MANUAL COUNTING OF NARCOTICS, help

Nurses General Nursing

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I am an RN in Texas. I work in a ambulatory surgery center with only 8 employees, 3 of which are RN's. On certain occasions I am the only RN in the center we close. My DON has said it is ok to have the receptionist, surgical tech, medical assistant or office manager co-sign my final narcotics count of the day. I just dont feel comfortable with this. What is anyones experience with this or any knowledge of the subject is appreciated.....

Thanks to you all

rosie

Specializes in Peds - playing with the kids.

i've worked in some small units before...but we always had to have 2 nurses sign.

i would certainly make sure there are 2 signatures in the narc book. i don't know the legalities but why don't you call the TX BON to find out? that way, you'll know for sure.

much luck to you!

leslie

Definitely check with your BON, normally it is two licensed personnel. Do you have a Dr. onsite then?

No, no, no!!!! LICENSED personnel, not any warm body that happens to be in the vicinity!! If the count were off or if there were any other problem, it would be YOUR neck in the noose!

Specializes in Med/Surg, Ortho.

NO,, i agree, i would want 2 licensed personnel to be signing that count. If someone cant administer it, they shouldnt be counting it. If they cant come up with a way for 2 licensed people to count they need to go to a pixus system so it can be controlled by a licensed pharmacist and only has to be counted weekly. That way your DON can be present and make sure she signs off on the count.

thanks to all of you so far that have given me you opinion on this. I definately agree with ya'll that it should be 2 licensed personel. I have approached the director with this, and in her own power hungry way she has said she rewrote the company policy to let the unlicensed staff count. Guessin I'm gonna give her the keys and look for employment elsewhere. On top of all this, I'm expected to pre-op and recover up to 13 pain mgmt patients alone in a 4 hour period. :eek: Agency is lookin better and better....

rosie

And have you checked with your state BON yet to know exactly for sure what the answer is? I think a doc could probably sign with you. Let us know. I'm curious.

thanks to all of you so far that have given me you opinion on this. I definately agree with ya'll that it should be 2 licensed personel. I have approached the director with this, and in her own power hungry way she has said she rewrote the company policy to let the unlicensed staff count. Guessin I'm gonna give her the keys and look for employment elsewhere. On top of all this, I'm expected to pre-op and recover up to 13 pain mgmt patients alone in a 4 hour period. :eek: Agency is lookin better and better....

rosie

She cannot override what is stipulated by the state Board of Pharmacy, and the DEA. It requires two licensed personnel. It can even be a nurse and a physician, as long as they hold a license. Where is your anesthesiologist is you are doing the recovering? They can sign as well. Just od the count before they leave.

Or just contact the Board of Pharmacy and let them handle it. Send a copy of the policy to them and see what they think.

thanks. I dont have the luxury of having a doctor or anestheologist present after the surgery. They bring em to recovery and split. Scary, huh. I will check with the state board of pharmacy. I was always under the impression it required licensed personel. I'm thinkin its time to find a new job, before I keep placing my license on the line. Thanks for the input.

Rosie

You are definitely correct, it requires two licensed personnel.

thanks. I dont have the luxury of having a doctor or anestheologist present after the surgery. They bring em to recovery and split. Scary, huh. I will check with the state board of pharmacy. I was always under the impression it required licensed personel. I'm thinkin its time to find a new job, before I keep placing my license on the line. Thanks for the input.

Rosie

Now wait- forget the narc count for a minute, I've gotten sidetracked- The anethesiologists leave while you're still recovering their patients! Is this after they "moved" (on paper anyway) from PACU care to ambulatory post-op care? I hope so! I think I just interpretted that wrong the first time. They certainly can't leave the minute the last pt leaves the OR. Even if there's still a point where your patients are all past PACU care, it sounds like you should have a second nurse anyway... for up to 13 patients!

I'm sure you need a second license for the count, too. I know when I work as the only RN on my floor I need to call the house super or borrow a med surg nurse to witness any wastes I have and also if we closed he unit (I just D/C'd the last peds pt... unit closed... I'm on call) I need another nurse to count before I go.

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