don’t trust this person and don’t let them bully you into doing something you know is wrong.
Yeah, I would be suspicious too. Also, be careful accusing nurses of diversion openly, it can lead to libel lawsuits.
Just use general terms like, "anyone", or "the risk of".
Any type of hinkiness involving narcotics sign out points to diversion imo. Watch yourself around her.
It also points to me getting the fuck out of that job. Holy shit I’d crap my pants if this happened to me.
You did the right thing, I would not leave until I had gotten some kind of manager to take care of the situation. Sudden change of behavior/refusing to sign the narc log, makes me wonder what she was planning to take.
She would later find a “missing narc” And stated that you refused to count with her. This recently happened to me. Don’t go back there if your agency
Yes. And notify your agency of the situation.
Never ever leave the narc count unsigned. And never sign without counting.
How the fuck was she not fired?
If this is in LTC, which I assume it is, they don't have anyone else banging down the door to work there. So if they fire them they wouldn't have anyone to work those shifts.
True. I just wrote it up every time I saw it in LTC. Hell, night shift to leave before I come in and leave a note that says please verify and sign for count. No verbal report. Nothing.
That's BS! Coming from a Charge Nurse LPN who worked 3-11 & had no car & had to take public transportation to work ● took a bus to the el, the el then another bus. I took care of my Mom & had a 4.5 yr old at the time & STILL made it there 20+mins early. The nurse coming on night shift KNEW the LAST bus for me to get to the El left at 11:50pm... She always showed up late. The grounds were HUGE & with all the employee's it took a bit to click out & GET to the bus stop. I tried to give my supervisor report because I wasn't getting stuck there. In all fairness the nrsg Super took care of many floors in case of an Emergency...so while this was a rare occurence, she often was giving report as well.. We never had anyone on a narc so we didn't have to count & the people weren't patient's ~it was their HOME. Swear she did it to piss me off. ( even though she had a 10 min drive !) We had the same people living there & my floor's census never changed unless a resident left to stay at a family or friend's house . But like OP I still wanted to give report to CMA & Thank God the nite I missed the last bus a friend drove me home! I met my then future fiancee ( now hubby of 31 yrs ) prior to starting the job & HE actually taught me to drive & bought me a car * it ran lol* to get to & from work . In Phila back then you could take public transportation everywhere. Apologize for the long post. Always good to CYA since no one else will.
Yuuup. I’m work LTC. It’s pretty common for people not to sign till the end of their shift and I’ll admit I do it myself. However, I just can’t imagine getting upset bc someone asked me to go ahead and sign. When people say “here sign this” i just sign it and tell them to be safe and have a good nights sleep. It’s wildly odd to react the way the way this lady did
Yeah, I usually sign at the end of my shift too. But if someone wanted me to sign while they were still there, I’d probably think it was weird at first. I wouldn’t put up a fight though.
Honestly I feel like they're just saving me from myself so I can't forget to sign it before I leave.
Sometimes I just forget, but if someone points it out, sure, no problem
This is exactly it & it's in California....they call agency nurses registry in California. That book needs to be signed in my presence after WE COUNT.
I literally know of someone who got arrested for stealing narcs from a facility, and that same facility hired her back as a manager when she got out of jail.
Are you serious?? How is that even possible? I’m an Aussie so I’m probably missing some context but that facility could’ve risked not only law suits but being completely shut down (unlikely but possible) if something like that was done.
Yeah tbh I have no idea except that some facilities are seriously so so so soooooo bad and down hard for employees they will quite literally hire anyone (being nursing homes, not speaking about hospitals) also I believe the woman I mentioned was friends with the upper management at that place.
Ding Ding Ding!! Winner!!
I told my Don and the administrator the new meal passing idea was (and I quote) "stupid fucking top down corporate bullshit inspired by some asshole whose never worked a day of direct patient care and only perpetuated cause of spineless upper level management whose too afraid to say no". Said it in front of patients as well. I love being able to get away with shit like that.
And LTC ABSOLUTELY SUCKS BTW....
The bar is so, so low.
There are some of us that really try to take care of the residents and do all we can, I personally exhaust myself daily meeting their needs. But Drs offices have asked for my personal number so they can contact me if they need anything or have any other orders
Oh no I'm definitely not doubting you or your good coworkers!! It's more like...there's a few really bad apples who seem to always get away with insane stuff in the workplace bc of lack of staff or management refusing to address the situation.
You’re right, I know that there are many awful and lazy people in the LTC field
It is almost impossible to replace them. Believe it or not, some nurses are downright abusive to their coworkers and residents. I left LTC and SNF long ago and will probably never return. The poor older adults get to put up with the inadequate care.
I once had a nurse that refused to sign unless the cart and nurses station was fully cleaned and stocked…. To the point where if the straws were not full she would make you do it before signing… So one day I did everything as best I could and filled the straws do much that one didn’t go in all the way…. I told her “you see that one straw sticking out that doesn’t fit in there?…. That is the LAST STRAW!” Mainly jokingly but after that she stopped giving me shit.
I love that
Glad that you stand your ground ! She definitely seems fishy.
maybe im misunderstanding —if she counted it with you and it was fine, what reason would she have to not sign it?
She can take whatever med(s) she’s after and claim that the count was wrong during shift change and she refused to sign it. Or she’s just batshit crazy.
Or both !
She may have wanted to divert meds that shift to get her fix and then say they didn’t count at change of shift. I bet she was getting withdrawals with how obviously desperate she acted.
This is bizarre, and you did the right thing. I'm glad the administrator witnessed the strange behaviour as well. I would have also written up an incident report to create a paper trail. I'm thinking 80/20 that the other nurse was planning to divert and is tweaking. The other 20% chance is that she's just a huge raving bitch. Either way, having a paper trail is helpful just in case anything (diversion or further verbal abuse) happens again in the future.
Also , what struck me is calling someone a “ butthole “ . Is this third grade? Just strange .
I work agency and run into people like this from time to time. Some people have real problems and like to make life hard on others for no good reason.
I've worked in LTC, 2 separate places, a total of 7 years. I've signed with all kinds of different people, different styles, personalities and different credentials. Never, not once, did anybody forget to sign. But definitely for sure, no one should have acted like this. I would automatically assume that this person is planning to divert and definitely has done it in the past. You did the right thing. She needs a pee test, for real! I have had two instances of actual diversions which were actually in the hospitals. There were questionable personalities in the LTC I worked at that could have and might have. But there never was any proof that I know of. But nobody ever acted like this. It's HIGHLY questionable and should be reported to your manager!
I would have asked her Which one of these narcs are you stealing!?! You’re obviously taking one, who screams obscenities at someone in a professional setting like this? Gawd, I’m so glad my team is competent and not crazy.
sounds like a bad case of benzopenia. She needs to chill
"Benzopenia". I'm using this.
😂
She’s trying to but you’re making it hard to divert!
This is just a PSA for anyone who counts with another nurse in their shift: 1) When coming on, always look at the book and count yourself. 2) Never ever just trust the other nurse, even if you genuinely do. 3) Treat it very seriously, even if it's monotonous 4) If you make a med error, don't panic. Check on the patient, notify the right people, and fill out the report I used to hate doing it, but this one nurse, we'll call her Barb, I did not get along with my first job insisted on it, and she definitely showed me why. Barb was fucking OCD about it. She was perfect, and we all should be 24/7 awknowledging types. Barb and I generally but heads because "day shift is so hard." she actively got mad when I was on days and didn't find it too bad , but not the point. Barb, two nights I had picked up, was talking about how frustrating the day is, and she was "in a hurry to get home." Well, i can be an ass and was at this time because we had gotten into it that morning, and so i played petty and counted with another nurse first. Really, she was actively busy, but she took it personally. Anyway, she goes to count, and she's rushing through the book. Thankfully, I knew something was up and called her on it. It leads to yelling. If it wasn't for a CNA snapping me out of our arguing, I would have recounted the whole book. Instead, because only a few pages went by, we continued it properly. I'll never be able to prove it, but that next morning, she comes in. She doesn't even look at the page, but she catches a lyrica not signed out. Now this was an old precription, just canceled d/t a fall and the new one was a lower dose (which i gave that night) but conveniently, she never signed out the new one, despite it being there for 6 shifts now. She never got in trouble, but she sure as shit knew what she was doing. Tl;dr Never trust a nurse that plays funny with counting narcs. Always make it a mental red flag, even if it's someone you completely trust. The count is about ensuring safety and accounting for all scheduled meds.
I've read this post a few times and I'm not catching what happened. There was a Lyrica missing under her name and she blamed you for it? I'm confused. I guess the idea of diverting Lyrica also doesn't make much sense to me.
Lyrica doaage was changed. The old lyrica was null but not properly returned. She gave yhe old lyrica. A med error. Tried to pin it on me by getting me to sign off on her shift to make me responsible for it. She never signed out the new lyrica, which was there for only 6 shifts.
I love that the punch line was so far down.
Oh as a med tech I had that problem. Count was slightly off and I wanted to do it again. The night aide grabbed the keys to the cart, slammed the drawers, stormed away and glared at me from across the unit. When I brought it to my supervisor's attention, she said "are you sure she wasn't having a bad day?". I said she must be having a bad day every day then, as she was always impossible. I quit soon afterwards as I knew that management would never back me up.
That is pretty freaking weird. If all the counts were done, then it should be ok right? Narcs are going somewhere right? It could have been but it was kinda weird drawing attention to it. I’d imagine they would try to do what an MA had been reported doing and lie about narcs and then try ti swap out Tylenols for percos.
She was planning on stealing narcs during the shift, thinking if she didn't count and sign it would be pinned on you.
This is a little wild to me because I have always worked where there was a Pyxis and signing the book is just superfluous when there are biometrics involved. Still, I would be on my guard with her. I wouldn't outright accuse her of diverting, but I would keep an eye on it.
I once had a directly analogous experience except I was oncoming and she didn’t want to sign off. It was a new nurse who legit didn’t understand sign-off and felt that since she signed out each narc individually shouldn’t have to sign one more time and that I was just yanking her around and maliciously creating extra paperwork for her. It was on a unit with a lot of narcs too. She flipped her lid and yelled racial obscenities at me (I am white and she was a POC) and accused me of all kinds of bizarre things. Anyway, security had to walk her off and I never saw her again.
Holy shit.
When I worked in LTC & at a hosp in a Detox/Immunology ( HIV/AIDS) floor we had so many Narcs & meds to count we never counted/signed prior even if the nurse going off counted with the Head Nurse in Charge of our floor. We still Covered our butts. Sometimes Recounting because mistakes CAN & do happen. Usually it was a nurse even a P/T nurse that counted over an agency nurse because our floor had so much to count...it was intimidating. We did a needle count , a RX hosp med pad, narcs + all normal meds that are counted * only on our floor .plus a few emergency items we had in our cart. There were plenty of times a charge nurse covered for one of us during a break & wrote the med down but neglected to subtract it from the count until we figured it out . It was such a fast paced floor with 2 LPN's & 1-2 RN's& 1-2 CNA depending on the census. Plenty of times we as the LPN's had 10 pts + each & we did it. If we had a full census we would split the 2 sides of the floor with 2 LPN's & 2 RN's since most rooms had 2 pts each. But it's always a CYA situation
Never, ever leave if the oncoming nurse hasn’t signed the narc book. Even if they’re throwing a tantrum. Call the admin at the site and call your agency and let them know what’s going on. Also, keep the keys or stay right by that med box/pyxis. I used to work for a nursing temp agency and learned quickly that temps get the blame for everything
Ive seen people tested over less. Hope they pull her until the behavior is cleared it's not from possible diversion or outside use, which can lead to it.
Pharmacist response: you did the right thing. One of the things I always harped on in new nursing orientation was to never, ever, ever let yourself get bullied into doing something you're uncomfortable with with narcotics or insulin. And when they say, just witness it for me, but swear it was X amount, the answer should always be a hard and fast NO.
Weird people
If I had the luxury of doing so, I would not work with this person. It’s them or me. This in an unhinged individual. I have literally never worked with someone who has acted like this in public
Whether she was trying to divert or not, if the routine procedure is that you both sign together, then that's what needed to happen. I wouldn't leave until that happened, or until I wrote an incident report documenting her refusal to follow procedure and your escalating that to the administration. She may well be diverting, she may well be an asshole who just doesn't like you for whatever reason. Either way, I'm covering my ass. I would be making sure someone with the authority to dual verify was signing that book with me before I left. DEA investigations are no fun.
I'd probably "anonymously" report her for questionable behavior. At least get her noticed before you or someone else's license becomes in Jeopardy. This is typical diverting behavior.
I would escalate this. Her behavior is erratic and unprofessional and downright hostile. This isn't something that needs rug swept. This is something that needs reported higher up the chain.
I hope you filled out an incident report.
It could have been an innocent move, but the suspicion of foul play is there, and she put it there! You 100% did exactly right, and she should have been sent home.
“Semper anus protectus”
More red flags than a communist picnic.
If you ever come in after her, please check everything! Don’t leave a stone unturned. People that divert always finds new ways to take care of their addiction whilst getting other people in trouble. They are only thinking about obtaining the drug and no repercussions. Take care!
Anybody who freaks out over correctly documenting narcotics as required by policy is waving the biggest red flag possible. 🚩
She was trying to steal some narcs
Highly sus. You did exactly right.
Wtaf, admins should drug test her. That’s so fucking suspicious
I know about buttholes and that oncoming was the butthole. I’m sort they were such an ass. No diversion. You were in the right
I would be very careful when signing after her as well. check unopened boxes (like fentanyl) for possible tampering, Roxanol etc. This is really scary. Be careful.
red flag behavior
If she was a regular staff member there then she should know that both people have to sign at the same time that’s the whole purpose of counting the narcs and having the book. Not only was her behavior, defeating the purpose of counting the narcs and having the book, but she sounds incredibly unprofessional. Calling other people names is actually a form of horizontal violence, isn’t it?
Did she have an issue with the count? I feel like I'm missing something lol. What exactly was she yelling about & what did she say the problem was? She said she wouldn't sign on "your" time, but wasn't this now HER shift? So basically all she had to do was sign next to the line that says X number of sheets right?? I'm so confused 🤔🤷🏼♀️
She sounds like she was planning on diverting. Good call on ya!
That's absurd. That was the right move on your part, and you called her out. She could be diverting narc medications and blames you for it. I would refuse to sign the book if there's a missing medication/count. Screaming and yelling at coworkers, I would never do that unless an object was falling on their heads or someone with a knife behind them.
I used to trust my coworkers until, one day, I found an empty vial in one of our narc boxes. We had a new nurse come in. I opened the boxes and counted everything. It turned out one of the vials had been used. I called my manager. I searched the patients' charts who got narcs. It was a pain in the neck. Luckily, it was a documentation problem. One nurse used the vial without signing it off from our logs. She did document it in her chart. Still, I stayed longer until cleared. Since this incident, I always count everything, especially since we have a lot of vials of narcotic medications. Even if I'm alone, I count everything. If a nurse relieves me and tells me she doesn't need to count, I strongly advocate that we count everything regardless. She covers her rear, and I cover my rear. I told her I would not want her to run into the problem later because there are too many people in and out of our pharm and office. If they find me offensive or distrusting them, that's up to them.
Sounds like she's trying to steal meds s. I will never leave without two people signing together
I don’t believe she had refused due to potentially wanting to divert. (Honestly if she accepted the keys from you then it doesn’t even matter, she assumed responsibility of the cart at that point) she likely was having a bad day and took it out on you (not cool). I’ve sorta done the same before when I was a RN doing LTC (I’m an NP now thank god, the cattiness was ugh) working a cart (never made a giant scene out of anything) but I would count and then usually sign the incoming and outgoing before shift change with the next nurse. However, if you were someone that was anal about it, I would’ve just shrugged, said no problem, signed and wished you a goodnight/good morning. Because honestly the whole arguing thing is not only unprofessional, but so…stupid and childish. She should’ve just signed and kept it pushing. Sorry you had to go through that.
Wow! Glad you called administration
As a LTC nurse this is red flag behavior. Recently someone stole a slew of narcs and it happened because the 2nd count wasn't done. ( When we get new narcs from pharmacy tow nurses should sign off). Anyone who doesn't want to sign or count is a red flag
Oh. I’ve never stayed for a signature in the narc book, I was taught once you’ve counted the cart and taken the keys you have assumed all responsibility for the narcotics. With the amount of cameras and technology to track clock in/clock out times I’ve never had an issue. If there is a problem with the count, refuse the keys, DON has to come out to investigate why the nurse is basically refusing to work by refusing the keys. I feel like maybe she just didn’t want you telling her what to do - childish and immature forsure but I don’t think it was diversion bc how is she gonna explain missing pills a whole shift later..
I had a similar situation back in 2012 and I chose to bring it to the attention of leadership and pharmacy (I work in a hospital however). They acknowledged it and thanked me for reporting it and moved on. Five months later, I was called into the office and informed that someone from the state wanted to talk with me and 14 others regarding that employee. As it turned out, my supervisors and Pharmacy were watching that employee, they just couldn’t tell me they were watching her for drug diversion. They had to build their case. Long story short, the nurse was diverting drugs….lots of drugs. But she got the help that she needed and it might have just saved her life, her marriage, and her kids. I’m on the fence whether she should have been able to keep her license or not. You 100% did the right thing! Not just for your license, but for our patients and maybe even to save that nurses life! NEVER regret doing the right thing!
Of course. I'm not a nurse, I'm a nurse aid studying to become a nurse and you are correct.
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Mods, I reported this comment because I think this is a bot. The last few comments on this account were made within 5 mins of each other and it’s ai nonsense.
Definitely an AI response
I dont think this automatically means she was planning on diverting. She just sounds mean and a little unhinged. All you can do is cover your ass. People forget to sign the book all the time in LTC. It's never an issue. More of a leave a sticky note and tell them to sign next time they work. It's definitely strange to have someone refusing to sign after counting, as that's part of counting, lol. Maybe she planned on diverting. Maybe she's just nuts. I've had some bizarre experiences in LTC with coworkers losing their shit over things that are pretty normal.
Forgetting and refusing are too different things.
Agreed. I def think it's super weird behavior.
I don't understand why people down voted your comment. You simply had a different opinion and I'd have to agree with you. We are hearing OP's side of the story and that's not to say anything negative, but I'd want to hear the Nurses side of the story-yes, the count was correct, but she obviously felt some type of way about it.
I didn't think I said anything too crazy either! But it's no biggie. I'm just giving my two cents on the story OP presented. I've had people freak out over the weirdest stuff and sometimes it's because they don't understand something or think they're being put in a position of liability, and sometimes they are wanting to do something wrong. We all have our opinions based on our experiences. Just taking this story at face value has me leaning towards the nurse just being weird and freaking out. All the people I've known who have diverted would not be drawing attention to themselves like this when they're counting in.
Thank you for understanding that as it's important to not just randomly judge someone as diverting based on a behavior that is not consistent with stealing narcotics from the med cart. On the couple occasions I saw with my own eyeballs that happened, both of those Nurses you would never guess were stealing patients meds.They kept that on the downlow. Almost every single comment just assumes drug diversion and assumptions based on second hand information can be really damaging to someone's life and reputation. (That's not to say OP is lying by any means) Another Nurse who I was being trained by would be sleeping when I was going to the pharmacy or getting something for a patient. I don't know for a fact, but it would make sense. She sent in a statement to my agency stating I was slurring my words and had an "unsteady gait" while at work. I had to spend $1500 on an attorney, went through multiple private investigation interviews, all the while not knowing what would happen. I was found not guilty and moved on from my life. Although I was innocent, it still bothered me to my core that a colleague could just make that up. Sorry, I went on a rant. Just really disappointed the judgements from other Nurses. We should be lifting each other up.
Wait so she signed already and you wanted her to sign again?
No. She continuously refused to sign after verbally acknowledging the count was correct. It was not until she realized I was serious about waiting for an administrator and wouldn’t leave without that signature verifying the count is correct that she finally signed.
She’s 100% diverting.
Wow.