Can a narc count be invalid if the offgoing nurse counts the meds instead of sheets?

[tybutler74]

I was coming off a shift and I counted narcs w/ oncoming nurse. I counted the meds, and she read the sheets. Our count was good, she signed and took the keys. About 5 hours into her shift a narc came up missing- now she is trying to blame me, and they said something about the count was invalid b/cauz i was the offgoing nurse. What???? I am a new nurse and nothing was ever said about who counts what when, and I don't remember anything about it from school. Also, she is a vetran nurse and she should have said something to me if I was doing it wrong---??/ Obviously, I am a newbie, my first job.

[nightmare, RN]

If your facility has policy and procedures books,read up on handling and counting narcs.It should tell you exactly how they want it done,well ours does!

[bill4745, RN]

See what the policy is. It is best if the incoming nurse counts the actual narcs. If she says you were in the wrong for counting them, then she is as guilty as you are, and maybe a little more. If I was the incoming nurse, I would want to be counting them myself.

[nursemary9, BSN, RN]

When we counted narcs at end of each shift, oncoming nurse counted the actual narcs, outgoing took the book; we had a written policy.

Now we have pyxis---much better!!

[TazziRN, RN]

Depends on what the policy says. Where I've worked it didn't specify which nurse did which task during the count, but many places do. If that is the policy at this LTC, the oncoming nurse is more to blame than you are. You, as agency, should not be expected to know the P&P for every single hospital you go to, just your state's Nurse Practice Act. The facility nurse, however, is expected to know the P&P for an everyday chore like counting narcs. If you were wrong to count the meds, then she should have said something and should not have accepted the keys at the end of the count. The fact that her signature is there makes her just as responsible for this is as you are, even more, and she should be called on the carpet too.

[indigo girl]

I've worked in a few hundred LTC's as an agency nurse. I have had a few good scares too, enough to make me very careful before I sign that narc book.

Usually the oncoming nurse counts what is in the drawer or box. If you want to be really safe, it is better for both of you to look at the book while you are counting.

The person with the book, usually the off going nurse could be very tired and stressed. She may read a number wrong, and you could end up short a pill. It happens. It could happen on purpose. You need to know that what is on that page is what is in the drawer, and you should not just take her word for it.

Coming up short is scarey. I really feel for you. I think most of us have been there, but it usually gets resolved.

She should have looked at the book with you.

[cappuccino]

Well just let this be a learning experience. When we count at my job, we're both looking at the amount that's being counted. I like to take the meds out and count them w/ the other person so they're acknowledging the amt. It takes a tiny bit longer but it verifies that 2 rns saw the same amount............

[CaLLaCoDe, BSN, RN]

i've worked in a few hundred ltc's as an agency nurse. i have a few good scares too, enough to make me very careful before i sign that narc book.

usually the oncoming nurse counts what is in the drawer or box. if you want to be really safe, it is better for both of you to look at the book while you are counting.

the person with the book, usually the off going nurse could be very tired and stressed. she may read a number wrong, and you could end up short a pill. it happens. it could happen on purpose. you need to know that what is on that page is what is in the drawer, and you should not just take her word for it.

coming up short is scarey. i really feel for you. i think most of us have been there, but it usually gets resolved.

she should have looked at the book with you.

i could not have given better council than this. really smart nursing to prevent worries down the road while at work and at home. kudos indigo!

[catlynLPN]

Our oncoming nurses take the pills and off going take the books.

But where I work we have some nurses from dayshift that don't watch the book carefully enough and we will end up with discrepancies after they leave. The reason that we know it's a dayshift discrepancy is because we set up all of our narcs for the night....{this is due to the way we have to go give meds, would be lengthy to explain} and then we count again after we have set up our narcs.

If there's a mistake we find it before we've ever given a narcotic on the PM shift.

Alot of times we find where they didn't sign for something or put down the wrong number.

It's nearly every single day that this happens.

The best safeguard we have from having to accept the error ourselves is because we count again before we've given any meds, but not all places can do that.