Narc count short!!

heron, ASN, RN · Feb 1, 2011

DON sounds a bit overwhelmed. Technically, you're clear if the oncoming nurse signed that the count was accurate when you handed over the keys. Reality is, those investigations can go anywhere ... I'd say be prepared to donate a urine test and answer some questions.

Keep copies of any write-ups that happen. If you don't have an attorney, at least figure out where you can retain one quick and how much it will cost.

Just don't panic ... it could be something as simple as someone forgetting to sign something out.

Meriwhen, ASN, BSN, MSN, RN · Feb 1, 2011

If the count was accurate at 7am and the oncoming nurse signed off and accepted the keys, then it's not your problem. The count was accurate when you handed over and the oncoming nurse verfied that the count was accurate: therefore, the narcs must have been lost after you left. And as they were lost on the oncoming nurse's shift, liability falls on her and not you.

If the 7am count was inaccurate, the oncoming nurse should not have signed and accepted keys, nor should you have released responsbility for them, until the discrepancy was resolved.

If the oncoming nurse didn't actually count each med before signing--and you'd be surprised how many nurses won't count off every single med because they're in a rush or can't be bothered--then it's her fault since she should have counted them properly. If that is the case, perhaps this will be a reminder to her--and to you--to physically count each single pill/bottle/etc. whenever accepting the narc keys.

Either way, you should be in the clear...however, IMO it couldn't hurt to protect yourself legally just in case. Best of luck getting this sorted out.

WillowNMe · Feb 1, 2011

I agree that if the nurse coming in after you signed off that the count was correct, that you should be off the hook. Unfortunately I have experienced other wise... I work as a CNA and we have narc counts. One time when they were off, they wanted to have me come in for questioning - even though I had signed off on these particular narcs two shifts earlier. I guess I would just make sure that you are covered.

caliotter3 · Feb 1, 2011

The oncoming nurse signed off on a correct count. She is responsible. If you need to, get legal representation.

dthfytr, ADN, LPN, RN, EMT-B, EMT-I · Feb 1, 2011

The count went wrong after shift change when the count was correct, and the keys handed off? How can the blame you for what happened after you left? Don't sweat it. You may have to do a whiz quiz, but I doubt it unless they make everyone do it.

I think you're wrong to let your director treat you badly, in person or by phone. Ever hear of caller id? I'd tell her to bite my asterisk.

Do you carry your own malpractice insurance? You should. Some offer license protection. For less than it'll cost you to speak to a lawyer for 1 hour you could be protected, and the insurance company will pick and pay for the lawyer.

systoly · Feb 1, 2011

Did you and the oncoming nurse sign off on the narc count? If so, I don't see how you are involved in this at all and that's what I'd tell the DON. You don't need a lawyer. You don't need to be in a defensive position. This isn't your problem and if the DON is trying to involve you ask her if it has been reported to the state yet, because you're sure the state will find the hand off was handled appropriately.

dlissa74 · Feb 1, 2011

Thanks all of you that have sent replies in thus far. Yes I have Liability Insurance. Yes she does always talk to me badly. Feel like a child getting scolded by a parent. My best friend a nurse told me I should quit that the job has to much drama. I do not want to quit I like my residents and would miss them if I left. And I also know that they don't have enough help we have lost over 40 nurses in the last year and a half. Mostly because of the DON. All the new nurses that just started said they are going to quit. So they will not have any help? I do not want to quit. I have been there over 3 years what to do?

heron, ASN, RN · Feb 1, 2011

I have a suggestion that won't actually help you in this situation - but might help forestall it happening again in the future.

In one facility where I worked, both nurses looked at both the count in the book and the number of narcs counted. A little time consuming, but worth the extra check.

I also found that when I'm counting, I have to ask the nurse reading the control sheets to not tell me what the count is supposed to be ... I'm a suggestible soul and if you give me the number, that is sometimes what I'll count, even if it's wrong.

dlissa74 · Feb 1, 2011

Thanks for the advice I did not sleep well last night

INLPN93 · Feb 1, 2011

Well the other nurse signed with you that it was right and took the keys.

So it is in fact her responsibility. Tough luck to her.

Might I suggest when counting on and off make that other nurse show you the book and you do the same, while counting that way you will not ever get this kind of call again. Just take the time during count to verify each card with the narc sign off sheet. It takes only a few extra minutes. If someone has a problem explain nicely that your not having those phone calls waking you up again.

I do this in any questionable situation, whether its a particular nurse or facility that has lax in their judgement.

GHGoonette, BSN, RN · Feb 1, 2011

FORTY nurses in a year and a half???! Your DON may very well be under the spotlight herself, as I'm quite sure management is asking searching questions concerning the staff turnover -which would partially account for the "panic mechanic" reaction.

Unless she gets her marching orders, that facility will become an increasingly toxic environment. I'd start looking around for alternative employment.