How do you handle an unprofessional nurse?

vincrawford · Jul 29, 2009

I actually work inpatient psych and my count was off by one this am. We have a paper system which is horrible, all the lines...lol...Anyways, I have been there for about a month now, new grad since May and I have never had a problem with the Narcs until today. I worked 3rd shift, it was a quiet night and the only time I was even in the Narc drawer was to count at the start of my shift! Well, I PHYSICALLY put my hands on every-single med, inspected them for color and shape...while the off-going nurse called out her change of shift numbers...sounds good right?? Well, when we counted, the numbers matched flawlessly....Time to leave my shift the next morning, and the next to last Narc was off by one!! I was looking at the on-coming nurse who had just counted with me, her hands currenlty in my Narc drawer telling me one is missing (don't be judgemental!!)......SCARY.....I thought to myself....I haven't been in the drawer all night...it's impossbile....then we had to notify the Nursing Supervisor.....while waiting like a criminal waiting to be executed I frantically searched the old MAR's for the missing dose....5 minutes of agonizing fright and I found it.....the previous nurse had documented in two seperate places as our policy stipulates (thanks GOD!) that she gave the drug, she just did not document/subtract the dose from the Narc count. Who's to blame??? Both of us......I am just as guilty for only looking at the pills themselves and not observing the number that the off-going nurse is recording on the Narc sheet....LESSON LEARNED.....the scariest feeling in the world to have a missing Narc and a brand new license! BE CAREFUL.....I will in the future slow the turn-over process down a bit and ensure that what I physcially count, the number recorded on the Narc sheet and what the off-going nurse says all match...because once I accepted the keys it became my problem. I HOPE SOMEONE ELSE CAN LEARN FROM MY MISFORTUNE. I was lucky in the fact that the nursing supervisor was very supportive, they never accused me of being a Narc-Thief......but it felt like the whole world was pointing the finger at me......horrible feeling....don't let it happen to you! Because I did not observe the written number, I could have jeopordized my career. If I would have looked at the number with the off-going nurse I could have caught the error and saved myself a lot of problems. By the way the off-going nurse is a Great Nurse, she's just happens to be human like the rest of us! Once the person you counted with is gone...it's truely up to you to defend your license!!!! :banghead: On the way home I was thinking to myself....what if I could not have found where the med was dispensed....I would have provided a urine sample which would clearly exonerate me right?? Well, of couse my UDS would be clean...I don't even take any prescription drugs, barely Tylenol...I should be good right? Not exactly, if they could not have found the drug...just because I my UDS would have been clean would only have proven that I did not ingest the Narc....that still would not without a shadow of a doubt prove that I did not remove the Narc with intent to commit a crime!!!

PEACE, BE CAREFUL OUT THERE AND MAY GOD BLESS!

CapeCodMermaid, RN · Jul 30, 2009

If you've ever had to have any dealings with the Drug Enforcement Agency, you would NEVER leave without doing count or ever accept the keys without doing count. My nurses think I am a lunatic about these things. I stand there and make sure they do count the right way and then I have them sign saying they've been shown the correct way to do things. When we had a drug diversion I notified the DEA and did an investigation. A month later there was a suspected diversion. Again, I did an investigation. The DEA finally came out. I showed her my files and the investigation. I included all the inservices I had done on the correct way to count, sign off meds, correct errors and the like. She said "Everyone is responsible for their own practice. You clearly gave them the education and information they needed so you don't have to worry." Don't take narcotic count lightly. Take every Duragesic patch out of the box and inspect the package. At one facility, someone slit the bottom of the envelope, took the patch out and stuck the envelopes back in the box. No one looked and the theft wasn't discovered for 2 more days. Smell the liquid narcotics when you open the bottle...make sure they haven't been diluted. Have someone watch if you have to destroy a narc and have 2 people sign. If a co-worker shows you crushed pills in applesauce and asks you to co-sign the waste with them, write "altered in applesauce'..that way if it isn't the narc YOU will be in the clear.

I think I got way off topic, but it's important to take the time to do this the right way every time.

lena1951 · Feb 7, 2012

I have been trying to find how to post a question since before 8am eastern time. I found this and thought I would post a comment to it about unprofessionals in health care. I cover shifts for employees that request time off during the week usually on 3rd shift, I work 12 hours every weekend both saturday and sunday. Well when I work 3rd i have two halls to cover both at opposite ends of the building one is downstairs the upstairs at the opposite end of the building, I have a real problem with the person I count off with moving my med cart before we count, this morning was worse I left her a note attached to the 24 hour report sheet on a clipboard in big bold black letters written in magic marker saying "I AM NOT FINISHED PLEASE DO NOT MOVE CART!!!!" well when i come back from the opposite end of the building she has moved it way down the hall far away from the resident i still needed to give meds to and get her blood sugar, the person had not even looked at the 24 hour report sheet she just moved the med cart. I have been told that moving a med cart without counting is against n.c state regulations. How true is that? Is it a state violation to move the cart without counting first and getting the keys to the cart? Why move it when you cant do anything with it until you have the keys? The person tells on everyone runs to the DON over the smallest things and seems to get a thrill out of getting others in trouble or fired!!

silverbat · Feb 7, 2012

I don't think physicalaly moving a cart is against any state laws, but it is really inconsiderate. I am curious why you are counting before you are done with your work? Why not fnish one side completely, then the other, the count both carts when you are done with your work. If it were me, counting with you, then you getting back in that newly counted cart, I would insist on re-counting when you were done. NOT to say you would be dishonest... but to cover my butt and yours. they can wait to count until you are ready.