Narcotic count

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    The case I'm on seems to always have major issues and the "primary nurse" is lazy and making so many mistakes. The case manager makes every excuse not to jump in and either fix things or have a talk with the primary nurse (see med error post about this same nurse)

    I counted a narcotic and found after the primary nurses shift that is was about 7mL off from what she counted. I called the supervisor and asked her how she wanted it handled. I told her that I didn't think anyone was to blame specifically (and I reallly don't) but that because the family gives it when there are no nurses sometimes that it could be low because of that. I got a speech about how many ways it could be lower than it should be....like I didn't already know. The supervisor is VERY condescending. I was just wondering what she would like me to do since the nurse prior to me had one count and I had another that was 7mL less than the previous nurse. Its clear the previous nurse didnt' count the narcotics and just subtracted what she took out of the bottle without a second glance at it. So the supervisor told me I shouldn't count what is in the bottle ( I thought that was what the count record was for!!) She told me it would waste meds every time its counted (not 7mL...no way!) She told me just to subtract from the number I saw from the last nurse and not worry about the real count.

    I just don't want any trouble to come out of it. If I don't count like the supervisor requests I can get in serious trouble. If I continue to count it like I should the supervisor could get me for insubordination. Seems like I'm stuck either way.

    Any thoughts?
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    I would put the actual amount. At some point in time, in most situations, someone besides you would get their hair twisted, and decide to put the actual amount, instead of just subtracting. Then you, along with the others, would be under suspicion, because the supervisor would probably side with the accurate counter at that point in time. Seven ml is too much for normal loss. The supervisor should have advised you to put the correct amount and she would do a writeup to explain. Or, you could follow the supervisor's directions and make a written, dated, memo to yourself, quoting her. Use the 'mail it to yourself and don't open the letter' technique. It is too bad we have to deal with unreasonable supervisors as well as unreasonable coworkers. Accountability of controlled substances is too important a matter for the supervisor to take such a cavalier attitude about.


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