I am a staff Nurse working in a NHS Hospital. I am working there for 8 years. I am suspended because I forget to sign a controlled drug. Because of busy I thought that it can be signed afterwards.
I told my Matron what actually happened. She filed a report accusing me and suspended me. My union is not supporting me. Please give me an advice?
(The identity is kept confidential as advised)
We are very sorry for the untoward incidents meted in your long profession.
We are trying to answer your question in line with the well-established rules and guidance\'s of record keeping as per the Nursing Law and signing and recording of Controlled Drugs (CD) as per various guidance’s and directions.
We have come across different scenarios of qualified staff nurses, caught with the allegations of poor record keeping or allegations of not signing vital documents like MAR/ KARDEX sheets while administrating Controlled Drugs (CD) or non-Controlled Drugs. We bear in mind the difficulty of qualified staff nurses arrayed in disciplinary proceedings because of the similar situations.
The record keeping of the qualified staff nurses are governed byNMC code of Conduct (the Code) and the corresponding practise directions/practise guidance\'s formulated by the employers. Article 42 – 47 of the NMC Code of Conduct (the Code) spells,
Keep clear and accurate records.
Record keeping: Guidance for nurses and midwives.
42. You must keep clear and accurate records of the discussions you have, the assessments you make, the treatment and medicines you give and how effective these have been
43. You must complete records as soon as possible after an event has occurred
44. You must not tamper with original records in any way
45. You must ensure any entries you make in someone\'s paper records are clearly and legibly signed, dated and timed
46. You must ensure any entries you make in someone\'s electronic records are clearly attributable to you
47. You must ensure all records are kept securely
Hence it is explicitly clear that, all the qualified staff nurses are duty bound to strictly adhere to Article 42 - 47 of the NMC Code of Conduct (the Code) and any dereliction from the "the Code" will be the violation of Article 42 - 47 and the qualified staff nurses practise may be impaired.
As far as the non-signing on the MAR/KARDEX sheet is concerned, we believe that, you are obliged to follow the relevant procedures and protocols which stipulated by various guidance’s coupled with Article 42 – 47 of NMC Code of Conduct ( the Code). For the better clarity a specimen of a guidance is portrayed.
(I) Any Personal Protective Equipment identified as required must be provided and used.
(ii) Two members of staff, one of whom must be a senior member of staff on duty, the other must be a permanent member of staff, must follow this procedure.
(iii) Staff should read the medication record sheet and select the medicine required.
(iv)Staff should in the controlled drug book, identify the name of the person and the drug to be administered from the index at the front.
(v) Staff should remove the specified drug from the cupboard.
(vi)Staff should check the label on the drug against the medication record sheet which should confirm:
- The name of the person
- The name of the drug
- The dosage to be administered
(vii) Senior person checks the stock balance in the controlled drug book tally with the stock balance in the cupboard.
(viii) Staff should check that the dosage has not already been administered.
(ix) The members of staff will then administer the controlled drug (one administers, while the other witnesses).
(x) Following administration, the records are to be signed by both members of staff.
(xi) In the case of patches or other topical dressings, the patch/dressing removed must be disposed of in a Controlled Drug waste pot/bin
(xii) If medication has been removed from its original container and is not taken by the Service User, it should be destroyed and the action recorded on the medication sheet and in the controlled drugs book. It should not be replaced in the container.
(xiii) When a person is unable or unwilling to take the medication prescribed, it is the responsibility of the Head to notify the General Practitioner and relevant others as the individual’s circumstances require (for further details see Mental Capacity policy).
(xiv) Any discrepancies must be reported immediately to the head of the establishment, or their immediate Line Manager.
In addition to the requirements for recording identified in current medication procedures and guidance, the following will apply:
- Records of controlled drugs will be kept in a bound book/register
- Date supply obtained
- Name and address of pharmacy obtained from
- Quantity obtained
- The register will include the balance remaining for each medicine with a separate page being maintained for each service user
- The balance will be checked prior to administration (the total amount given to a service user to self-medicate is recorded not the individual doses)
- Records will be signed by the person administering medication and by the person who witnessed the administration
- The Head of Service will undertake a monthly check
- Any discrepancies must be brought to the attention of the Manager or Assistant Manager responsible for the Service at the earliest opportunity, who will then inform the Director of Operations.
DISPOSAL, Services and Homes Providing Personal Care Only
(i)Controlled drugs which have been obtained in individual prescriptions must be disposed of by returning to the supplying pharmacy.
(ii) Records of disposal must be kept by an entry within the controlled drugs register.
(iii) A signature of receipt must be obtained from the pharmacist.
Hence it is true to say that, for the administration of Control Drug (CD) is concerned, you are obliged to follow scrupulously the above protocols and procedures.
Any deviation from the above protocols and procedures will attract disciplinary actions.
In your case, you admitted that, you have deviated from the protocols and procedures in the administration of Controlled Drug (CD). Considering your long span of career as a qualified staff nurse, we advise you to mitigate your actions.
We think a comprehensive legal advice is prudent and fair and we request you to do the same.
Zenith Solicitor (Legal Defence Team.)
The information contained in this article are from the event happened previously. The author of this article takes no responsibility in any shape or form should someone decide to act upon or use it for his/her personal consumption. The article has merely been presented exclusively for information. Should some on decide to use it for any reason, is strongly recommended to take independent legal advice prior to acting upon.