I work my PRN job pretty infrequently - and usually stick to the same unit when do. I was called in yesterday to work a unit I haven't been on in over a year - since I oriented actually. I had never even met the med nurse that I followed. That should have been my first red flag.
My facility does not use any kind of pixis machine for our narcs - they are in a locked drawer that only the med nurse on shift has a key - and we sign them out by hand each time one is given.
In my one year there, I've never had an issue. Last night started out the same. Showed up, did the count with the off-going nurse - ran through the 50+ drugs and went out about my business.
Then shift change came this morning - started the narc count and ran into a problem when we came to valium. The count was 5 when I came on. All 5 packets had been separated and like usual, had been lightly tapped together on the back, so that they didn't get lost in the drawer. Nothing out of the ordinary, so during my count, I didn't make much of it.
Well, the on coming nurse did. She took them apart and we discovered that one of the blister packets had actually been opened, and taped back up. The pill inside was actually broken. Of course, she refused the count (and was making a HUGE deal about it on the unit while notifying the off-going supervisor) I felt like crap (she had already been 45m late for the shift!!) I was mostly just po'd that I had missed it. But I came on at 11 - called in late due to a nurse not showing up - so just whizzed though the count.
The supervisor came up and told us to just waste the med. That she would do it and sign. The oncoming nurse protested - continuing to state that she wasn't going to waste a med that she didn't believe was actually valium (Super never told her to wasted it - she hadn't accepted the count!) She kept stating that who knows what went on last night - clearing insinuating that I should be tested for the drug - WTH?? She told the super over and over that she had been gone for a week - making a huge deal about it. Yah, it was an opened pack (and the super agreed w/ me that it looked like all the other valiums) She finally told the nurse to leave the med room since she hadn't take control of the narc drawer. When she did, she apologized for that nurse's behavior and told me to relax - that she had no reason not to believe me and didn't for one minute suspect a diversion. She told me that she would not be requiring me to complete a drug test - just an incidence report (I felt like crying just at that though!) She gave me a heart to heart and told me that if I was going to RN school this fall, I just learned a HUGE lesson - go over the narc drawer like it was my bank statement. Scrutinize ever single drug that I pick up before I sign off on the sheet.
I felt like crap by the time I left - and that nurse was still at the nurse's station carrying on and on about the opened pill pack that didn't look like a valium.
The worst part - this nurse was my preceptor last spring when I was hired
So, that's the story of my first Narc count issue.
