How to count Narcotics?

Which time does the signing of the narcotic book confuse you?

1) Coming on the shift?

2) When you give out the narcotic?

3) The end of the shift for the oncoming nurse?

When I give it out and then the end of the shift. Coming on the shift is fine because you just count how much you are receiving and you are not giving anything.

The narcotics need to be tracked. If the signature is for ongoing/off going you would sign appropriately for where you are in the shift. Don't accidentally sign in slot that was left blank by someone else.

By signing at the end of shift with the nurse, you are accounting for the narcotics being the same or reduced or increased based on activity (dispensed or received from pharmacy)

You count at the start of shift to verify an accurate count. Narcs are a big deal. When the count is off, the person with the key is to blame. Missing narcs can result in board and police involvement. Always count your narcs coming in shift. Accept no excuses. Saying "nurse b was in such a hurry to leave we didn't count narcs, I don't know why the count is off" is never acceptable. If the count is off, don't take the key. Call the supervisor.

All of this is the same reason you count out at the end of your shift. You are proving that the count is accurate. No one can say that narcs are missing because you didnt count with them.

Always sign out the narcs you give, this is where your count comes from. It's the paper trail and proof of what you did and where that narc went. It's your accountability. At the end of your shift, always double check your count. It will save you some stress when you're count is off because you forgot to sign one or in a hurry. Also, always check your math! Better to just get into the habit of signing first, then popping.

Side note; ask what to do about empty cards!

Some places also count the number of cards in the lockbox (because someone could take the card and the sign out sheet and no one would be none the wiser). If you're place counts cards, you may not be able to just remove the card when it's empty. You may need a second nurse to sign off on removing the card, or maybe only a manager can remove a card.