Narc count right, then WRONG

Ask your DON if there 's grounds to have her drug tested. It certainly sounds like it to me, especially during the probationary period.

Would love to know why she left her last job!

Well, call me naive, but I thought that there were policies in all LTC facilities that said that if the narc count was off, NEITHER NURSE left the building until the missing narcs were accounted for and the DON/Supervisor was notified if the count could not be justified.

Many LTCs are different from a hospital in that there is no pixys to help control the counts. Granted, it is easier to steal drugs in an LTC because the LOL that is confused might not remember if she took the med or not and the nurse could say she did, could chart that it was administered, and it could end up in the nurses pocket. However, if this happens enough times with the same nurse and no other nurse, someone is bound to get suspicious.

To the OP, I am going to agree with the other posts that say NEVER NEVER give your narc keys to someone without first doing your count! Also, you may want to talk to your supervisor/DON about adopting a policy in which neither nurse leaves and the supervisor is contacted if count is off.

By the way, what did you find out when you reviewed the tapes?

Its either shes not signing out narcotic form after giving medication or its something else. You never ever want to give keys to another nurse unless you do the narcotic counts with who will be taking your keys.

I'm just wondering, is there a pattern to medications given to patient? Is it a patient who usally ask for pain medicine daily or does this patient rarely take pain medicine?

Under no circumstances should anyone under the rank of RN be carrying the Schedule drug cupboard keys. Yes, I know passing them on to a junior is something we all do, especially when workload dictates, but only when absolutely necessary and only when there is a second trustworthy junior to witness. At the end of the day, you will be called to account for any discrepancies.

As you can see, the person who wrote this thread is from the US. So stating your countries laws mean nothing.... are you telling her because she is an LPN that she shouldn't hold the narcotic keys because your country doesn't allow it? Um... well she isn't in your country, so who cares, your post was pointless. Here in the US LPNs are allowed to have the keys to the narcotics.

so OP, after reviewing the tapes, what has been discovered? had the lpn indeed steal narcs, a human error/miscount, comp error....etc?

does this lpn currently know they are being investigated?

what does your facility now plan to do? if s/he is innocent, what other new efforts are now in effect to offset miscounts?

Under no circumstances should anyone under the rank of RN be carrying the Schedule drug cupboard keys. Yes, I know passing them on to a junior is something we all do, especially when workload dictates, but only when absolutely necessary and only when there is a second trustworthy junior to witness. At the end of the day, you will be called to account for any discrepancies.

I work at an assissted living where there are no RN's, none, our DON is an LPN as well. What then? We have the keys to the med cart, including narcs because thats our job. In most LTC that is who passes pills, LPN's. I'm assuming thats what "juniors" are.

In my facility the first thing we do at shift change is count narcs. I've been counting with the same crews of LPNs for 8 months. We've never had narcs come up missing.

If narcs do come up missing, the problem is immediately reported to the supervisor and the nurse responsible is suspended for 3 days.

I don't understand why the OP's facility is so lax with narcs. Scary.