cnas and end of shift med. count

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I am a CNA and work in an assisted living facility. Like most assisted living facilities this place has its share of issues. I know I can not give meds. But I am expected to do the end of shift med (narcotic) count with the LPN. I work second shift 3 to 11 and the nurse leaves at 9. The next LPN doesnt come in until 5 am. Third shift cnas come on at 11. The med room is not locked and the keys to the med cart are accessible. So if I count with the nurse verifying that the count is correct when I leave, if something were to happen to the narcotics, who would be reliable? The nurse , me or both? This is the first place I've worked were a CNA was expected to count with the nurse. And I want to know if something happen if I could be responsible.

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Specializes in Ambulatory Care-Family Medicine.

The policy everywhere that I have worked is that it has to be two licensed people to do the narc count (nurse, PA, NP, physician). I would tread very carefully if your facility is having unlicensed staff (CNAs and med aids) count narcs. Also if you are doing narc count so the nurse can leave you are essentially assuming responsibility for that med cart.

Also how are they getting away with not having a nurse in the building all night long? I'd be very careful if I were you. 😳

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Specializes in hospice.

No way in hell would I allow my employer to make me responsible for medications I can't even legally touch. I actually had to do battle with my boss about a similar issue regarding scope. When your butt ends up in a sling with the BON these people WILL NOT be there to defend you! I think you need to find another job. This place sounds like a disaster waiting happen in about ten different ways.

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Look into what your state does or does not allow. In Washington state, nurse delegation allows CNAs to pass medications if they are properly trained. I am required to do a narc count at the beginning and the end of my shift as a "med assistant". I am allowed to give narcotics, and I do on a regular basis.

You probably were not trained properly in how to count unless you have had training/certification. It would be extremely easy for a nurse to trick you during count. For example, I was trained to always look at both the Med cards and the books before you sign off. A lot of nurses have one person read the book while the other reads the cards aloud, and you just trust that the nurse is telling the truth. I have heard of nurses stealing narcotics by lying as they read the number aloud. It is your fault if you sign off and the count was off, even if it was not you who stole the medication. This is why proper training is essential. Lots of dirty tricks like this if you aren't aware.

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Specializes in hospice.

Arizona allows CNAs to be trained as med techs too, in certain kinds of facilities. But a CNA who does not have such training is violating scope by being responsible for medications in any way except assistance with self administration, like reminders or help opening difficult packages for a client who then takes the med themselves. OP did not describe him/herself as a med tech, only a CNA.

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Specializes in OR/PACU/med surg/LTC.

I believe here in ontario PSWs ( which I think is the equivalent to CNAs) can do a shift count with the registered staff but the oncoming registered staff also has to sign it (after they count as well) when they come. We don't do it because it's easier to wait for the oncoming nurse. Sometimes we will ask our manager (who is a registered nurse) to count if they are available.

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Specializes in PCT, RN.

What a nightmare. I would have nothing to do with that.

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Arizona allows CNAs to be trained as med techs too, in certain kinds of facilities. But a CNA who does not have such training is violating scope by being responsible for medications in any way except assistance with self administration, like reminders or help opening difficult packages for a client who then takes the med themselves. OP did not describe him/herself as a med tech, only a CNA.

My points were:

1) OP should look up the laws in their state. Then I stated Washington's laws since some people think CNAs are never allowed to give medications, count, etc. when in fact they are allowed under some circumstances.

2) Even if their state allows it legally, OP should refuse to count unless properly trained because if something were to happen, the blame would fall on them.

Those were my only two points. The advice to jump ship is not always helpful for everyone depending on their circumstances. My advice was simply an alternative to quitting, although I do agree that the facility the OP is describing sounds sketchy and I personally would avoid it if at all possible.

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As with any job in any sector, excrement rolls down hill. If the state were to fine your employer, it won't come down on just the upper management, but on you and you would bear the brunt of it. In my state, it is legal for med aides to count narcs with the LPN coming on as the charge nurse if it is in a nursing home. In a hospital, only RNs can do narc counts.

Some food for thought if you are debating whether this is a good fit: When I worked in a nursing home, we had a PRN RN who was notorious for borrowing narcs from one patient when another was out and not marking it on the narc sheet. What would happen if you were put in that position and the nurse going out didn't make a note but you signed off that the count was correct and an investigation into missing narcs came about?

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Specializes in LTC.
I am a CNA and work in an assisted living facility. Like most assisted living facilities this place has its share of issues. I know I can not give meds. But I am expected to do the end of shift med (narcotic) count with the LPN. I work second shift 3 to 11 and the nurse leaves at 9. The next LPN doesnt come in until 5 am. Third shift cnas come on at 11. The med room is not locked and the keys to the med cart are accessible. So if I count with the nurse verifying that the count is correct when I leave, if something were to happen to the narcotics, who would be reliable? The nurse , me or both? This is the first place I've worked were a CNA was expected to count with the nurse. And I want to know if something happen if I could be responsible.

NO....Just no. OMG..NEVER do that...I don't care who tells you to.

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Specializes in LTC.
No way in hell would I allow my employer to make me responsible for medications I can't even legally touch. I actually had to do battle with my boss about a similar issue regarding scope. When your butt ends up in a sling with the BON these people WILL NOT be there to defend you! I think you need to find another job. This place sounds like a disaster waiting happen in about ten different ways.

Very well said!

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Cover your ass. Its easier for them to fire non licensed employees. Don't continue to count tell them it makes you feel uncomfortable and if it pursues contact board of nursing

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