Do you always have an RN waste narcotics with you?

CaLLaCoDe, BSN, RN · Oct 25, 2008

Why just the other day when I was witnessing a waste, the RN I was witnessing for spoke of another who had not witnessed a waste and had her license revoked. It appears that the "trusted" colleague had swallowed the waste. I guess you could call it waste not want not. :bugeyes: :smackingf

Midwest4me · Oct 25, 2008

Our policy states we must have "two licensed nurses" waste narcotics which of course can mean two LPNs.

EarthChild1130 · Oct 25, 2008

When I worked in the hospital I ALWAYS watched and I ALWAYS grabbed another nurse for waste...they always got annoyed with me, but hey, it's my license...I don't care if they don't value THEIR licenses...I DO value mine!! :nurse:

shodobe · Oct 25, 2008

We use an Omnicell system in the OR so we have to use either an RN or one of the anesthesiologists. Waste can only be witnessed by these individuals.

GadgetRN71, ASN, RN · Oct 25, 2008

In my department the people doing the wasting are the CRNAs and the anesthesiologists. They will ask the circulator to waste with them and we all comply. Everyone follows the policy to the letter because there are just too many oppoutunities for abuse considering the drugs anesthesia uses. We have a pyxis and the witness has to put their finger on the reader as well.

MadisonsMomRN, BSN, RN · Oct 25, 2008

We have the policy of two nurses witnessing the waist and signing off that we both witnessed it. I am anal... because I follow the rules. I won't sign off unless I witnessed it.

hikernurse · Oct 25, 2008

I always double-check. From what I've seen, all the nurses in my unit do. Our doses are so small, I don't want to accidently give too much. As far as wasting, we are in a pretty small area, so it's easy enough to watch :).

GrumpyRN63, ADN, RN · Oct 25, 2008

My experience is just like racing-mom4, we never witness, just grab someone if they are near while its being pulled out(altho we never actually witness the waste), if not sometimes get someone to sign as a witness later, most of the time its not even documented and no one has ever been written up for it, altho I have worked with several nurses during the years who were let go for diverting , so they do track some things

OregonGal · Oct 25, 2008

What I understand is that my license is what is at stake. I won't sign as a witness if I haven't actually witnessed. Seems pretty darn clear to me.

Babs0512 · Oct 25, 2008

I either have another RN or anesthesia waste with me. Most of the time, much like others have stated, no one actually watches the wasting. I always watch, as I use to work in the ER with a nurse who was diverting. Most don't watch me. Heck, they know just thinking about Narc's make me puke!! If I was diverting and using, I'd be chucking all the time!!!

SunnyAndrsn · Oct 25, 2008

I've only had another nurse ask me to witness him waste a med once, but I was with him when he gave it. I do think he'd have asked me to witness it anyway. I've also asked other nurses to witness with me and they have.

We used to have a huge problem in our facility with our narc books, recently things have dramatically improved.

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.

MaryAnn_RN · Oct 25, 2008

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.

I work in the UK and if we have to waste narcotics (out of date for instance) then we wait till the unit pharmacist arrives (they do a Monday to Friday walk round the pts) and they do it with us. CD book is signed by both and that way our back is covered if there should be any problem.

If we have controlled drugs that are not required - say methadone, or fentanyl patches - then we return those to pharmacy as soon as the pt is off the unit. Our CD cupboard is quite small and usually full with what we use regularly.

If I have to waste part of an ampoule then personally I always make sure another nurse witnesses it, and we both sign the CD book entry i.e. 5mg morphine given, 5mg wasted.