Miscounting Meds

[WickerRN]

I have been in my new grad program here in NYC for about 3 months (since April). During my time in the program, on 2 occasions miscounted controlled substances (ativan and PO norco) on the Pyxsis causing discrepancies. These were both quickly alleviated (within 10 min) when I informed my charge or preceptor of the miscount and they quickly did an inventory on the pyxsis and the discrepancy went away once the actual count was made. No meds were lost and all meds were accounted for quickly. My manager has been on me each time these incidences occurred telling me im on probation and these occurrences wil look really bad on my evaluation. Also, each time I had to write an incident report as to why the discrepancy was made. These were honest miscounts. I know I should slow down, but I get really anxious at times when i'm in the med room and 3-4 nurses are waiting for me so they can get on the pyxsis. Now i'm recounting all the meds at least 3 times to make sure I get the right count. However, I am really worried about what my manager told me regarding my evaluation. I really don't know how I can redeem myself to my manager for making these mistakes.

[Sour Lemon]

Does everywhere not require 2 nurses to count narcotics? When I worked in the hospital, 2 nurses always counted every time a controlled substance was being pulled.

I've never encountered that, thank goodness. I'd go crazy.

[turtlesRcool]

Does everywhere not require 2 nurses to count narcotics? When I worked in the hospital, 2 nurses always counted every time a controlled substance was being pulled.

Goodness, no! Though I think I'd like to work in a hospital with enough staff that an extra nurse would be available every time I pulled my meds. We only need another nurse to witness a controlled substance waste, and even then it can cause (usually minor) delays in patient care to find someone who can waste with me.

[NurseCard, ADN]

Oh for crying out loud, this happens where I work all of the time.

Someone goes to get a med, they count, accidentally miscount,

oops there's a discrepancy. So, recount with someone, solve the

discrepancy, problem solved.

WHY the need for so much scary discipline, over small mistakes

that are easy to fix? Mistakes that everyone is going to make?

I don't get it. Is it a power trip kinda thing?

Edit: our pyxis... actually it is an Accudose... does the "are you

sure? This number will cause a discrepancy" thing whenever you

put in the wrong number. However for some reason,

discrepancies still get created. All we have to do is

go back in and recount the little box with another nurse.

[Kallie3006, ADN]

The pyxis is set up to alert you if the first number entered is wrong, and discrepancy is created- telling who last accessed, their beginning count and what was removed, your actual count and the expected count, so as to trace the problem. A miscounted pocket is the easiest one to fix, I dont understand why that would be something that would be a factor in your evaluation.

We would need a full time pyxis nurse if we had to had a witness every time a narc was pulled. Wow, that just seems crazy to me!

[Kallie3006, ADN]

The pyxis is set up to alert you if the first number entered is wrong, and discrepancy is created- telling who last accessed, their beginning count and what was removed, your actual count and the expected count, so as to trace the problem. A miscounted pocket is the easiest one to fix, I dont understand why that would be something that would be a factor in your evaluation.

We would need a full time pyxis nurse if we had to had a witness every time a narc was pulled. Wow, that just seems crazy to me!

[JKL33]

Oh for crying out loud, this happens where I work all of the time.

Someone goes to get a med, they count, accidentally miscount,

oops there's a discrepancy. So, recount with someone, solve the

discrepancy, problem solved.

Hear, hear!

[JKL33]

As far as med cabinets alerting you when you've typed a wrong number but haven't entered it yet, I have not encountered this. Not sure if that's because not all are programmed that way or because double-counting has prevented me from encountering the warning message.

Another thing is that before I even begin my transaction, I note whether there is already a discrepancy (icon is present on home screen). If there is, I don't proceed with my transaction until it's fixed (or until pharmacy/supv/appropriate party is aware there's a problem and has advised how to proceed).

I don't think any of this is overkill given the potential for hateful/unnecessarily punitive handling of mistakes if/when anyone sees fit to handle them that way.