HELP!

[b79j81]

I have been an RN for 3 years but just recently took a job at a LTC for the first time. Well, an issue occurred the other night and I would appreciate some advice from ppl that have worked LTC longer than me. I came on @ 11p. The nurse leaving had worked 7p-11p (lets call her nurse B). I got there, got report and was handed the keys so that i could open the med cart to count narcotics. Upon counting narcotics, i noticed a discrepancy. Seeing as how neither I nor nurse B had ever been in this situation, we called our nurse hotline (which is either the unit manager or DON). I asked the unit manager what I was supposed to do in this situation and she informed me of what to do and that she would investigate the following day. well, i got a call from the DON the next am and she stated that I and nurse B share equal liability because i "should not have taken the keys". I did everything that i was told to do by the unit manager. She was aware and wanted to wait until the next am to investigate. i dont understand how i share any liability in this. can somebody please help me?

[TerryBSN]

You should have counted with Nurse B to make sure the narcotic count was correct before she left and handed her keys off. If the count was off she should have looked over the MARS to make sure she had signed off each narc med given was signed out. By allowing the Nurse B to leave and you taking the keys you were accepting that the count was correct. You accepted the responsibility and would share in the discrepancy.

[b79j81]

Im sorry. I guess i didnt make that clear. We ALWAYS count narcotics together. The count was correct when she counted with the previous nurse @7 but when I counted with Nurse B @ 11, we were off by 1. She looked thru the MAR to see if she had missed anything, but found nothing. She said she is almost positive she didnt give it to the resident. Nurse B was there while i filled out the incident form and she signed it (as I was told to do by the unit manager). Nurse B did not leave until it was filled out and I didnt start passing meds until everything was done that i was told to do.

[tie_dye00]

The LTC facilities I've ever worked at tend to be a little more lax on the narc counts than the acute facilities. Granted, I've never been in this situation exactly, but it sounds like you did what you were supposed to do based on the advice you were given. Hopfully the nurse manager will step up and explain that she/he had instructed to do exactly what you did. But I would also look up the exact policy your facility has on this issue too, just so you know how you need to handle this in the future.

[Seasoned]

:typing

well first you need to find out: what's the specific liability?

everything you can do, or will do, will depend on knowing that.

the "liability" could be anything from just an anecdotal note somewhere to a major infraction. the latter carries a disciplinary action up to and including termination with one more incident. drugs and suspicion of nursing abuse is serious business!! and they might not tell you that until the day of termination.

:smokin:find out and come back for some great advice!

[CapeCodMermaid, RN]

In most narcotic books there is a space to indicate Yes count is correct or NO count is not correct. If the nurse before you signed the count as correct and when you counted with her there was a discrepancy, the liability, if that's what you want to call it, is with her. She signed the count as correct . You can sign as incorrect, follow your facility's policy for documenting discrepancies, and continue along.

[b79j81]

Thank you all so very much for your responses.