narc count question, I need advice...

[ennylyecats]

I have another post going right now about this situation but wanted ask DON and ADON's their opinion. I started at a snf and my first day orienting I noticed several things that troubled me. First the nurses don't count narcs with the offgoing nurses. When we come in the leaving nurse has already signed the narc sheet and the oncoming nurse signs it at some point without even looking at the narcs. I was told they trust each other. At first I thought maybe I just missed seeing them count but when I asked a question about it I was shushed by my preceptor because the DON was nearby she said she'd tell me later. Second the schedule IV drugs don't even have sheets to count them. maybe the don't need to be but I work at another facility where we do. Third, the med carts are never locked and for the most part the keys are just left laying on top of the carts. I can rectify that on my own when I'm done orienting by just locking my cart up on my own but other than insisting I count before taking control of the cart I don't know if I should be doing anything else like bringing it up to the DON. I don't want everyone to hate me but it just seems so wrong.

Thanks for any advice you can give.

[CapeCodMermaid, RN]

Yikes. We do count at every shift change and the carts are locked unless in the nurse's line of vision. Don't sign your name to anything until you count it. Speak to the DON or your pharmacy consultant to do an inservice on proper narcotic count. Also find out what's up with the missing sheets....seems an easy way to be stealing.