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by neetnik461

I just finished orientation classes at a new job. It's been going really good and I am pleased with how thorough and professional the educating trainers have been. Yesterday we went over medication administration. We were told that at this facility a narcotics waste can be witnessed by anyone, even non-nursing staff. It was clearly stated that housekeeping, dietary, maintenance staff, "anyone you can grab" can witness a waste and sign the reconciliation sheet. I guess this could even mean family or visitors if no one else is available (they didn't clarify if it had to be a facility employee).

You should have seen the look on the new orientee's faces! One of the RN's doubled checked what had been said, the trainer repeated "wastes can be witnessed by anyone". One of the STNA's said, "I feel really uncomfortable about this, at my other job only RN's can witness a waste".

I agree. At my previous job in a metropolitan ICU we were told that another RN had to witness a waste. Now, that floor was staffed by all RN's and a CTA. This new job is more of a mixture of STNA's, LPN's and RN's.

The reason cited for this rule was that in some areas of the facility (like the Alzheimer's Unit) there are no RN's employed, yet narcotics are given.

Wow! Help me out with this one . . .Is it true that "anyone" can witness a waste???

[CritterLover]

Re: Who can witness a waste?

At my facility, it must be another licensed person. It can be an RN or an LPN, but it must be someone with a license. I've never tried it, but I'd bet that a pharmacist could do it, too.

Since we have to record all of our wates in the Sure-Med, it effectivly limits the witness to someone with a Sure-Med code.

I would think that if you were in a LTC facility, there would be AT LEAST one other licensed person in the building that you could walk the narc and narc sheet down to see them and do/record the waste.

HOWEVER, that being said, before I was a nurse, I worked in an Assisted Living Facility, and the aides (not certified) not only passed meds, but counted/wasted narcs alone. Wouldn't be caught dead working there now that I have a license!

Check the state law and/ or check with a pharmacist about it.

[TazziRN]

Re: Who can witness a waste?

Licensed personnel only. I think your trainer should doublecheck on that. Since only licensed personnel can give meds, it only makes sense that only licensed personnel can witness wastes.

[jetscreamer101]

Re: Who can witness a waste?

Our policy is that an RN had to be one of the people who waste a narcotic, and the other can be a pharmacist or an LPN.
Yesterday I was counting narcs, and we counted some haldol? Why? just thought we should I was told. Huh!

[Softballmama]

Re: Who can witness a waste?

Where I used to work, we only had one RN staffed in the ER with a tech. Our pharmacist programmed our Pyxis so that the tech could sign in to witness a waste. The techs' ID would not work if they tried to access a drug - it would only work for wastes.

Re: Who can witness a waste?

A quick clarification. At this new job there is no pyxis or automated dispensing system for narcotics. The narcs are kept in a rolling cart with drawers and a locked sidebar. So, it's impossible to program in an unlicensed person's name for a waste (as a security measure). Just a log sheet that is used for counts, with a column for a signature witnessing a waste.

[Schatzi RN CEN]

Re: Who can witness a waste?

I work in a small rural CAH, where on nights I am often the only licensed person, so I have a Tech co-sign my wastes.

[aileenve]

Re: Who can witness a waste?

Anyone with a license RN or LPN

[TheCommuter]

Re: Who can witness a waste?

At my workplace, another licensed nurse (LVN or RN) must witness narcotic waste. No one else is considered suitable.....

[TheCommuter]

Re: Who can witness a waste?

Originally Posted by TazziRN

Since only licensed personnel can give meds, it only makes sense that only licensed personnel can witness wastes.

In many states, unlicensed medication aides freely give medications.

I have the pleasure of working with medication aides at my job.