3 day on med carts, 4th day on the floor as a new LPN.. Narc count...!!!!

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:angryfire

So I feel as I haven't been properly informed about narc counts in the skilled facility I have been hired on to until it comes up that a pack of narcs turns up missing on my cart shared with another nurse that is my preceptor. And we can a very well lessoned learned... Trust no one and be a b*tch about the narc counts even if the person doing it with you is in a hurry to chart to go home.

What gets me is in the narc book that has the counts in it had several papers and empty packets of the drugs that have to go to the DON. Two nurses have to sign these empty packets out of the cart to be delivered to the DON. But these nurses are signing them out and taking them out of the cart without getting a second nurse to sign for them. Come to find out after I have been informed of the missing packet that this is the same cart where a nurse was busted and fired two weeks ago for diverting drugs for personal use.

There is sign in and sign out sheets for each patient where a label of the drug is placed on this sheet and checked in by two nurses, and this same sheet must be signed out by two nurses when this packet is perm moved out of the cart to be given to the DON for either to be destroyed left over narcs or for records that these drugs are being given to the patients. Then there is also sheets that you actual do the number count for each drug. Well I was 'taught' in orientation that you go by the numbered sheets, not the sign in/sign out sheet. So today during the drug count with the day shift nurse she reads off the numbers from the book and the name of the patient and the drugs checked out fine. However my preceptor did the drug count at the end of the shift cause I requested that she did it cause she pulled allot of narcs out for our patients and not signing them out as she goes. And during that narc count they actually counted the packets per a patient first on the sign in/sign out sheet then the number left on the card.

Which from now I will use this method seeing how the DON was called at midnight over this matter. The supervisor thinks that these drugs were taken off properly off of the cart but just never taken off of the sign in/sign out sheet properly. But I'm thinking, it was only a week since a nurse was busted with this cart about the narcs and diverting for personal use... What IF this nurse diverted these as well and it wasn't caught until now? What if I get the blame for this?

Needless to say, I'm a bit freaked. Tonight was overall stressful anyways. Cause this book was full of empty packets being crammed in the folders and these nurses not taking care of them and the responsibility is being handed off to the next shift. Which I wouldn't mind taking these empty packets to the DON with my signature on them, BUT this is my first time EVERY on this floor as of tonight and I had no clue rather or not these drugs were actually delivered to the patients and I wasn't about to put my name to it and then hand it to the DON.

Lesson learned.. but I'm anxious to see what these next few days will be like for me.. if I even have a job when i get back.. BAH!!!! :(

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Be careful on the the counts. I came up short *a* vicodin two weeks ago and, while it was not something that I got into trouble for, I know how you feel. And it was the same thing - the offgoing nurse was in a real hurry and rushed throguh and I didn't slow her down. No more.

We have gone to a bound ledger so sheets can NOT be removed. Yu might want to mention something like that to your DON.

And good luck.

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I am so sorry that you have to face this, but it is a critical part of learning for nurses. At one time, it was hospital policy that no one could leave until the narcotic count was correct. Assume nothing. You won’t be disappointed!

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I'm in the clear. come to find out it was one of the packets that the nurse that they busted stole but was never removed from the sign in/sign out sheet.. A very valuable lesson learned for me that's for sure. Maybe I can get some sleep tonight!!!

I just wish there was better orientations for new grads about these things that seems like most people these days take it forgranted.

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Vexed, also, do NOT share keys to the counted marcs for which you have signed off. Period.

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Something similar happened to me a while back.... nothing came of it luckily.....

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Specializes in L & D, Med-Surge, Dialysis.

similar situation happen to a friend. Why narcotics not excedrin?

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Specializes in Derm/Wound Care/OP Surgery/LTC.
Vexed, also, do NOT share keys to the counted marcs for which you have signed off. Period.

Best. Advice. Ever.:yeah:

Heed the advice Sue just gave you. Even if it means you have to get a little ugly sometimes. Don't let ANY nurse intimidate you into handing over those keys no matter what. I am telling you this from personal experience. Don't let the lesson ever be lost on you. You protect your license at all costs.

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For orientation I have to share keys, but when they stick me with a nurse that pulls narcs out without signing them out immedietly I hand back over the keys and they gladly accept them back and understand.

The past couple of nights though I have had med carts all to myself so that hasn't been a problem.

Only two more weeks on orientation... hooray~

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