Theoretically, narcs are counted by two nurses one going off shift and one coming on. The one coming on is checking the count to make sure that the person leaving didn't take anything. If it is all cleared at the beginning of your shift then you now take responsibility for the narcotics from the beginning of your shift until the end of your shift. This includes making sure that all narcotics are logged out correctly in the MAR and in the Narc record book as per facility policy. This also includes the often overlooked detail of not keeping your keys out on your med cart but IN YOUR POCKET and not giving them to anyone--even to fellow nurses if you are not going to be in their presence. The narc box on your med cart MUST ALSO BE LOCKED! These are "small" details
that nurses often fail to remember in the rush rush of our days.
NOW: to answer your question.. Often times if the narcotics are unaccounted for regardless of whether you took them or they just "went missing" (which i just can't see happening) they are your responsibility if you are the licensed professional who accounted for them. Like I said you are responsible from the beginning until the end of your shift so you must make sure that the count is correct when you come on your shift otherwise it becomes YOUR burden. It is NOT better to lie about taking the narcotics..obviously if you do not know what happened to them I would rather be written up for leaving my keys out on the med cart than admitting to stealing narcotics (that I really didn't take) although both are grounds for dismissal the latter could be grounds for the reposession of your license. If a nurse is CAUGHT stealing narcotics they are usually terminated immediately and referred to a rehab program & therapy... it is at the discretion of the state board to decide if the person needs to have their license revoked.. I have heard of nurses who have been caught with needles stuck in their legs on the bathroom floor DURING a shift being recommended to rehab programs and keeping their licenses although they were never allowed to work with narcotics again.
I think that narcotics are one of the BIGGEST responsibilities of a licensed professional and therefore I recommend treating it as such. DO NOT LOSE OR STEAL THEM.. its never a good outcome.