Ideas on ways to remember to sign out narcotics

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Specializes in 6 yrs LTC, 1 yr MedSurg, Wound Care.

I've been punching out the narcotics last or setting the cards near the narc book and not putting them away until I am finished with everything else. Counting at the end of my shift makes me nervous because I am so afraid I will forget to sign something out. So far, my count has been right on every day, but there has been once or twice that I have accidentally put one of the narcotics back in with the rest of a persons meds. I caught it quickly because I am always aware of where the cards are. The last thing I need is 28 Lortabs coming up missing! Lol!

Anyone have any tips on remembering to sign out narcotics?

Dondie

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Specializes in ER, progressive care.

Sign them out as you go? Sorry, I don't know what your policy is or what kind of medication carts you use. My facility uses Pyxis and they always prompt you to count before signing them out.

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Specializes in 6 yrs LTC, 1 yr MedSurg, Wound Care.

Ha ha! We just have a big, messy 3-ring binder!

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It depends on the number of narcs the resident will be receiving as to when I punch them out. If the person only receives one or two, I'll do them in the order they appear on the MAR. If the person has a BUNCH of them, I save all narcs for last. It's too much of a pain to punch a few regular meds, unlock the narc drawer, find what you need, pop it out, sign it out, put it back, punch more regular meds, unlock the drawer again, etc. Just takes too much time.

Regardless, I always sign them out in the book as I go. I know a lot of med aides that are able to keep track of everything in their heads and reconcile the numbers at the end of the shift, but I just can't do that. I know of one that just writes vitals and narcs in a small notebook and copies them into the MAR and narc count sheets 1-2x a shift. What works best for me, though, is to just do it as soon as I punch them.

As for being nervous for the narc count, I always do a quick comparison of the count sheet and all the narcs in the drawer a few minutes before the next shift comes on. Better to realize you forgot to sign something out when you're by yourself rather than counting with the next shift, especially if the other person is paranoid. EVERYBODY forgets to sign stuff out at one time or another.

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Specializes in ER, progressive care.
Ha ha! We just have a big, messy 3-ring binder!

Yikes, that does sound like a mess!!

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Specializes in 6 yrs LTC, 1 yr MedSurg, Wound Care.

It is a mess--that's why I am so nervous about it! Lol

Thank you Coffeemate! I definitely don't trust myself to remember at the end of the shift. No way! I keep a small notebook with me and use it ALL day. It's a lifesaver! I think signing them out as I go is my best option. And I agree, if there are only a few meds to punch out, I do it then & there. It's the ones that have like 20 meds that I get mixed up with.

My biggest issue so far has been those people with a lot of meds. For example, we have a woman with cancer. She was already taking a lot but then she got all of this new stuff on too of it and my first day on the cart was overwhelming. One of the nurses (she was a med aide for a long time) leaves the cards in the cart, pulls out just enough of it and just punches it into the cup. I end up pulling it all out and holding them, digging through the stack an laying them facedown on the top of the cart, and then going through the MAR. I know that has to be time consuming, but vending over the drawer and digging through them over and over gets to hurting my back.

Everybody keeps telling me that once I learn what everyone takes, I'll get faster, but it freaks me out to just start going by memory. I'm afraid I'll miss something, or not catch a change.

I thought today that I might get a Sharpie & dot the top corner of the cards for the morning pass. Whatever it is, I have to do something different because I'm not finishing until my shift is almost over.

Plus, everyone is going nuts because they're expecting state again in the next couple of months so I don't want to get any bad habits started, but I can't be finishing my 9:00 pass at 1:30 either.

So now that I've thrown all my problems on the table...! Ha ha! Got any more advice?

I appreciate your input Coffeemate! I was really relieved when you said that you were a CMA too!

Dondie

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