Narc count question

[tybutler74]

I am a new LPN @ 5 months working for an agency (did home care for 1 year before the agency)- I worked last Friday and I had 2 carts, both with narcs- I counted off each cart w/ a different nurse and they both accepted the count and signed and took the keys. Well, when one of the nurses was getting off and counted w/ the next nurse, there was a narc missing. She told the office that I was in a big hurry to leave work Friday, and that I shoved the narc book in her hand and I counted the cards. She is trying to imply that I was acting shady and took this med and tried to speed up the narc count so she wouldn't notice. Now they are trying to say my narc count was invalid because I should have counted the sheets and the oncoming nurse should have counted the meds. I go out of my way to be extra polite to other nurses because 1) I am a new nurse and respect those w/ more experience than me and 2) I am a visitor in their facility, they know the policies and regulations better than me. I always ask the oncoming nurse "Do you want the book or the cart?" because I didn't know it had to be counted a certain way, because to me, each nurse should look at both the book and the pills to ensure a correct count. I am ESPICALLY careful w my narcs because I am agency, and I know how easy it is for nurses to blame the agency nurse for mistakes. I have a meeting at 10 am tomorrow @ this. I am livid. Does it matter who counts what? And isn't this out of my hands because she accepted the count?

Also is this slanderous? I can prove that I wasn't rushing out of there. After I handed both keys over I went to the central station because the oncoming nurse needed a med that was kept in central supply. I picked it up for her and dropped it off to her to help her out. This is not the med in question, it was a med that was in our cart. But this proves I was in no hurry to leave! Plus, I believe I placed a call to my home from the nurses station so if it comes to it and I have to hire an attorney I can hopefully get phone records pulled proving I was there about for about 15 min after I was off the cart. Please, any advice would be great.

[Elektra6, ASN, BSN, RN]

A nurse who'd been burned taught me to count the bingo cards at the start of my shift being careful to look at the SHEETS as well. I don't care if it takes longer. Although she was burned by a nurse who took out Percocet and put Extra-Strength Tylenol in the bingo card and taped it. That would be hard to notice on shift change. That's why I don't tape in meds on the bingo card. I would rather waste them or give them out of sequence.

[gentlegiver, ASN, LPN, RN]

I've always counted the cards at the beginning of the shift and the book at the end of the shift, however I always observe both the cards and the book at narc count, making sure the nurse I count with signs the book when narc count is completed. I've had some oncoming nurses say they'll sign later and that's not cool with me.

That's the way I do it too, I make sure they look at the page to ensure they see the number & drug I read off is the same as the one they are looking at. As for signing, after we finish the count I open to the page for sign off, sign it, then hand it to the nurse taking the book along with my pen if necessary. I don't leave until they sign off.

My pet peeve is when I come on shift and they read the narcs off then sign and say "Oh Yah, there are some Narcs in the fridge, check them later, I gotta get going", trust me, I don't sign until I check the fridge and have them look up the info in the Narc Book. Ticks them off when thier in a rush but I believe in the "CYA" principal

[indigo girl]

If they are going to make you come in to talk to them about it, then I think you should contact an attorney. I have never heard of any facility doing this before, and I have worked in many thru several agencies. Canoehead may be correct about not going. I would get legal advice. You may think it looks bad, but saying the wrong thing could look worse. Reschedule that appointment if you feel that you must go, but talk to an attorney first.

Just remember that the oncoming nurse signed the book. To me that means that she accepted the count as being correct.

In the future, when you count, if you are going off shift, then you get the book in most places.

Let the oncoming nurse view each page, and you both agree that what is in the drawer is what is on the page. That is the safest way to count. If they do it a different way, then you both should still be viewing those pages together.

Good luck, and be careful. Being an agency nurse, you are always going to have to prove yourself to everyone.

[leslie :-D]

i agree w/canoehead.

this is total bunk.

regardless of how count was done, the other nurse accepted it and signed the book.

imo, the burden is on her to defend her actions.

i always cross-check the book count against the card.

i've had a couple nurses who have tried to pull a fast one in the past.

but regarding your situation, there isn't anything to discuss.

count was accepted as such, and the other nurse was in error if she signed, not being sure.

she has the explaining to do.

don't let anyone put this on you.

best of everything.

leslie

[tybutler74]

thank you all so much! I went to the meeting and it went very well. It became very clear to those investigating what truely happened. Thanks everyone

[LuvWounds]

Let me tell you that once she excepted the keys and signed the book its on her. If you took or didn't take the narc she excepted the keys and now its her responsibility, not yours.

Usuually the out goiing nurse will have the book and the incoming will have the pills to count. Depening on where you work the way its done varies. Where I work I count the cart by myself and so do the other nurses unless you don't know or trust the person. If for some reason the nurse forgot to sign for a narc you will just flag it for that nurse to sign. But I will tell you that you can not trust every nurse. Nurses are said to be the biggest drug abusers, because they have acess.

Rule of thumb ALWAYS CYOA= cover your own A_ _

Do remeber in it all narcs are a federal offense. Remeber all the time, money and sacrafices you put into becoming a nurses and not let anyone jepordize your license.

[Nursebarebari]

I am a new LPN @ 5 months working for an agency (did home care for 1 year before the agency)- I worked last Friday and I had 2 carts, both with narcs- I counted off each cart w/ a different nurse and they both accepted the count and signed and took the keys. Well, when one of the nurses was getting off and counted w/ the next nurse, there was a narc missing. She told the office that I was in a big hurry to leave work Friday, and that I shoved the narc book in her hand and I counted the cards. She is trying to imply that I was acting shady and took this med and tried to speed up the narc count so she wouldn't notice. Now they are trying to say my narc count was invalid because I should have counted the sheets and the oncoming nurse should have counted the meds. I go out of my way to be extra polite to other nurses because 1) I am a new nurse and respect those w/ more experience than me and 2) I am a visitor in their facility, they know the policies and regulations better than me. I always ask the oncoming nurse "Do you want the book or the cart?" because I didn't know it had to be counted a certain way, because to me, each nurse should look at both the book and the pills to ensure a correct count. I am ESPICALLY careful w my narcs because I am agency, and I know how easy it is for nurses to blame the agency nurse for mistakes. I have a meeting at 10 am tomorrow @ this. I am livid. Does it matter who counts what? And isn't this out of my hands because she accepted the count?

Also is this slanderous? I can prove that I wasn't rushing out of there. After I handed both keys over I went to the central station because the oncoming nurse needed a med that was kept in central supply. I picked it up for her and dropped it off to her to help her out. This is not the med in question, it was a med that was in our cart. But this proves I was in no hurry to leave! Plus, I believe I placed a call to my home from the nurses station so if it comes to it and I have to hire an attorney I can hopefully get phone records pulled proving I was there about for about 15 min after I was off the cart. Please, any advice would be great.

I don't think you will need an attorney because the facility has no case against you. That nurse should have made sure the count was right before accepting the keys, or she should have reported it to the supervisors right away. :nono::nono:

[sissiesmama, ASN, RN]

Hey! Glad to hear your meeting went ok. I have worked in a variety of facilities, as agency as well as staff. It sounds like everything went ok, especially since the other nurse accepted the count and signed off. I'm glad that the mgmt. was able to see your side of the story. This is not always the case.

I am glad it worked out for you! Always remember CYA!!!

Anne, RNC

[Southernurse]

hey all!

this has been bothering me for over a week....i currently work at an alf that allows ra's to give and sign out narcs after 7pm when there are no nurses in the building. (i did not know this until after i started.) anyhow, i discovered an oxycontin missing after my shift was over (there was no one to count with from the night before when i came in the morning.) well, of course, having discovered the discrepancy, i was made liable for it. this is coming from an ocd nurse that, if i am wasting, makes the signing nurse watch me flush the toilet with a wasted narc, after eyeballing it in the water. i am the type that checks and rechecks and checks again to make sure i have the right narc, right pt etc...i have prided myself on being honest, and even at the cost of time, (what a commodity!!!) will triple check if there is any doubt. there were a number of discrepancies in the book that day. mind you, i had been off for four days, so there was no recollection of any possible mistakes made. i felt like the lowest form of dirt, doubted my nursing abilities, and felt like a criminal. i still don't know what happened to that pill, but by god it still bothers me. i got a verbal warning, and that was my first one ever. i am so freaked out. naturally, not one of the ra's will come forward if there is a new-employee nurse there to take the heat. it makes me nauseous. how can i protect myself in this situation? if there is no no one to count with until after 9 am on some days and i start at 6:30, how can i be protected??