laws regarding narcotic boxes

[metfan]

So...tonight I had to share my narcotic box. I was very uncomfortable with this. I actually refused at first to take the keys until I could talk to the DON. This request was refused so I eventually counted. I counted my half of the meds and signed the count. The nurse for the other wing did the same thing for her meds. I took the meds I needed and left the rest in the box. The other nurse did the same and had the keys to the box the entire night. I did not have the keys. I guess what I am wondering is where I can find the laws regarding the use of narcotic boxes? This may happen again tomorrow and I want to be informed. What if say one whole sheet of narcotics for my wing came up missing. The other nurse had the keys, however, I signed the count. Who would be responsible? I did not have access but I signed the count. I was made to feel if I did not accept the keys I could get fired! Thanks.

[metfan]

I just wanted to clarify. I had the keys to the narc box on my med cart. I did not have the keys to the bigger narc box...you know what I mean. I took the narcs I need for my shift and put the in the box on my med cart. The rest I kept in the bigger narc box on the wall in the med room. The more I think about it, the more upset I get. I was made to feel like I was being ridiculous when I questioned the situation. Does it matter who had the keys if I signed for them. Thanks again.

[BrnEyedGirl, BSN, MSN, RN, APRN]

I'm not sure I understand the question. You took narcs out of one box and put them into another box?

Our narcs are all locked in one unit,.every nurse in the deptartment has access to the narcs and they are counted everytime the box is opened. I only take meds out for one pt at a time,.is this long term care you're talking about and maybe the system is different?

[morte, LPN, LVN]

I just wanted to clarify. I had the keys to the narc box on my med cart. I did not have the keys to the bigger narc box...you know what I mean. I took the narcs I need for my shift and put the in the box on my med cart. The rest I kept in the bigger narc box on the wall in the med room. The more I think about it, the more upset I get. I was made to feel like I was being ridiculous when I questioned the situation. Does it matter who had the keys if I signed for them. Thanks again.

i have worked acute and ltc, and havent run across this arrangement.......unless there is documentation of who had the keys, i would think you would be on the hook....as well as the other person.....if the box in your cart is big enough and the cart has a double lock, can you simply put all YOUR narcs in the cart for YOUR shift?

[CoffeeRTC, BSN, RN]

i have worked acute and ltc, and havent run across this arrangement.......unless there is documentation of who had the keys, i would think you would be on the hook....as well as the other person.....if the box in your cart is big enough and the cart has a double lock, can you simply put all YOUR narcs in the cart for YOUR shift?

I'm confused too. Why do you have a big box of narcs in the med room? Are they the emergency supply?

[metfan]

Let me try to clarify. I work in LTC. We have lots of narcs and are only allowed to take what is needed in the med cart. This is the rolling cart that I take while doing the med pass. It is double locked. The thought is if we take all that we have for the 40 patients in the rolling med cart, someone could walk away with the cart. Each unit has a locked narc box on the med cart as well as a box on the wall in the med room. The narc box in the med room is bigger and locked by two locks. Of course we count off each time we come on and leave. We are now being forced to share one narc box between 2 units. Only one unit has the keys. Last night, if I needed a PRN narcotic, I would have had to get the other nurse. Am I making sense? I really want to know my rights. I am not comfortable with this arrangement. Does anyone know where I could get answers? Thank you.

[CoffeeRTC, BSN, RN]

YOu make sense, but the situation doesn't. LOL.

I've never worked in place where they didn't trust the nurses to keep all the meds on the cart. The extra box situation makes more room for error or theft esp since others are borrowing the keys and someone different needs to count. Too many hands in the pot. I'm not sure where you would find the legalities of it all, maybe call the BON. If they are afraid of someone walking off with a med cart, I've worked in places where we locked the carts to a wall or in room when we weren't passing meds. Or, the person with the keys and signing for the box needs to get the narcs for the other nurse...this doesn't make sense because you don't have all the time to be doing this.

We use the card system for drugs. Each hall has a cart with their own narcs. One hall has an emergency supply box that we share, but the nurse taking it out, signs it out and the other nurse has to let them into the box.