The patient has consistently reported 8/10 pain levels despite large doses of morphine being supplied. The nurse brings the patient’s IV morphine dose to the room to administer it. The patient states, “That is way more medication than the nurse gave me all night.” The nurse verifies the dose and amount and finds it consistent with the order and the amount that has been removed from the Pyxis. Which action by the nurse is appropriate?

Question

The patient has consistently reported 8/10 pain levels despite large doses of morphine being supplied. The nurse brings the patient&rsquo;s IV morphine dose to the room to administer it. The patient states, &ldquo;That is way more medication than the nurse gave me all night.&rdquo; The nurse verifies the dose and amount and finds it consistent with the order and the amount that has been removed from the Pyxis. Which action by the nurse is appropriate?

Accepted Answer

Inform the charge nurse. The patient&rsquo;s report indicates the patient has been receiving less morphine than is ordered and that has been removed from the Pyxis, which strongly suggests someone is diverting morphine. The correct accounting for controlled substances is strictly controlled.  Any discrepancies noted should be immediately reported to the charge nurse, so they can be properly accounted for.  It is not appropriate to inform hospital security or the pharmacy before the direct supervisor.  It is not appropriate to say nothing and delay reporting the error.

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