The narc drawer...I'm so upset.

Specialties Geriatric

Published

Hello all,

At the end of my shift we do a narcotic count...the oncoming nurse counts the actual med/narc packs against the other nurse who reads off the signed off drugs from the DEA book. Well two of the narcs were off at the end of my shift...meaning two were missing from a resident's pack against the DEA book(the percocet med packet had two less when the oncoming nurse counted as I left my shift) and I signed off two percocets given by me at 2am. I will admit I dont always lock my cart but i'm in and out of them rooms so fast that I don't see how anyone could steal them. I'm currently on orientation and have been for a month and three weeks now. I was written up for giving Roxicet to a resident after the preceptor told me she has been giving it and told me to give 5mls after is was d/c'd. She also got written up. Then at first I got blamed for giving Fosimax out when it was supposed to be given once a week because I was on that "hall" that week, BUT I was off the weekend and it was caught the second night when I was on the other hall(we switch halls when there are two nurses) which makes that 4 pills and there were 4 in the packet and those 4 were gone within 4 days...at first I was written up to make a long story short but then they figured out what happened and it was ONE nurse on the weekend I was off and ANOTHER nurse two days after I was on another hall. So that got thrown out thank goodness. Anyways, now I'm worried about this. Either I didn't hear the count correctly at the beginning of the shift, or she called out MORE than there was (by two) in which I wouldn't have known because I'm not checking the packs of pills against the DEA book at the same time as she is verbally calling the number out(I'm sure the system is pretty much this way in most places?). Nobody does. I work the night shift and haven't slept yet, I hope this all makes sense but I'm sitting here crying. I worked so hard for this license, what do you think they are going to do. I went to the supervisor and told her that the count was off this morning and I have no idea what happened but I know I signed of the two I gave the resident. This particular resident gets percocet PRN every 6 hours for pain, and if you look at the mar and dea sheet history, she does usually get two around 6p or 8p every night but didn't tonite/last night in which I'm thinking it wasn't signed off but given but I SHOULD have caught that, and could have heard it wrong or I don't know. You would think she would have called out the right number, I would have seen it wasn't right, and she would of said "oops I need to sign that out" which happens alot. The supervisor told me not to worry about it and go to sleep but I have a feeling I will get written up for this.

Please advice, support, comments, anything.:o I may have to look for a new job but I dont want to BUT at the same time I do not want to lose the license I worked so hard for.:cry:

i work in two states and it is policy in both that BOTH nurses check the book with each med....i would surmise it is the same where you are, and you have been taught improperly....and know you have learned the hard way why it is done that way.....i, too, have been caught....the 2nd shifter had given a med and gave me the number that would reflect that, but didnt stop and sign it off, and forgot to at the end of count......good luck

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I'm sorry you had to learn your lesson this way but hopefully you won't be penalized to harshly.

I was too trusting when I started out but I learned quickly. Thankfully I have never had to deal with any repercussions but I could have been in big trouble.

I had a near miss with a nurse when I didn't bother to watch her count because me and her were so "cool" I ran to another floor to punch in because I was working a double shift and hours later she called me and claimed a narcotic was missing. Luckily, the supervisor was willing to sign that it was wasted and no harm came of it. I never did this again and later on I find out that another nurse was written up over narcs because of this same nurse. It happened a third time...again the other nurse was blamed and written up. Funny how it always happened with the same nurse but since she is friends with the DNS she was getting away with it until a resident said that she is swapping their percocet 5/325mg with look a like ES tylenol. I never would have suspected her but drug addicts don't look like what you might think they should.

Now I know when I count that it means I must put my hands on the blister pack, turn it over to look for tampering, compare RX # to DEA book. When the other shift is taking over make sure they write down a number and sign as well. At first the other nurses make fun of me for being overly cautious but now they know not to question me

I don't care what they do on their shift but I don't play with my license.

Be leery of people who encourage you to be lax in your practices. What's the big deal about locking the cart when it only takes a second to unlock?

Do not leave the cart unlocked when it is out of sight EVER. One of my nurse co-workers almost lost his license at his second job because a drug addict darted out of a room and stole a lot of methadone off his cart while he was in a resident's room for only a few seconds. Not all residents are bad but the ones that are have nothing to do but watch our routine. They know down to the second how long it takes us to pass a med. Also sometimes they can be working together...maybe one is the lookout while the other one steals? You just don't know so take no chances. The only reason this man has his license today is because the resident was arrested selling the methadone while he was out on pass.

I hope everything works out for you but in the future be more careful.

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We have always done the same thing. One has the book and one has the meds. After getting burnt by this, I always read the book while I am checking the narcs too. Yes, some nurses get snarky about it...but it is my license. One of the other things I have been seeing a lot of, is nursing giving there narcotic keys to another nurse after counting. Like, if a nurse goes on break and someone request a pain pill, she will let another nurse go into the barc box and medicate them. Well, you just signed the count was correct, so what if that nurse takes decides to take some meds from another resident in the narc box how are you going to prove that??

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Specializes in LTC.
I'm sorry you had to learn your lesson this way but hopefully you won't be penalized to harshly.

I was too trusting when I started out but I learned quickly. Thankfully I have never had to deal with any repercussions but I could have been in big trouble.

I had a near miss with a nurse when I didn't bother to watch her count because me and her were so "cool" I ran to another floor to punch in because I was working a double shift and hours later she called me and claimed a narcotic was missing. Luckily, the supervisor was willing to sign that it was wasted and no harm came of it. I never did this again and later on I find out that another nurse was written up over narcs because of this same nurse. It happened a third time...again the other nurse was blamed and written up. Funny how it always happened with the same nurse but since she is friends with the DNS she was getting away with it until a resident said that she is swapping their percocet 5/325mg with look a like ES tylenol. I never would have suspected her but drug addicts don't look like what you might think they should.

Now I know when I count that it means I must put my hands on the blister pack, turn it over to look for tampering, compare RX # to DEA book. When the other shift is taking over make sure they write down a number and sign as well. At first the other nurses make fun of me for being overly cautious but now they know not to question me

I don't care what they do on their shift but I don't play with my license.

Be leery of people who encourage you to be lax in your practices. What's the big deal about locking the cart when it only takes a second to unlock?

Do not leave the cart unlocked when it is out of sight EVER. One of my nurse co-workers almost lost his license at his second job because a drug addict darted out of a room and stole a lot of methadone off his cart while he was in a resident's room for only a few seconds. Not all residents are bad but the ones that are have nothing to do but watch our routine. They know down to the second how long it takes us to pass a med. Also sometimes they can be working together...maybe one is the lookout while the other one steals? You just don't know so take no chances. The only reason this man has his license today is because the resident was arrested selling the methadone while he was out on pass.

I hope everything works out for you but in the future be more careful.

Funny you mentioned this, I did give my keys to the other nurse on the unit who was supposively my preceptor...and me and her are cool. She is very friendly and invited me over to her house, to go shopping with her, etc. But she would have had to do steal the narcs so quickly that I really don't think it was her but there is a small possibility. I called the 11-7a supervisor just a bit ago and she told me not to worry about it and she thinks she knows what is going on but needs to investigate. She said "don't worry your not going to lose your job over this." I mentioned how I worked so hard for my license and was concerned about losing it bla bla and she said "this happens so don't worry." I asked her if I was I going to get written up for this since I was responsible for the cart that shift?"(thinking ouch it may sound like I'm guilty but I AM worried) and she said again "don't worry about this." So we will see. I'm getting used to the job, already got my insurance cards in the mail and my insurance is in effect and active so I don't know.:o I'll just try to forget about it, I will admit it is still bothering me a bit but what can I do.

I appreciate all the responses. It's such a shame and I only started a Sep 14.

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Specializes in Gerontology, Med surg, Home Health.

First of all...just because you go to a different facility doesn't mean your license if safe. Not to sound harsh, but if your practice is poor (and leaving the narc. drawer unlocked is very poor practice) your practice follows you where ever you go. There are scads of ways to steal drugs. I insist that both nurses look at the book AND the card of drugs. Someone said their supervisor signed a med was wasted when count was off??? Stupid practice. I tell my nurses NEVER to sign for something they haven't seen and if their coworker shows them something crushed in applesauce and asks them to co sign it as wasted, they are to write 'altered in applesauce' on the page in the narc book. Never give your keys to anyone without counting off. Never take someone's word that count is correct without looking at it. When counting duragesic patches, take each patch out of the box and look at it. At one facility, someone slit the pouches on the bottom. No one found out for days because there were 3 pouches in the box and it was assumed there were 3 patches. Always have 2 nurses sign in narcs from the pharmacy. 2 nurses should sign a page change as well. And, please, don't just sign. Look at the number of pills your coworker says they moved to the new page to make sure the number matches the actual number of pills on the card. And never give ANY med without making sure there is an order for it.

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Specializes in LPN.

Another tip: Always, sign your nar book when giving a naroctic, double check the actual pack against the count in the book both before and after you take the med out of the pack, and before you give it. Once, I almost gave an incorrect med, but the count was not correct, so I checked again It saved me from making an error. I say this because sometimes my eyes see what they want to see. I can drive past a sign, and my brain will finish a word I see without me even realizing it. So when you are in a hurry to give a narc, and you reach for the pack of narc's your eyes can incorrectly finish the word, or your hand can misgrab and get the wrong med.

I haven't been personally checking every nurse and reading the book, I usually check for people I don't know or have don't have a good relation with But, it is a good idea to do it the right way all the time. My first job I had as a nurse was with a person who did eventually get caught for stealing naroctics. This nurse could have cared less if I would have been fired. Thankfully, I was very diligent and spoke often to my supervisor when things seems to be suspious. At the time I thought I was being paranoid, but now in hindsight I am glad that I was careful. It kept me employed, and my liscense intact.

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