Discontinued Narcotics

[makes needs known]

I work on a very busy sub acute rehab floor with a pretty steady turnover of patients. We keep our narcotics locked in a lock box and count them at the change of q shift. We currently have alot of dc'd narcs, pts that went home, pain med orders that were changed or dc'd, pts who have died. We have 7 packages of different dose fentanyl patches, some roxanol syringes, blister packs, bottles of pills, and 1 huge bottle of 240 pills. We are supposed to count all of this at every shift change. We have requested that they remove these:#1 because it takes a really long time to count all these along with all the narcs being currently used, and#2 this is a potential problem if we have a staff member with a drug problem. I think there are rules about how long we should hold onto them, we have patches from someone who died over a month ago. Does anyone have this problem in their facility? Any ideas about who to contact?

[Silverdragon102, BSN]

Can you not contact your dispensing pharmacy and ask them to collect and destroy? Although in Canada I know this is what we do at the facility I work at

[VivaLasViejas, ASN, RN]

Are the floor nurses at your facility not allowed to destroy narcs with another nurse, or does a supervisor have to be involved? I think most places prefer a manager to be one of the witnesses, so if your facility requires a DNS or RCM to witness narcotic destruction, you may have to be proactive and ask them to assist you. Suggest that a time be set up every couple of weeks for this to be done, and remind them........I know that as a busy DNS, I don't always put this at the top of my priority list, so my resident care coordinators and I have scheduled days twice a month when we get together and destroy narcotics.

Or, if someone dies or the D/C'd narcs start taking over the drawer, the med aides tell us and we'll get rid of the drugs in between our scheduled days. I was a floor nurse myself not too long ago, and counting zillions of unneeded meds twice a shift was a waste of valuable time, so I'm pretty proactive about getting this done to help the staff.

I wish you luck. Destroying narcotics and dealing with the paperwork is a huge PITA, which is why nobody enjoys the process; however, it has to be done, and if you do it regularly it's less of a hassle. Good luck.