Dilemma with Narcotic Med Count - page 4

I work at a LTC facility as a new nurse for 2 months. I work 3-11 shift, well last night when the new DON came on to work 3rd, we did our narcotic med count as usual, the count came up correct, we... Read More

  1. by   Santana
    In my experience with counting narcs, one way this could have happened is : One nurse is verbally calling out the number of narcs on the narc sign out sheet while the other nurse is verifying the count by the number of narcs remaining on the cards. This can also be done visa-versa. Keep in mind that this method usually does NOT have both nurses standing side by side while both nurses witness the narc sheet count and the narc card count which is the ONLY SAFE way to know for sure one of the nurses didn't call off an incorrect count.

    As far as being concerned about this, I disagree with the others......this DON didn't get where she is by being a sweet, noble , person. They are snakes and NOT to be trusted!

    But.......that's the way I see it. This is the way I have seen it for years......
  2. by   nurseangel78
    Quote from Reigen
    At the LTC where I work, any time a narcotic count is incorrect, everyone in all departments who worked on that shift has to have the random drug screen done, and the person who last had the medication passing job is not allowed to pass medications until the results are back and are cleared. In the past 3 years, I have had to give my "sample" twice, and I am the MDS Coordinator! Perhaps a new policy is in order to cover this? I would suggest that to who ever makes new policies, so that there is a protocol to follow should this ever happen again.
    Just my $0.2 worth
    I think at the next nurses staff meeting, this issue should be brought up.There definately needs to be a policy on what to do if this happens again because I don't want to be blamed again for something I didn't do. I feel like since I'm so nice about everything that I always seem to get ran over by most people and they think they can take advantage of my kindness. I don't trust the DON now after what happened. I will keep doing my job just like I always have and try not to think about what happened.
  3. by   Daye
    as a student, but working in the field of medicine for many years i can honestly say this is something that will really help me in the future to be very careful and attentive of so that i can hopefully avoid this same situation myself. thank you for sharing a very important insight and personal experiance. daye
    Quote from nurseangel78
    ok, gotcha! thanks.
  4. by   Daye
    As a student, but working in the field of medicine for many years I can honestly say this is something that will really help me in the future to be very careful and attentive of so that I can hopefully avoid this same situation myself. Thank you for sharing a very important insight and personal experiance. Thanks
    daye
  5. by   LPN1974
    Quote from longtermcarern
    a couple years ago, I had the nurse who followed me change the numbers on the count sheet to reflect differently from what we counted together. When the DON called me I was able to remember exactly how many pills were left in a particular residents packet and she could see the numbers were changed so she knew I was telling the truth. The other nurse was let go, but a copy of that count sheet would of been a life saver for me had she not believed me. Now I put my numbers in a way no one could ever change them. I print the whole number on the individual sheet and fill the box on the other.
    I was wondering how you mean you print the whole number?
    Don't we do that anyway? If it's a single digit number I print like 04, or 07, etc.
  6. by   longtermcarern
    Quote from LPN1974
    I was wondering how you mean you print the whole number?
    Don't we do that anyway? If it's a single digit number I print like 04, or 07, etc.
    Our individual sheets have an area for date/time, number of pills dispensed, signature and remaining pills in packet. so I always do it this way:
    3/5/5 1800 one (1) longtermcarern twentynine (29)
    Our pills come in a packet of 30 so if I give one and there are 29 left I spell it out. each resident has there own packet and you can not borrow from resident to resident.
    Last edit by longtermcarern on Mar 5, '05 : Reason: add more info
  7. by   LPN1974
    Quote from longtermcarern
    Our individual sheets have an area for date/time, number of pills dispensed, signature and remaining pills in packet. so I always do it this way:
    3/5/5 1800 one (1) longtermcarern twentynine (29)
    Our pills come in a packet of 30 so if I give one and there are 29 left I spell it out. each resident has there own packet and you can not borrow from resident to resident.
    I see....very good idea, except our narcotic books that we use don't porovide enough space to spell it out. Just enough for date, time, amt fowarding, amt. used and pharmacy refill, amt. remaining, and signature.
    That's a great idea tho. Then these nurses who like to write over stuff in narcotic books would be even more discouraged in doing so. You can't write over a word and change it like as good as you can a number.
  8. by   explorer
    Quote from LPN1974
    I see....very good idea, except our narcotic books that we use don't porovide enough space to spell it out. Just enough for date, time, amt fowarding, amt. used and pharmacy refill, amt. remaining, and signature.
    That's a great idea tho. Then these nurses who like to write over stuff in narcotic books would be even more discouraged in doing so. You can't write over a word and change it like as good as you can a number.
    You counted the drugs, count correct, give oncoming keys. Case Closed.
  9. by   Fallen Angel
    She's one I wouldn't wish to be working with. What's her reputation..history?
  10. by   kadokin
    This thread brings up some ?s for me. We do a weekly narcotic count on my psych unit for the pyxis. I am amazed at the nurses who want to do a "call and response" type of count. . . .i.e.-one person calls out the count on the pyxis screen, the other person actually physically counts the meds. To me, this is just careless. BOTH nurses need to count the physical meds AND check the computer count. I am constantly amazed at how sloppy our practice can get.
  11. by   burn out
    I love our accudose machine...we never have to count anymore.
  12. by   Jerimiah29:11
    I have a question. I am worried sick about a situation. I counted narcotics with the night nurse and they were correct, then I work a 12 hr shift. I have a pt who takes a narcotic routinely. I sign the narc book before I pull the pill, so I don't forget. The count that night came up with 2 EXTRA pills than there should have been - which I guess is better than 2 less, but still, I may have forgotten to give her the pill that morning - which would have only made the count off by 1! I told the supervisor who just said to write the 2 numbers to the side instead of wasting the pills to make the count correct. I am a new nurse (4 month). Can I get fired for that?

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