OR Narcotic Waste

heartICU · Sep 18, 2005

We have recently be told that the Circulating Nurse can no longer witness our narcotic waste in the OR. How do CRNA's in other institutions waste and account for narcotic waste.

Our staff anesthesiologist will witness, or the PACU nurse will witness.

rn29306 · Sep 18, 2005

Our in-house OR pharmacy accounts for the waste that we return from procedures.

Endorphin · Sep 18, 2005

Do you sign out drugs for each procedure or for the entire day. Right now we sign out a drug box at the start of the day and return it to our pharm at the end of the day. The Pharmacist won't witness because they "don't know what is in the syringe". Catch 22!!

I might also add that we are a private group and arn't employed by the hospital.

Thanks

rn29306 · Sep 19, 2005

Do you sign out drugs for each procedure or for the entire day. Right now we sign out a drug box at the start of the day and return it to our pharm at the end of the day. The Pharmacist won't witness because they "don't know what is in the syringe". Catch 22!!
I might also add that we are a private group and arn't employed by the hospital.
Thanks

We sign out a "box and bag" everyday or when we need more supplies and the "box" is exhausted. Box = tackle box with most needed OR drugs. Bag = paralytics. Narcs are obtained on a per-patient basis and signed out on a log sheet. We are issued a card that allows us to write amounts given and returned. Empty vials are returned in the bag we are issued with the narcs.

I'm kind of passive-aggressive so I include the tops to the medicines I return just to mess with him. We are a test-at-will (urine drug test) facility and the pharmacist don't play with narcs. Do something stupid (like abuse narcs) and its over.

He runs a pretty tight ship and half the battle my junior year was learning to comply with pharmacy. He's ex military, perhaps that has something to do with it. Can't argue with it because it works and is very efficient.

jwk · Sep 19, 2005

We have recently be told that the Circulating Nurse can no longer witness our narcotic waste in the OR. How do CRNA's in other institutions waste and account for narcotic waste.

That would be a hospital policy - it is certainly not a DEA or state board of pharmacy requirement. It's a power play on the part of your OR nurses.

skipaway · Sep 19, 2005

I have individual narcotic supplies that I keep in double lock boxes in our department drug room. I take from my supply what I need for the day and return what I don't after shift. When I'm out of a particular narcotic, we have our own department supply with which I replace my stash. I have a sign out sheet that goes to the Pharmacy who then replaces what I signed out in our department. I log our uses on narcotic sheets where I list patient's name and what drugs they received. If drug was wasted on that patient's case, this is listed too. Also, when I "buy" drugs to replace my stock, that is listed, in red, on the narc sheet and the serial number on the box is listed. Wastes are witnessed by any CRNA, RN, MDA or PACU nurse. Great system that bypasses standing in lines waiting on others to replace our needs before, during and at the end of cases.

jcgcrna · Nov 7, 2005

In our one OR very small rural hospital the OR nurse witnesses the waste of all my narcotics. We then go to the pixys and account for it there.

yoga crna · Nov 7, 2005

One of the reasons I love office anesthesia and the fact that I own the facility, is that we cut the BS down to a workable and reasonable process. I ask the circulating nurse for the narcotics, administer it, record it and have her countersign the waste. Two RNs (one can be me) count and verify once a day. I also have access to the narcotic keys and can get my own drugs, but I choose not to. We don't have a Pyxis, a pharmacist or an OR manager. Everyone does their work with joy, gets paid well and has minimal complaints (usually about surgeons). I love my work more and more every day!!.

By the way I would ask why there is a change in policy and ask to see, in writing, the federal or state law that mandates it. I agree that it is probably a power play by someone with a lot of initials behind her name.

Yoga CRNA