not counting narcotics anymore

Nurses General Nursing

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I went to work last night and found out we don't have to count all narcotics anymore, just certain ones. I am puzzled. I thought it was required by the state or something?

We used to spend several minutes at each shift change counting them, mostly Lortab and Ativan for our residents. But now we only count Duragesic patches and certain drugs, like morphine or something. I find it odd to have to count the patches. Seems someone would be more likely to steal a pill than a patch.

Specializes in Critical Care/ICU.

The pyxis keeps our counts continuously. We don't do a q shift count, per se, of anything. But the med is counted by the RN removing it each time a slot or drawer is accessed. Ya know...pyxis.

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Specializes in Critical Care/ICU.

The pyxis keeps our counts continuously. We don't do a q shift count, per se, of anything. But the med is counted by the RN removing it each time a slot or drawer is accessed. Ya know...pyxis.

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Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

I'm shocked too.

I took care of a patient that went into respiratory arrest after he stole his dad's duragesic, opens it and swallowed the contents.

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Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

I'm shocked too.

I took care of a patient that went into respiratory arrest after he stole his dad's duragesic, opens it and swallowed the contents.

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Never counted Ativan, it was just considered ward stock. Still have nightmares over Tylenol 3's though, and how often have you seen Tylenol 4?

Morphine syrup was the worst. Never used after the patient left and pharmacy wouldn't come and take it back. Those little marks on the med bottle, I'm sure they're responsible for the new bifocals...

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Never counted Ativan, it was just considered ward stock. Still have nightmares over Tylenol 3's though, and how often have you seen Tylenol 4?

Morphine syrup was the worst. Never used after the patient left and pharmacy wouldn't come and take it back. Those little marks on the med bottle, I'm sure they're responsible for the new bifocals...

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Where I work we give mostly Phenobarb, Ativan, Xanax, Lortab, Valium. We count it all, every shift. I've never been in a place that didn't, nor would I want to be.

I know a nurse who got a Duragesic patch and drew up the contents in a syringe and injected it into her vein. She almost died, and would have if someone hadn't found her when they did.

I worked at nursing home once, I came in to count at the beginning of my shift as usual, and there some Oxycontins in a bottle.....there were alot of them, like up around 90 or 100 if I remember correctly. {All the other narcotics were blister packed except this bottle.} Some of the nurses had gotten lazy and didn't count them every time. They TRUSTED each other. They would say, "Well, so and so on previous shift said they were right." Well, I'm sorry, I don't trust my own mother when it comes to Narcotics...she's not perfect either. So...I proceeded to count those Oxycontins, and guess what....about 11 of them were missing.

Guess who got sent home right then and suspended for several days until the investigation was completed....the nurse I relieved! To be fair, tho, she took a drug test and it was negative. They eventually thought another nurse got them. It couldn't be proved, but she refused to take a drug test, so she was fired.

Now what if I hadn't counted those pills and then the nurse who came in to relieve ME decides she wants to count them? I would have been the one to be sent home.

No, ma'am, if I relieve you, or if you relieve me, we're going to count...ALL of them.

I'm not going to be held responsible for something that was short before I got there.

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Where I work we give mostly Phenobarb, Ativan, Xanax, Lortab, Valium. We count it all, every shift. I've never been in a place that didn't, nor would I want to be.

I know a nurse who got a Duragesic patch and drew up the contents in a syringe and injected it into her vein. She almost died, and would have if someone hadn't found her when they did.

I worked at nursing home once, I came in to count at the beginning of my shift as usual, and there some Oxycontins in a bottle.....there were alot of them, like up around 90 or 100 if I remember correctly. {All the other narcotics were blister packed except this bottle.} Some of the nurses had gotten lazy and didn't count them every time. They TRUSTED each other. They would say, "Well, so and so on previous shift said they were right." Well, I'm sorry, I don't trust my own mother when it comes to Narcotics...she's not perfect either. So...I proceeded to count those Oxycontins, and guess what....about 11 of them were missing.

Guess who got sent home right then and suspended for several days until the investigation was completed....the nurse I relieved! To be fair, tho, she took a drug test and it was negative. They eventually thought another nurse got them. It couldn't be proved, but she refused to take a drug test, so she was fired.

Now what if I hadn't counted those pills and then the nurse who came in to relieve ME decides she wants to count them? I would have been the one to be sent home.

No, ma'am, if I relieve you, or if you relieve me, we're going to count...ALL of them.

I'm not going to be held responsible for something that was short before I got there.

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Specializes in ICU.

1) ask to see the policy for the facility regarding this. It is too late to claim "someone told you" when the proverbial has hit the fan

2) check with your pharmacist. He/she SHOULD know the scheduling for each drug and the legal requirements. If they don't they will be able to tell you where to find the relevant legislation.

Good luck!!!

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Specializes in ICU.

1) ask to see the policy for the facility regarding this. It is too late to claim "someone told you" when the proverbial has hit the fan

2) check with your pharmacist. He/she SHOULD know the scheduling for each drug and the legal requirements. If they don't they will be able to tell you where to find the relevant legislation.

Good luck!!!

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Specializes in Med/Surg, Ortho.

What i find strange is we count injectable ativan, but dont count it in pill form since it comes in the patients cassette from pharmacy. Go figure, but i know i usually keep very close eye on xanax, ativan, librium when we have patients on the floor that have been ordered these. I have had patients pills come up gone, but patient reporting they didnt take it. The nurse says he did. All you can do is report it. So i keep a close eye from then on, i check when cassettes are replaced and make sure they are still there if not signed off at the end of my shift.

As far as the locked narcs. We still do shift counts with oncoming nurse counting the drawer and offgoing nurse verifying with the book count.

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Specializes in Med/Surg, Ortho.

What i find strange is we count injectable ativan, but dont count it in pill form since it comes in the patients cassette from pharmacy. Go figure, but i know i usually keep very close eye on xanax, ativan, librium when we have patients on the floor that have been ordered these. I have had patients pills come up gone, but patient reporting they didnt take it. The nurse says he did. All you can do is report it. So i keep a close eye from then on, i check when cassettes are replaced and make sure they are still there if not signed off at the end of my shift.

As far as the locked narcs. We still do shift counts with oncoming nurse counting the drawer and offgoing nurse verifying with the book count.

Up Vote Up Vote ×
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