shan, I have worked with pyxis and since I don't have a criminal mind, so the only thing I can think of is this nurse replaced these narcotics with bogus narcotics.

Whenever I've used the pyxis, it takes the patient's mr, your password and only allows you to remove the drug you've requested.  I do know, when getting any drug, there are only a certain number of the drugs in a drawer.  Pharmacy, wherever I've worked, has kept very close records and track of drugs being used and they follow up immediately on any discrepancy. 

Is it possible to replace ampules with bogus ampules and someone not know it? I mean your are suppose to do the 5 rights, right? I am just completely floored by this mostly because I know this person.

I have absolutely no idea

I work in a facility that has an Accu-Dose, much like a pyxis. You have to sign in with a your user name and password and then go under the patient that you are pulling narcs for. It ask you how many you are taking and then the drawer pops open. There are many pockets in the drawer, but you are only able to get into the one you requested.

Then it ask you to enter a count after you take what you have entered. Example: You request one item. The machine knows how many is in the drawer before you even request it. So if it had 30 and you requested one and then it ask you to enter count remaining, you will have to enter 29. You could take 2 and still enter there were 29 left, but the count would be off when the next nurse accessed the Accu-Dose, and they would investigate.

The only thing I can think of that she could have been possibly doing to get away with it for so long is. She was taking the correct number out, and charting that she gave it to the patient when she actually was putting it in her pocket. I have lots of patients that have pain med ordered but doesn't ask for it. She could have been requesting pain med for all these patients knowing they didn't want it charting that she gave it, and just kept it for herself. If you have 5 or 6 patients for 12 hours and they can have pain med every 3 to 4 hours she could have collected a good bit by the end of her shift.

Does that make sense?

We have to count the narcotics in the pyxis every morning with the on coming shift.  It use to be counted twice a week on night shift.  I don't know if there was a problem or what caused the change in counting.  If there is a missing medication then those that have used that pyxis in the past 24 hours, since last count, all must submit to a drug test.  The only thing that I don't think is fair is that if I didn't use the pyxis but I am counting, because it is my turn, I also have to submit my sample.  We are suppose to count on the pyxis that we did not use since we have two. 

Starlight- Thanks it does make sense.

Martini: I am thinking that if our local hospital had been as deligent as your (as much as a pain in the butt it probably is) hospital, this nurse might had been detered from destroying her life, and her family!

If your floor doesn't use alot of narcotics, then it couold go on for quite a while.On the floor i work, we go through ALOT, so it would get picked up quickly.

very wierd,

Yeah that is is very scary.

You know that just doesn't seem right, but you know they will be watching her like a hawk.