Who's Responsible?

[showtime1970]

I Started A Job A Few Months Ago In A Nursing Home As An Rn. I Work The Floor Just Like The Lpn's Do. I Was Surprised To Find Out That When We Are Short Nurses For That Shift, (which Is All The Time) We Share Med Carts, As Well As Narcotic Boxes Located On Those Carts. This Means That If We Are Short 1 Nurse, I Share A Narcotic Box With 2 Other Nurses. Pretty Scary! Since I Am The Rn, I Am Usually The One That Has To Count Both Narc Boxes That Are On The Carts While The Other 2 Nurses Also Pass Narcs. The Other Nurses Don't Sign Or Count With Me. Twice It Has Happened That A Narcotic Was Not Signed Out Or Signed In The Wrong Place. Thank God That We Found Where The Narcs Went Both Times, But I Am Very Uncomfortable With This Practice. One Nurse, Suggested That Since We Couldn't Figure Out Where It Went To Just Document "wasted" This Is Not My Kind Of Nursing Practice And I Worked Too Hard To Loose My License Over This. Please Give Me Some Suggestions Or If You Have Ever Heard Of This Kind Of Practice? Am I Just Being Overly Concerned Or Should I Quit And Find Another Job?

[cjmjmom]

LTC facilities operate differently than hospitals, as you can see. First, I would not document wasted on any narcotic unless you actually saw it was wasted. Second, there is supposed to be 2 nurses counting narcs and if that is not happening I certainly would document this along with your other concerns in a letter to your director. However, keep in mind that documenting bad practice of a facility may not sit very well with administration but it PROTECTS your license (believe me when I say that NOBODY is concerned for your license but YOU and it is UP TO YOU TO PROTECT IT if you want to keep it). I do not know your personal situation so I don't know if it is best for you to do nothing and leave to find another job or not.

[barefootlady, ADN, RN]

A narcotic count with another nurse before accepting the cart is necessary to protect your license. If there are 2 other nurses on the unit, at least one should count with you before the shift and the on-coming nurse should count with you after the shift. There are rumors regarding theft of narcs in all types of facilities, so to eliminate that problem and threat to your license, you should talk to your DON and Administrator regarding this concern. Good luck, if there is not a better way found, I would look for another job.

[PsychRNOhio]

Insist on a narcotic count before the off going shift leaves and one before you leave.

Never say a drug was wasted if you didn't see it done.

Be aware that clients will deliberately distract you in order for another to steal from your drawer.

Make sure your facility has a procedure for counting narcotics and make sure you do.

Nightmares: a green sheet with no narcotics to go with it

BUT be aware a good thief will steal both the medecine and the sheet you document it on.

Nightmare: your records say 20 alprazolam and you only have 19...and no one is supposed to receive it.

As I get older I am much more possessive of my nursing license-I don't intend for a co-worker to cause its loss