keys for narcotics

[onthemark]

I'm a new LPN at a LTC facility so I'm given the key to the narcotics box while on duty. I know I'm not to give the key to other nurses but what about my supervisor or even the DON? I'd feel embarrassed not to give my superiors the key if they asked for it so want to make sure I'd be correct in not handing the key over to them. Please advise, thanks. (This is probably a simple question but I want to make absolutely sure I know what I'm doing :) )

[yooperPN]

I don't know why your supervisor or DON would even ask for the keys. I guess if mine asked me for them, I'd give them since they are above me in the chain of command. But, if they were asking for the keys to administer a med, I would make sure they were the ones who signed the med out.

[Siddhartha]

Where I work, having the narcotic keys means that i have counted the narcotic box and am liable for them.

If another nurse (yes my manager or the dns too) wants access to the keys, then they will count that box with me and take over the keys. if they just want to borrow the keys to give a med (?), they could take something out without your knowledge (either to give to someone or steal...you'd have no way to verify. At shift change/count time, if there is a drug missing or count is off, your the one liable because you "had the keys".

Chain of command for narcotics count stops with the nurse holding the keys

[merlee]

You counted, you are responsible. If someone wants the keys ask them if they are willing to do another count with you, or if they want you to obtain something.

If the count is off, it is your head, your license.

Best Wishes!!!

[RNsRNotOut]

If they just need to get a med out then you can watch them as they take it out and make sure they sign for what they withdraw. If they need to keep the keys for a bit for whatever reason then I'd do an inventory of the meds with the person then they will be in control of the keys.

[vampiregirl, BSN, RN]

If I've counted, then I'm responsible. Therefore, I don't give my keys to anyone. If a supervisor needs in my narc drawer, I'll gladly unlock it for them and stand by while they do what they need to do - verify counts, check something etc.

I've also heard of a supervisor asking for keys as a test - to see if a nurse would let someone else borrow the keys:)

[ChuckeRN, BSN, RN]

I don't give anyone the keys to the narc room. If they need access, I am always in there with them - yes, even DONs, sups, whoever.

[onthemark]

Thanks for all your helpful responses! and thanks to VampireGirl for tipping me off that a supervisor could ask for the key just to test me. It'll be hard to tell her no, but I guess I'll just have to. As others of you have suggested, I can always go in the med room with her and do a count so that she's the one who ends up signing. Thanks again everyone!

[CapeCodMermaid, RN]

I've asked nurses for keys to the cart on rare occasion so I can check for outdated meds. But I ask them to stand next to the cart and I wouldn't even think about opening the narc drawer.

[maelstrom143]

I agree w/everyone else here. At my AZ facility, once the narc key was in my hand, it did not leave again till end of shift, no matter what. Anyone else wanted to check, they could check w/me standing right there next to cart or med room.

Don't get me wrong, worked w/amazing people (still miss them), but it is too easy for mistakes to be made and you to take the fall if count is off.

[9livesRN, BSN, RN]

I had risk management test me once, they had the DON ask me for the key, I asked what she wanted before hand, she did not answer... So I said no ( a really shy, scared no ) I said we could count in case she really needed them though... They all laughed!

[onthemark]

Thanks for sharing, 9livesRN! I'd say you handled it well.