narcotic box counts

[joRN18]

Here is the scenario:

A narcotic box is locked and signed out by nurse A. Nurse A unlocks and counts the medication in the narcotic box with nurse B. Nurse A & B go to lunch. Nurse A locks the narcotic box. Nurse C unlocks the narcotic box without Nurse A knowing for a procedure. Nurse C- places patient label and medication administration documentation in chart in box (witnessed by Nurse D & E) for a patient procedure. Nurse D witnesses waste by Nurse C and both Nurse C and D initial. Nurse C and D count the medication in narcotic box post procedure. Nurse A comes back from lunch and is upset Nurse C got into the narcotic box that was signed out by Nurse A. Is there a federal offense committed in this scenario?

[Nunya, BSN]

Not if nurse c had keys and was authorized to go into the box. Was she supposed to wait till a and b got back from lunch?

[joRN18]

Nurse C has access to keys and is trained to administer medication. The purpose of Nurse C in the room to begin with is to continue with the schedule.

[apsychRN]

Nurse A should have counted off with nurse C. Or whichever nurse was going to be carrying the keys while she is out to lunch. Nurse A & C should also count upon the return of Nurse A if she is given the keys back. What’s the point of A&B counting together and leaving. A&B are besties, or sister n laws or whatever so if the count is off it’s their word against Nurse C which gets you nowhere. Nurse A & C perform a count and both agree that the correct amount of medication is accounted for vs what’s been signed out. If the count is off it’s corrected then and there with Nurse A more than likely figuring out what’s happened (wrote down 43 instead of 48 due to misreading the 3 or checked the MAR & Norco was given but not signed out etc). That way Nurse C starts off with a correct count.

[Davey Do]

Gee, I'm confused, but I never was good at algebra.

If everyone has legal access to the narcotics, the count is correct, and all the appropriate documentation is completed, then Nurse A might just have some control issues.

Now personalities and power struggles are things I can sink my teeth into!