I've worked in a lot of LTC facilities, and most use similar systems, short of the disciplinary action (unless, of course, a nurse is observed making an error repeatedly that causes harm, or has the potential/ or the nurse is not getting the hang of the education). Since I "do agency" I've been followed by a lot of SDC nurses and several different pharmacies. The SDC nurses seem to do it differently, as if they are, in fact, looking to punish. I find the pharmacy auditors to be very valuable learning tools! Instead of getting nervous and blowing the whole deal, I always ask questions about what's right and wrong, etc, and they've never hesitated to answer. So, when it came time for state surveys (and trust me, they head for the pool nurses first), I'm always confident, and have always gotten 100% accuracy. Hopefully your SDC can learn from the pharmacy auditors, and you can too (take advantage of them, even if the SDC is a pain in the butt!! )