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If an RN overlooks signing off meds after the facility where she works changes the format of the MAR, can they say this was diversion?

Wednesday May 14, 2014
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Dear Nancy,

I have worked at a hospital for 10 years. When it changed the format of the Medication Administration Record, I overlooked signing off medications, which included BP meds and narcotics, more than once. Can they say this
was diversion?


Dear Nancy replies:

Dear Morgan,

Although blood pressure medications are not often a concern in relation to medications that are diverted, narcotics certainly are. And, in reality, any medication that is used for a purpose other than what was originally intended (e.g., ordered for a particular patient but utilized by a person other than the patient for whom it was ordered) is fair game for an allegation of diversion.

The institution in which you work most likely will do an investigation into the lack of your signing off on the medications that were ordered and then decide how to handle the situation. In addition to diversion of the medications, the employer could decide your documentation of the medications was sloppy, you did not follow facility policy in documenting these medications, and/or you did not successfully internalize the in-service required to educate you to the change in the MAR. Based on their decision, consequences will follow.

Once you know what the facility's decision is, you may want to consult with a nurse attorney or other attorney in your state in terms of how to handle the allegation the employer utilizes against you based on its investigation.


Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.