My narc count was over!

[August10]

When I started my shift we counted narcs, I read off the physical amount of pills while the nurse leaving checked the paper, she agreed with all my counts. When I went to give one the paperwork was off. I had an extra pill so obviously one was signed out but not given. It's my fault because I didn't look at the paperwork as I counted, right? I reported it as soon as I found the error and the director was really mad about it. I guess at least I was over and not short. I am a new nurse and I have been really stressing about this. Is there anything I should have done differently, what can I expect to happen over this? Any experiences like this?

[reisling]

Nurses still count nars???? Our med system is all computer generated so if you request one percocet, then one pops out under your password, easy to see who got what and at what time and for whom. I use to hate those end of shift counts. There was always something missing.

[demylenated, BSN, RN]

It happens sometimes. You just have to do the count per protocol... every.single.time. so this type of thing doesn't occur. If the other nurse is rushing, ask her to calm down that you must get this right. Once it happens to you, you'll be a bit more cautious.

If it happens too much, you can get a moratorium so to speak, where you won't be able to give narcs for awhile.

Just be careful. Check, and double check... if the other nurse signed off with you, she is just as responsible if it is over... and if it was your first time (giving said med), that means she didn't give one. It could be as simple as she/you was/were going to give 2, but gave one instead and just didn't correct the mark.

That is why I

[mazy]

Are you saying you 1st read the number of physical pills to the nurse who then was checking the narc sheet? Because it's not supposed to be done that way. The outgoing nurse is supposed to first read the pills off the narc sheet, the incoming nurse verifies that number with the physical pills. I usually repeat the number of pills back to the reading nurse to verify that I'm seeing the same number that she is telling me.

You never say what you are physically seeing to the nurse who is reading. Too many ways for miscommunication to occur.

Well, at least you were over and not under.

[August10]

This is my first rn job and I was given no real training, just following other nurses around for a couple of days. Yes, I read the physical amount of pills and the outgoing nurse checked the paperwork. So you are saying I should have the number from the paperwork read to me as I check the physical amount of pills? None of the nurses there do this including the director, I need to protect myself obviously!

[klone, MSN, RN]

You never say what you are physically seeing to the nurse who is reading. Too many ways for miscommunication to occur.

why not? That's how it's done with a Pyxis count, too. It asks you how many are ACTUALLY there, and then it lets you know if that's correct.

[arw979]

Yes that 's the way we do it at our facility. The offgoing nurses looks at the sheets and tells the oncoming nurse the number of pills that should be in the card. the oncoming nurse looks at the cards and makes sure the number is correct. I am one of the few nurses at our facility thet reply to count with numbers most of the other nurses just say ok to every count on each card.

[mazy]

Yes, the outgoing nurse reads the number from the narc book, you look at the narc card and verify that those pills are there and repeat the number back to her. Otherwise you run the risk that she's a) not really paying attention or in a hurry and agrees with the number you say without actually seeing that on the narc sheet; b) is misreading the narc sheet and agrees with what you say: c) in a worst case scenario, she's trying to cover a narcotic mistake or diversion.

I don't really understand the way they are doing it in your facility but my suggestion is that in the future you read the book along with her while you do count. I've had nurses who don't know me or the facility do that to cover themselves and don't object if that's what they want to do -- I don't know them either!

[FLArn]

Off going nurse reads amount from count sheet, oncoming nurse counts pills on hand and both nurses should be able to look across and see the pills/count sheet. DO NOT EVER, EVER, EVER let anyone hurry you. Count takes however long it takes!

[mazy]

Yes that 's the way we do it at our facility. The offgoing nurses looks at the sheets and tells the oncoming nurse the number of pills that should be in the card. the oncoming nurse looks at the cards and makes sure the number is correct. I am one of the few nurses at our facility thet reply to count with numbers most of the other nurses just say ok to every count on each card.

Yes, I started doing that when I realized I was zoning out from the monotony of count. Just saying "uunh hunh, unnh, unhn, snore......wait what!?":p

[vampiregirl, BSN, RN]

My supervisor also suggested to me that the narc book is visible to the (oncoming) nurse who is counting the cards. It just takes me a second to verify for myself that the number the outgoing nurse read to me is correct and the same number of pills that I am physically counting.

[dthfytr, ADN, LPN, RN, EMT-B, EMT-I]

Same thing has happened to me a few times. I find that if I tell the manager that the extra was mine I put there for safe keeping, the manager rolls his or her eyes and I never hear anything about it again.