My narc drawer runneth over

[Jendes1979]

I'm a new nurse who works in ltc. Over the past few months I've had several concerns with understaffing and the high acuity of my hall but nothing so serious that I feared for my license until today. A new company recently purchased my facility. They ordered new med carts, tiny lil med carts with even smaller narc drawers. This isn't an issue with the other 3 halls but it is for my hall. If you took all the narcs from the other 3 halls and multiplied by 2 I would still have more narcs in mine and with the new carts they simply will not all fit. Management's solution is to have the narcs that won't fit in my drawer placed in another halls cart. This makes me very uncomfortable for several reasons:

1) I'm the one that is responsible for those narcs during my shift. I must sign and be accountable for them even though they are on another nurses cart who holds the keys for that cart.

2) Most of my narcs are scheduled in the other cart but some are prn. I have to hunt the other nurse down everytime one is due. This means I have to know her break schedule to make sure I have them, but it is impossible to plan for prns.

3) I have to come in get report and do the count on my hall and then run to the otherside of the building to do my count there. Same thing for end of shift. This coupled with the second concern I listed is really causing me to run a great deal behind.

Is this legal and if it is how do you suggest I handle it and best protect myself. I would appreciate any advice you can give me on this matter.

[JKL33]

No exaggeration: I would kindly tell them point blank that I will not accept responsibility for controlled substances to which someone else holds the key.

[Jendes1979]

Thank you for responding. That is exactly what my gut was telling me to do.

[caliotter3]

It would make more sense to move all, or almost all, of the PRN meds that rarely get used to the other cart. The routine use meds should stay on your cart. However, I sense that there are still too many for your cart.

[ponymom]

Umm .... No....

Lay the smackdown on them.. Write up a statement saying you will not accepted this b-l-a-t-e-n-t mess of an inconvenient time suck/med error/incident just-salivating-waiting-to-happen scenario under *any circumstances for *one *more *shift. Depending on your work and financial circumstances, I would not even come to work until this is rectified. Inform the state.

Tell the family that their loved-ones meds are on the other cart and give them the offending pig's contact information.

Refuse responsibilities for narcs that are not on your cart. Document make copies and hand to your hr, union and inform your malpractice people. Get ready for something bad to happen, because it will.

Good luck..

[Miss.LeoRN]

I worked a an ltc/rehab for a bit and one unit had two carts. Sometimes the narcs would overflow and have to be put in the opposite cart. However, the nurse responsible for that cart was responsible for those narcs. I would have to sign them out with her and her witness my patient getting the med and visa versa. I would never assume responsibility for narcs in a cart I was not in control of. And breaks were never an issue because when the nurse went on break she counted the narcs off to the supervisor or charge nurse and have her the key, then counted them when she returned to accept the key back.

[caliotter3]

I worked a an ltc/rehab for a bit and one unit had two carts. Sometimes the narcs would overflow and have to be put in the opposite cart. However, the nurse responsible for that cart was responsible for those narcs. I would have to sign them out with her and her witness my patient getting the med and visa versa. I would never assume responsibility for narcs in a cart I was not in control of. And breaks were never an issue because when the nurse went on break she counted the narcs off to the supervisor or charge nurse and have her the key, then counted them when she returned to accept the key back.

The solutions presented in this post are excellent examples, IMO, of how it should be done.