Narc count right, then WRONG

[Dee_RN]

I am a new grad working in a LTC facility. Recently at the facility we have hired new nurses including myself. However since 2 weeks ago when an LPN was hired, narcs have been MISSING. Whenever this new LPN counts narcs with anyone the count is ALWAYS WRONG. She comes in really early to "start" her work and asks' for the keys, before her and I count. I know stupid on my part for thinking you can trust any and everyone.

So today I decided to nip it in the bud I told my D.O.N about the errors, because I have worked to hard to have my license taken away for speculation of stealing drugs. And we came to a conclusion of having a 3 man count instead of just 2 ppl counting the narcs. We have videotapes, so the tapes can be rolled back to see where the drugs are going. I never thought I would be in this situation.

Has anyone else been in the predicament, what did you do? and what was the outcome? PLEASE SHARE WITH ME!!!

[NamasteNurse, BSN, RN]

never give the keys until the count is right...why would you ever do that?

[lylenrn]

It's an awful feeling when the count is wrong. I have had it happen a couple of times, sometimes because the sheets have been adjusted or because a dose is more than one pill and requires two pills/signatures. The keys should never be turned over until after the count is done/other nurse is endorsed responsibility. If this nurse insists on "starting early" how about counting out early? I love our pyxis.....but every now and again i work at a snf and it is a pain to count all those pills. God forbid the count is incorrect,....they start to eye you suspciously. I know the feeling.

Best of luck in your new position. Make the count a priority so that you are not the one under suspicion.

[GHGoonette, BSN, RN]

Under no circumstances should anyone under the rank of RN be carrying the Schedule drug cupboard keys. Yes, I know passing them on to a junior is something we all do, especially when workload dictates, but only when absolutely necessary and only when there is a second trustworthy junior to witness. At the end of the day, you will be called to account for any discrepancies.

[Dee_RN]

Under no circumstances should anyone under the rank of RN be carrying the Schedule drug cupboard keys. Yes, I know passing them on to a junior is something we all do, especially when workload dictates, but only when absolutely necessary and only when there is a second trustworthy junior to witness. At the end of the day, you will be called to account for any discrepancies.

The facility I work in only has 4 RN's(recently hired in the last 3 months) and 9 LPN's and they have the "same" rank as an RN. For 1st shift, LPN's run the floor. 2nd and 3rd shift have 1 RN working the floor per shift along with the LPN's.

[Belle Epoque]

The 3 man count seems a bit overkill. If the outgoing nurse only handed over the keys after the count is done and signed off with the oncoming nurse then you shouldn't have these suspicions looming over who did what.

You say you have videotapes and narcs have gone missing so why haven't these tapes been rolled back to see what's going on?

[caliotter3]

I would never even think about giving the keys to another for any reason. You should have reported this earlier, but at least it is being dealt with now. With luck, the nurse, if guilty, will feel the heat and the need to move on.

[nurse2033, MSN, RN]

This is unfortunately an all to common story. Thank goodness you have taken action. Continue to follow through and don't tolerate any discrepancies in the future.

[Dee_RN]

You say you have videotapes and narcs have gone missing so why haven't these tapes been rolled back to see what's going on?

I have no idea why the tapes have not been reviewed, but tonight me and the outgoing charge nurse plan to review the tapes since we have the authority to. We are all in the same boat so we gonna review the tapes to cover our a__!!

[Forever Sunshine, ASN, RN]

Under no circumstances should anyone under the rank of RN be carrying the Schedule drug cupboard keys. Yes, I know passing them on to a junior is something we all do, especially when workload dictates, but only when absolutely necessary and only when there is a second trustworthy junior to witness. At the end of the day, you will be called to account for any discrepancies.

LPNs can hold narcotic keys. We aren't juniors. We are just as responsible for the narcotics as we would be if we were RNs.

[GHGoonette, BSN, RN]

The facility I work in only has 4 RN's(recently hired in the last 3 months) and 9 LPN's and they have the "same" rank as an RN. For 1st shift, LPN's run the floor. 2nd and 3rd shift have 1 RN working the floor per shift along with the LPN's.

What can I say but "ouch!" Nasty situation. You have my sympathies. As other posters have pointed out, if not in so many letters, CYA.

[GHGoonette, BSN, RN]

LPNs can hold narcotic keys. We aren't juniors. We are just as responsible for the narcotics as we would be if we were RNs.

In my country, the RN carries the ultimate responsibility for day end and day opening narcotics checks. She/he is also ultimately responsible for the safekeeping of those keys. Regardless of the amazing capabilities of my ENs (Enrolled nurses-your LPN/LVN equivalent) they cannot be held responsible for discrepancies in the drug count. Nor would it be fair to them....it's not in their scope of practice.