I've had a problem with how our facility handles this. I also have a very hard time convincing some of the nurses to stay and do the count with me. This was NOT solved when I went to our DON and asked HER to count with me. Yes, she yelled, yes, she fussed, but in the end we have some nurses who tape their report, do not count with anyone else, and just leave.
We had a situation this week where 1/2 way through my shift DON asked for the keys to my cart and told me an entire card was missing from my cart. I had done the count myself (she asked me if I counted, I said, yes alone) and she went over the count with me. Initially it looked like there was an entire card of oxycodone missing. Then we went back to the start date, the amount of pills used each day, and low and behold the number that one of the nurses had written down was wrong--and everyone just subtracted two from that point. So it looked like 30 pills were missing.
And yes, I counted wrong--all my DON has said was "well at least your trying to count them".
The nurse I relieved was very irritated with me last night when I wouldn't take the keys to her cart until she counted the narcs with me.
We also have a problem with nurses who do not go through the proper disposal procedure and/or removal procedure when pts. are discharged or die. When I looked through our book this last week, every single item removed for disposal was initiated by me. I've been complimented on this, "your coworkers will love you for this". I guess I don't understand why anyone else wants to keep this stuff around when it's not needed.
Quote from medsurgrnco
Wondering how other facilities deal with narcs missing at the end of the shift. We do not have a pyxxis machine, use blister packs kept in a locked area, several nurses get meds out during the shift, and have 2 nurses do narc count at the end of the shift.
Also wondering if travel nurses have been involved at a higher rate in taking narcs at facilities. I have nothing against travel or agency nurses, but in our situation we had recently hired a travel nurse and the other nurses that worked that shift had been employed with the company for quite some time.