narcotic restrictions- can you witness wastes?

Nurses Recovery

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I finally found a job after a year of searching. Heres the thing, my narcotic restriction makes things difficult for my coworkers and I am trying to find ways to help to 'make up' for this as much as possible.

Can I witness wastes?? Can I sign off on a controlled substance? Where I work they have to have a witness sign off on EVERY single narcotic, even if the whole dose is given.

My consent agreement does not say that I am unable to witness wastes and I have reached out to my monitor for further clarification. She doesn't seem to actually ready my questions as most of them are not addressed or answered at all.

I just want more perspective.

Thank you all

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In my case, no, I couldn't witness, couldn't do the inventory, nothing related to controlled substances. That was tpapn in Texas.

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This was from the TPAPN handbook under practice restrictions. Your program should have a similar section.

Participants agree NOT TO:

9. Have access to controlled substances during the first six months of work in nursing. No access includes:

a. Not counting or administering controlled substances.

b. Not witnessing wastage, signing pharmacy receipts for controlled substances, or having

the ability to access storage areas for controlled substances.

c. Not calling, faxing, or otherwise electronically authorizing prescriptions for controlled

substances.

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Mine says I 'shall not administer, have access to, or possess (except prescribed meds to myself) any narcotics, other controlled substances, or mood altering drugs for a minimum of six months in which i am working in a position that requires a nursing license. At any time after the six month period previously described I may submit a written request to the board to have this restriction re-evaluated. In addition i may not possess or carry any work keys for locked medication carts, cabinets, drawers, or containers. I shall not count narcotics. I shall not call in or order prescriptions or prescription refills for narcotics, other controlled substances, or mood altering drugs.'

Yours is quite clear, I could not do my current job with that wording..

In my position for example, I have to reconcile medications and my new admissions have these medications or new orders have come in. Obviously I cannot give them but I must reconcile the order. I also have to hand over written prescriptions that the doctor has ready for their discharge.

When a waste is performed you are not counting the medications in the drawer, you are verifying they are wasting the medication. Nothing is referenced in my wording addressing this.

Of course I am following the rules but this is so grey and their answer is always no.. too bad... tough s%#@.. I am afraid to ask questions and put myself on the radar.

This facility must have a witness for every single narcotic given. I don't know if i can stay there if I am unable to do this..

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Honestly, if it's gray, I always did it and figured I'd debate my way out of it if I got caught. Nothing bad, mind you, just like for example, I wasn't allowed to work "overtime", however I did pick up a few extra shifts here and there, when they were paying double time. I figured if you average the 2 weeks for the pay period, the extra 12 hours wouldn't really put me into "overtime". I work 36 hours per week, an extra shift is 12 hours. That's 84 hours, however I always leave right at 7:00 or sometimes even earlier, depending on when the day shift nurse arrives (all we have to do is count narcotics, there's never any patients to give report on at 7 am! It's a very small facility). My employer takes 30 minutes out of my pay each shift, to account for my lunch break.....so add up all those 11.5 hour shifts and I'm pretty much right at 80 hours for 2 weeks. No "overtime". I also picked up a couple of shifts at another location (same employer, multiple locations). I worried about doing this, because even though it's not technically working for multiple employers, which is against ,y contract, it is sort of "floating" which is also not allowed. During ,y contract I did that twice, but I worried about it, it certainly would not be worth getting kicked out of the program over an extra shift or two! So I stopped doing it. BUT, the thing is, how is tpapn ever going to know, unless my manager tells them? And why would she? She needed someone to cover those shifts! So I don't want to advise you to break any rules, but if you can argue your case, based on what they have in writing, seriously, who is going to contact your monitoring board and tell them?

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I agree with everything you just said.

What gets me is that we are all guilty until proven innocent. This is designed for failure on the nurses part. It took me a year to find this job and I am already a royal pain in the a$$ for six months as I cannot pass my own narcotics. Witnessing a waste has nothing to do with counting narcotics or handling them in any manor. This facility I am has someone sign off in the computer on EVERY narcotic given -- which is pretty odd to me! How can I work if there are only two of us?? Its one thing for them to do a large portion of my job for me but what if i can't even sign off on the meds they are giving for me!?

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I agree with everything you just said.

What gets me is that we are all guilty until proven innocent. This is designed for failure on the nurses part. It took me a year to find this job and I am already a royal pain in the a$$ for six months as I cannot pass my own narcotics. Witnessing a waste has nothing to do with counting narcotics or handling them in any manor. This facility I am has someone sign off in the computer on EVERY narcotic given -- which is pretty odd to me! How can I work if there are only two of us?? Its one thing for them to do a large portion of my job for me but what if i can't even sign off on the meds they are giving for me!?

Yep, just do it. You can argue your case if you ever have to, but you won't have to. My first job in monitoring was home health, and my manager knew the drill because she had had another TPAPN nurse before me. Technically I was not to be assigned any patient who had narcs on their home meds list. We never actually administered meds, their family/caregivers did that, but we did review their meds and I was in their home where the meds were available. Nobody was ever going to know if one little old lady had hydrocodone on her list of meds, unless I made a big deal out of it! So it happened, some of my patients had Xanax or codeine or whatever, but I never administered it, I never said a word and that job got me through my narc restriction.

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