Narc count

[dubspot]

I am a 8 month old new RN. I have a question about the "narc count". I work at a nursing home/rehab center. I usually work the 7-3 shift, and 9 times out of 10 the 3-11 nurse is always 15-20 minutes late. This is one particular nurse that is always late, and she typically works on the same days that I do. Giving her report plus counting the narcs usually take 20+ minutes. At 3:15 I gave up waiting for this particular nurse, so the other RN on the same shift and myself completed the narc count as we were waiting for the incoming nurse. I got a call the day after this event saying that I may get a written warning for counting with a day shift nurse instead of the incoming nurse. my question is, if the narc count was correct, no meds were missing, and the incoming nurse SIGNED the narc log saying that she counted with me.. can i really be written up for this?

[FineAgain]

We often do count for the day shift and the day shift often counts for us. Must be a policy thing at your facility? I don't understand what all the fuss is about as long as the count is right and two nurses sign it.

[Ruas61, BSN, RN]

If it is their policy that oncoming/off going shifts must count than yeah they can.

[applesxoranges, BSN, RN]

Read the policy carefully.

At my first two jobs (both rural EDs), the oncoming and offgoing nurses needed to count all the narcs together... any discrepancies fall on the offgoing nurse. This could not be skipped nor delegated/handed off.

It sounds like the problem isn't with the counting, it's one of tardiness... and that *needs* to be addressed (through department management).

[Been there,done that, ASN, RN]

It surely depends on your facility's policy.

Who called you regarding a possible write-up?

Why is the focus on this , instead of the real problem.... the chronically late nurse?

[dubspot]

It's not in our policy manual. All it says is "maintain correct narc count throughout shift". It doesn't say anything specific to counting with oncoming nurses. However our building did just get bought out by a new healthcare company. But they never gave us a policy/procedure manual..

[dubspot]

I've been having a lot of problems with this facility. If you guys can take a look at my other thread, I would really appreciate it. https://allnurses.com/nursing-issues-patient/c-diff-hallways-914197.html

It's not in our policy manual. All it says is "maintain correct narc count throughout shift". It doesn't say anything specific to counting with oncoming nurses.

Yet that is clearly and obviously the expectation and the practice... one to which yourself has been adhering.

Honestly, I don't see the issue you're having regarding the count. You know what you're supposed to do so do it.

If the oncoming nurse is late then address that issue. If you want to be passive-aggressive about it, say nothing but clock out accurately... the OT will get their attention, I promise you... though you may be unhappy with their response to you.

Really, you need to take the bull by the horns and address the issue of the tardy nurse.

[amoLucia]

A question - is the second signature space filled in (by the other counter)at the time you 2 count ... not waiting for the tardy nurse to come in and just sign off/in? Might that be the problem?

In reality, the intent of a count is that it should be reflecting the drawer status of the nurses who were directly & physically responsible themselves for the drawer. Is your 'substitute counter' counting again with the tardy nurse before she hands over the keys? Freq that doesn't happen.

What happens if the count comes up wrong between 3-11 and 11-7? You DID hand over the keys, but both the 3-11 nurses can fight over "NOT ME". Somehow the integrity of the count has be circumvented and now there's a problem. If there's an outside investigation, you'll probably be involved. And that can be messy.

Over the years the problems with narcotic diversion/theft has increased and has become so sophisticated at times. I think back on some of the 'innocent' alternative counts I've done early in my career. Would NEVER do them now!!!

And just think, your new corp may have had problems with their other facilities so they are esp scrutinizing your procedures for similar problems. And are you 100% sure there haven't been issues at your current facility that you just don't know about (say, on another unit)? You've only been there a short time - something is wrong somewhere and they're just being strict.

[Esme12, ASN, BSN, RN]

If the incoming late nurse singed she counted and didn't and your name is there...it's a problem

[MoopleRN]

...my question is, if the narc count was correct, no meds were missing, and the incoming nurse SIGNED the narc log saying that she counted with me.. can i really be written up for this?

If the incoming 3-11 nurse signed the count without actually counting and the count is off, it's on her because she's signed her name coming on. If you're signing the count with another 7-3 nurse who's leaving, who cares? The 3-11 can say *I* didn't sign the count was correct when I got here! and she'd be right!! She can swipe whatever narcs she wants then and it's all on you and the other 7-3 nurse because she hasn't signed/accepted the count with day shift.

You don't need to check your policy to figure out how to CYA, use your common sense. COUNT and SIGN WITH the 3-11 even if she's late. If you're not doing that and your policy only says the correct count must be maintained, then your policy needs to be rewritten. And if 3-11 signs that she counted with you and she really didn't, she's leaving herself wide open for you to help yourself... and possibly be investigated. CYA. CYA. CYA.

And I understand your frustration the she's often late, OTOH, you're getting paid to wait for her. Count your narcs correctly and you won't have to worry about it.