Do you always have an RN waste narcotics with you?

[uscstu4lfe]

Of course you know we are all supposed to have another RN watch us waste narcotics, like morphine, dilaudid, etc. Do the nurses at your facility actually follow this policy? At mine, I find that most just sign whatever the other nurse wants and doesn't really pay attention or doesn't even see the waste. When I'm wasting a drug I'll ask a nurse to sign for me... and go to show them the waste, and sometimes they won't even look! I am like Hello!? look at the waste! And they're like "yeah, yeah, yeah" and just sign and go back to charting.

[racing-mom4, BSN, RN]

Exact same at my facility. Part of the excuse is we both have to be standing at the Pyxis machine to witness the waste and our pyxsis is behind a closed door, rarely are we both in there at the same time.

In fact just last week another nurse and I were saying half the time the waste does not even get documented 1st time yet alone witnessed.

We just toss the glass vials in the sharps container.

Bad bad habit we are in.

[pielęgniarka, RN]

At my facility it has to be pharmacist + one nurse. We call up the pharmacist, he'll come over, go through them all together and flush 'em together. From what I hear that is unique.

Fun.

[vernRN]

I always have an RN waste narcotics with me, since the pyxis requires the other RN's password to complete the process.

[CoffeeRTC, BSN, RN]

No...most of the time it is the LPN. I don't have another RN on duty.

But, yes....I watch them, they watch me.

[mom4josh]

I was taught this procedure in school to always watch someone actually waste the med. When I first graduated, I stood there to watch my preceptor waste a narcotic as I had been instructed to do. She was so offended! She gave me the dirtiest look, and I wanted to crawl in a hole. But, I didn't know then what I know now. However, if I had even the slightest suspicion that a nurse was impaired or was using at home, you betcha I'd be right there watching (even if it was just carrying on a conversation, not necessarily letting on that I was watching).

[BrnEyedGirl, BSN, MSN, RN, APRN]

I've been burned twice in 10yrs by people I would NEVER have expected to be diverting narcs. I watch, even if it's from across the room. I'm in ER so our accu dose is not behind doors. If the narcs aren't wasted in the accu dose by 2 RN's the pharmacy sends out a report and someone is in trouble.

I have found that sometimes, when it's busy, I grab the vial, a syringe and a needle and find another nurse,.even if I need to go into a pt room. I say" hey Mary, I'm drawing up 10 of Morphine, giving 6, wasting 4." I draw up the 10, waste the 4 in the sink or trash and then as soon as the RN is free we waste it in the accu dose. If we get caught placing narc vials with meds in them, into the sharps container we are written up!

I've decided that if I go through the steps and the person doesn't' want to pay attention, and they are willing to sign, then they can explain at a later date, why they signed for my waste but didn't really watch!

BTW, the way I was burned was not watching the person draw up the meds. I watched the waste (clear liquid from a syringe into the sink) but I often hadn't seen her draw up the med.

[Straydandelion]

I won't sign unless I see and expect others to do the same. Usually if we can't catch another nurse on the floor, we can catch the charge or nurse manager, or even a supervisor.

[noc4senuf]

In MN my assistant and i gather all of the narcs to be destroyed (two pages worth) over the month and once a month the pharmacist coems in to destroy them with one of us.

In WI, I grabbed who ever was available, whether it was an RN, LPN, or TMA.

[scuba417]

I'm about to graduate in Dec. and work in the ER as a tech. The ER RN's always have another RN to waste narcotics with them.

[Quaffetti]

We usually just sign for each other without paying much attention. I pay attention if it's a nurse I don't know well, but if it's someone I've worked with for a long time I don't.

My feeling is, if someone wants to steal drugs, they will do it. What's to stop me from taking the morphine into a pt room, putting it in another syringe, and then filling the "morphine" syringe with NS, and then showing that waste to a nurse?

What's to stop me from giving my slightly confused pt tylenol instead of vicodin? Absolutely nothing.

Which is why I believe character is important in nurses. There are so many ways you could get away with things if you wanted to. Fortunately, I think 99% of nurses (and people for that matter) are pretty honest and decent.

[NurseCard, ADN]

Yeah, nurses where I work do that a lot.