Counting Narcotics Every Vist

[lifelearningrn, BSN, RN]

I've heard some chatter that this is proposed for the next round of regulations for hospice. What do you all think of this? I have a couple of problems with this- first, it assumes ALL patients are going to abuse their narcs, second- many people will be afraid to take them because they will be afraid of it LOOKING like they're abusing their narcs, and lastly, I am a nurse, not a narcotics officer. If the doctor prescribes a medication, I should NOT HAVE TO POLICE it. (In the HOME)

Now, if there comes a time when I suspect a patient or family member is abusing the drugs, I can see counting and getting things under control, but I hate the idea of it being mandated.

[caliotter3]

I went to a hospice case to do a continuous care shift where the family member told me that another relative, an addict, had stolen an entire bottle of morphine, so that I should be careful. Sure enough, when that family member came on the scene, their topic of interest was the whereabouts of the controlled medicine. Except for such a situation, I see less of a problem in hospice, than in regular extended care cases where theft can be a problem. On more than one case, I found the scheduled meds to frequently get "spilled", by one nurse, who only seemed to be clumsy when it happened with her apparently 'favorite' meds. The problem was made worse by the fact that the agency supervisors had no interest in dealing with the problem. They put me in an untenable situation when I requested accountability measures.

[TammyG]

I always look at the opioids every visit anyway, to make sure that there is an adequate supply. I don't see any problem with documenting the count. I hate to see any additional documentation requirements be put on case managers, but I don't see this as a big deal. I have not heard or read anything about this as a future regulation.