Missing Narc.....but for how long? - page 3
I found the missing narc thread but the last post was in 2008, so here is my issue..... Last night when doing the narcotic count, we were missing an ativan. You can visualize a card of 30......12 were punched out of the card... Read More
- 1Jul 4, '11 by Nascar nurse, ASN, RNQuote from nola1202and here's what drives me crazy. A nurse self reported herself to the board for diversion, she had been taking the liquid morphine and methadone, then adding water. We never noticed because the count was correct.
Isn't that the truth. They put all these systems in place to prevent diversion which is really just a pain in the arse to all of us who would never dream of stealing a medication anyways...but the real crooks can easily work the system. You could lay all this stuff right out in front of me, swear to me I'd never get caught and I have absolutely zero interest in taking any of it (for my personal use or to sell). But...I guess I'm just preaching to the choir.
- 0Apr 5, '13 by SuzieVNQuote from morningmomAt the facility that I WORKED at (long story there...I had to get out of that place)...We had a bottle of Roxanol that was about 4 mLs UNDER..yes UNDER. I couldn't believe it. I was the supervisor that night (rare occasion I was the supervisor w/o a floor assignment) and the LPN called me over to verify. The DON just happened to be there....I took the bottle and the Narc sheet right to her and her words were "How do you know it is under, the numbers on the bottle are never the real amount anyways..." Ummm yeah you are right but 9 times out of 10 the amount is over by up to 1 or 1.5 mLs at best, not under the count...and if it is under, it is very little.
UGH...that place still gives me the twitches when I think about it.
Impossible to be accurate with this- the stuff needs to come in premeasured doses in glass vials. Those plastic bottle and droppers get nasty anyway- I've seen nurses put them into a patients mouth and make contact.
- 0Apr 6, '13 by AngelRN27One simple "trick" I use during narc count if the bingo card has tiny pills (such as Ativan) is I shake the card. This way, all the little pills move in their bubbles. Nine times out of ten, your eyes will instantly catch if one of the bubbles that should be full doesn't have a little pill hopping around inside like the rest of them do.
- 0Apr 6, '13 by stardust80916Quote from MHSA LPNI've never heard of that practice and I've been working in ALFs for 5 years. We documented missing pills in the narc sheet. Never in the MAR. Now I have seen people refer to the MAR as well as the narc sheet to make sure all pills were double accounted for. If the situation did ever arise, we were to call our RSD for further instruction. Usually we'd be told to document the missing pill on the narc sheet with explanation as well as write an incident report. Both QMAPs would have to sign the narc sheet.The protocol was to "make the MAR reflect the medicine on hand"