Narc count---missing meds...

Nurses General Nursing

Published

Specializes in Surgical Center/OR.

ok, i am ashamed of myself. i feel awful and scared. i work at a surgical center that is growing. new people left and right. we used to be very small. our narc counts are sloppy. i mostly push fenanyl and versed all day. the amounts we give are crazy sometimes. we will count alone, then later get someone to sign...well, today....i forgot to count in the AM and at the end of my shift there was 7 missing fentanyl and 3 versed. of course fentanyl is the only one regulated by DEA but 7 vials? this is alot of meds. i am in huge trouble. i should just hand over my license? we all leave the room with meds out. sometimes drawn up already. (not guilty of that one though) and we all co- sign later....the DON doesnt even know what we need to do yet. i am sure the DEA will need to be notified. i offered to pee on the spot. i feel like the worse nurse ever. but the question is....who the hell took it? theres no way i could have screwed up 7 times in one day. will i really lose my license if its not found? will i get fired on the spot? i just got another raise for Gods sake. never been written up. i just feel like i am losing it. so ashamed at how sloppy we have been. now i am feeling so stinking stupid and worried. :uhoh21::cry:

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Specializes in Mental and Behavioral Health.

If you forgot to count in the AM, how do you know they are missing? Maybe someone used them, and didn't sign them out yesterday. You might find a reasonable explanation for what happened with no stolen drugs, and no ill-intent, but only if you pull yourself together, and keep your head. Get everyone together and figure out what happened. You are only partly be blame for this sloppy practice that was being used by everyone at the facility. This is one of those clarifying moments for everyone involved. This is a learning opportunity. You have to come up with a better way to account for your narcs. That, I think, should be obvious to everyone. Don't take the whole blame for a facility-wide problem. You could very well end up the sacrificial lamb here, but that still doesn't mean this is all your fault. Everyone's license is in danger when things are done that way. It should never have been allowed to happen the first time.

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Not being a nurse.. just using logic here.. As long as you're not the only person pushing fenanyl and versed then it shouldn't fall solely on you. You can test clean.

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Specializes in Trauma & Emergency.

Well it kind of sucks that you COULD end up being the scapegoat on this regardless if it is poor facility protocol/practice. Narcotics are supposed to be counted with one nursing coming on and the nurse leaving. Once everything is rectified with the count the nurse coming off her shift RIDS herself of the responsibility to the narcotics count and it now becomes your problem and it is unfortunate but I think that that is what it may come down to. I don't know if it's the same everywhere but at my facility if the narcotic count is not matched up with the log the nurse that is LEAVING her shift is not allowed to leave the building until the count is either figured out or the DON is notified of the situation. So as this may not be ALL YOUR fault (it's DEFINETELY not) you were responsible for the narcotics that were missing between the time you came on and the time that you left. I know how everything becomes busy and we forget to do certain things and I am sorry that this happened to you. Hopefully someone else just got busy and forgot to sign the narcotics out the shift before you. Learn a lesson from this and I hope everything turns out okay. Good luck!

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michele, i honestly do not have much positive to say right now...

but i would come clean w/everything to the DON.

put it in writing and give to her tomorrow.

everything...including the lack of narc counts and 7 vials missing today.

everything.

then take your knocks and please, don't ever do that again.

good luck to you.

leslie

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If it were one vial that would seem more "suspicious" I think. 7 vials (and Versed?) just seems like something went wrong, and an explanation will manifest itself shortly.

Hope it works out alright!

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

Leave meds drawn up out on the counter unobserved by anyone? Usually do your count alone and have somebody verify later who did not count with you? Yikes! Train wreck waiting to happen.

Hope you can get it all cleared up and overhaul their policies and procedures, and possibly some good can come out of it. You shouldn't have all the blame.

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Specializes in Surgical Center/OR.

well my boss is going to make me write a narrative today about what happened. i suppose this is where i hang myself. o, i know there is nothing positive about this one. except when they do the root cause ananylsis. i am sure big changes will be made and everyone will be on guard. i worked with a nurse once who wasnt alloud to open the narc box b/c he went to some program with nursing board b/c of his drug abuse. am i going to be that guy? IF i still have a job.

i suppose arelle is right, i should have people help me look for it. i been keeping it quiet b/c i didnt want people to think i was so bad...

when i first started there i remember thinking how sloppy the narc book was. remember thinking "wow. no co-signature for wastes?" and now....4 years later...i have become part of the problem....ughh!

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Specializes in ED.

I second what the others are saying, be completely open and honest with everything that has been going on and hopefully your wounds from the @$$ chewing will heal over time. Hopefully others arn't pressuring you into spining tales, keep your licsence and be brutally honest. :wink2:

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Sometimes we get in a rut about things and just over look them because that is the way it is done.

I've learned my lesson on this. We don't use computers and sign off the meds by hand. Sometimes pts will have two cards of the same med with similar count and you might accidentally sign on the wrong sheet. What we normally do is just error it out and sign on the right sheet. I refuse to do this any more. If that happens, I have the oncoming nurse who counts with me inital that page indicating it was the correct count and date and time it. Normally we just sign a sheet in the begining of the book stating we counted on and off (nurse coming on signs and nurse going off signs)

What happened one day is that the count was correct and accepted when I left at night, but when the am counted to start her shift...the pill was missing and it just looked like I crossed out the pill that was signed in error. yes...I was guilty of sloppy documentation, but that was it...the other nurse took the keys, signed, took responsibilty of the cart (and that pill)

Let this be a wake up call/ lesson.

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i dont know the pharm. of versed...but if the iv stuff will work po= date rape drug......

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You have had some good remarks. If there was no count when you came in then there was no count when someone before you went off. That would make 2 shifts responsible.

I am sure you feel sick as a pig about all of this right now. Keep your head up. Tell the truth. It really doesn't sound like someone pinched anything more like a culmination of a few documentation errors.

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