Missing narcotics

[karenrn111]

I work in LTC and awhile back we had whole cards of narcotics missing. We now have to count the cards along with the pills. Must of the nurses feel that we know who is taking the narcotics. This nurse is always late for work. She gives residents, who do not normally take pain medication, pain medication every 4 or 6 hours depending on the doctor's order. We believe she forged other nurse's name on the narcotic sheet. She signs out medcation at times when she is not even at work. She signed out a medcation for 1745. She did not even arrive to work until 1815. We believe she is selling them. The issue is trying to prove she is the one doing this. Any suggestions on how to prove she is the one taking the narctics?

[Lunah, MSN, RN]

It's really not your place to "prove" anything. That would be up to your management, should someone bring their concerns to the appropriate individuals.

[sailornurse]

When the cards went missing what did the supervisors/managers/charge nurses/admin people do? How long ago was this?

[karenrn111]

Management did a random drug screen on all nurses. This issue has been on going since the nurse started working there 6 month ago. We have found cards missing on a few occasions and it was first noticed in January. Management bascially told the nurse whose name was forged that the nurse we believe is doing it is the only nurse that will work night shift.

[roser13, ASN, RN]

If your management is not willing to own the situation, I'm not sure how anyone here can help you.

[quiltynurse56, LPN, LVN]

The only thing you can do is to do what you are suppose to be doing. I am surprised that with narcs missing, that there was not a stoppage of counting and looking for them immediately. Or are you saying they are missing because they are the ones signed out suspiciously.

Where I work, everything comes to a stop until any missing pills are accounted for.

[needlesmcgeeRN, ASN, RN]

In the SNF where I first worked, counting both the drug cards AND the pills on the cards was part of each shift change, with both nurses initialing the count.

[karenrn111]

Both. She signs out narcs to residents who normally do not take them. We did not know cards were missing until we called pharmacy one day. We had a resident running low on her narc pain medication. We called pharmacy and they stated it was to early to refill because they had sent two cards of 60 about 2 weeks before. That is when all the nurses had to take a random drug screen and we started to count the cards.

[Phledd]

Both. She signs out narcs to residents who normally do not take them. We did not know cards were missing until we called pharmacy one day. We had a resident running low on her narc pain medication. We called pharmacy and they stated it was to early to refill because they had sent two cards of 60 about 2 weeks before. That is when all the nurses had to take a random drug screen and we started to count the cards.

Does the pharmacy have a record of who signed for receipt of the narcotics when they were delivered? Did they not get logged into the narc book/record?

[jdub6]

Agree with others that if this facility for reason does not log their pharmacy deliveries and count both full and used cards that this should be instituted immediately. That is probably something staff can initiate. (The pharmacy company should be keeping records of who receives deliveries also).

Anything beyond improving the accountability processes is, in my opinion, not appropriate to be done by those not in management positions unless you directly witness something or have other proof. In my experience it is just too easy for it to become a finger pointing contest or gossip fest when there is suspicion without any proof. If you see her do something weird or suspicious then obviously report it (to management,not the entire staff).

also agree with others that if management is endorsing or ignoring shady behaviors or unsafe processes, I would start looking elsewhere for work. If management is on the ball someone taking narcotics will be caught, likely not the first time but it should not be an ongoing long term issue. If not I would not want to be around when **** hits the fan.

[CelticGoddess, BSN, RN]

Be very careful who you accuse. I worked with a woman who was accused of diverting, she was arrested, had to go before the BON, lost her job, and as a result, she had a hard time getting another job. She was completely innocent.

All because other nurses thought Nurse a was diverting. Turns out it wasn't Nurse A, It was Nurse B. It took Nurse A a while to pick up the pieces. All because others pointed the finger at Nurse A.