I work at a nursing home in the state of Maryland. Recently the grandfather of our DON was admitted. Over the course of the weekend the patient was given an order for MSIR 50ml q1h. During all this our DON stayed most of the day with her grandfather. While she was there myself and the other nurses on staff at the time whitened her remove a fresh box from the med cart and take it to his room. And that is where it stayed for the duration of her stay which was about 10 hrs. My question is it legal for her to take and administer the MSIR to her grandfather while not on duty?
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I would also be concerned for the nurse who had the keys to the med cart. Did they make note of how much ml's were there before and after the DON took them? Did the DON sign out the this dose on the controlled drug/narcotic drug sheet? Did the DON initial the MAR as administering this? If none of these things were done, or if the DON wasted any of the schedule II drug.....and someone notices it is unaccounted for.....that could leave to further issues. All I can say for you nurses is that thank goodness there are several witnesses. Otherwise, the DON could have alleged that one of the nurses misappropriated the drug (especially if there is some missing!)
If I found out during a survey or complaint investigation as a surveyor, I would probably consider a Board of Nursing referral on the DON, because that is not standard of practice.
If I found out during a survey or complaint investigation as a surveyor, I would probably consider a Board of Nursing referral on the DON, because that is not standard of practice.