Narcotic count (Drug and Alcohol Rehab)

Hey there everyone,

I'm new here and to the healthcare field. First I want to state that I'm not a licensed nurse in any shape or form, though I'm enrolling in school in fall for it. I work in a Drug and Alcohol Rehab facility (no, im not in recovery, why does everyone ask that? like its weird that i have never done drugs?). Anyway, so none of us are licensed and none of us "Med Techs" have had any sort of special training.

Now the situation has come up that people are saying that the med count can be done by two people of the same shift. Now I read the other forum post on this exact subject and talked with my Mother who is a 25+ year LTC LPN. Both state that the count must be done by one person from shift leaving and one person from shift coming on.

My problem is that I need to know where that law is. My Supervisor won't listen to me because im not a licensed health care person and she says that it can be done with too people from the same shift. I know that its a federal law so I really need to know where it is so that I can show this to her.

Thanks everyone
I don't think it's a law. It's probably based of facility policy. When I worked in ltc (only for a month) we just had two nurses do the count. They didn't care which shift as long as it was done morning and night.ETA - it may differ based on state as well. They desired one nurse from each shift but really just wanted the count done so didn't fuss about who did it.

Please check your facilities policy and procedure manual and follow it exactly.Is there a state rule on how to count narcotics? - Nursing for NursesNarcotic Treatment Programs Best Practice Guideline - Recordkeeping

Quote from NRSKarenRNPlease check your facilities policy and procedure manual and follow it exactly.Is there a state rule on how to count narcotics? - Nursing for NursesNarcotic Treatment Programs Best Practice Guideline - Recordkeeping

It seems to me that if two people from the same shift count the narcs, it would create some liability issues.Who's responsible if a narc comes up missing? Are both techs working that shift in and out of the narc box? That could get very ugly very fast.If your facility really only needs one tech to pass meds, then that tech should be the only one with the keys. If the workload is truly such that you need two techs to pass narcs, then each tech should be working out of his own narc box that he's soley accountable for.And it really should be the previous shift and the oncoming shift counting. When first shift is counting in the morning, I (night shift) want to be present during that count. I would never be comfortable with two day shift nurses verifying count with me nolwhere around. How do I know they won't just shove some pills in their pockets and come out and say the count was wrong?

and that's what I was saying.. who's to say they don't pocket something and say "well the count was right when we counted it" so when I came on shift tonight they said they had already done the count and I just looked at them and said "well we're doing it again cuz I'm not taking keys until I verify that count is right" and I got some attitude for it but it's my reputation on the line,

Yikes! And is there a licensed person on the premises at all?By Med Tech, do you observe residents taking their own pre-poured medications?I am not sure I would want to be an unlicensed person having access to narcotics to give to residents--after what assessment and by whom? If the resident has a negative outcome from the medication, I wouldn't want to be liable for any of that. Especially if the resident is in acute ETOH and/or drug withdrawal. This is typically medically based, and is not always straightforward.i would worry about the fact that there isn't any policies in place. It must be a private pay situation, as I am not sure what state agency would license a facility without policies.In most facilities, the outgoing medication nurse counts with the incoming medication nurse to make sure that the narc count is correct. But I am not sure why this is being done by UAP's in a situation of giving out PRNS, and not something that is specific to residents. So this goes deeper than a narc count. I would proceed with caution, and ASK to see the policy. Which have a way of magically appearing when the count is off, and the licensed person in the facility has to take the heat.

Quote from Taynakwell thats the thing... the company is only 6 months old. they don't have a book or anything. no policy. we were counting the normal way, one person from each shift then it changed because swing was complaining that they wanted to get out on time but always did anyway. we set up our shifts so that there is a 30 minute overlap in the schedule so that we can get the count and report done. but the tech sup is saying it can be two people from the same shift. But thank you NRSKarenRN. your first link lead me to the board of pharmacy for washington where i found the info i was looking for... Washington state only requires a count done once in a 24 hour period. so... thats a little discouraging to me... you think that it would say something like done at each shift... and doesn't say anything about which people it needs to be just that 2 people do it.

Is the employer saying they do not have policies in place because they have only been open for 6 months? They are supposed to have policies in place before they open.

Quote from Esme12The government regulations only give minimal requirements usually...the rest is "best practice" and policy. Even if the facility is 6 months old there should be a policy.Usual and customary is 2 people count...one from the on coming and on from the off going "count" the narcs. Many facilities make the licensed personnel on duty be one of the counters.

Quote from jadelpnYikes! And is there a licensed person on the premises at all?By Med Tech, do you observe residents taking their own pre-poured medications?I am not sure I would want to be an unlicensed person having access to narcotics to give to residents--after what assessment and by whom? If the resident has a negative outcome from the medication, I wouldn't want to be liable for any of that. Especially if the resident is in acute ETOH and/or drug withdrawal. This is typically medically based, and is not always straightforward.i would worry about the fact that there isn't any policies in place. It must be a private pay situation, as I am not sure what state agency would license a facility without policies.In most facilities, the outgoing medication nurse counts with the incoming medication nurse to make sure that the narc count is correct. But I am not sure why this is being done by UAP's in a situation of giving out PRNS, and not something that is specific to residents. So this goes deeper than a narc count. I would proceed with caution, and ASK to see the policy. Which have a way of magically appearing when the count is off, and the licensed person in the facility has to take the heat.

We do it both ways where I work. If we are counting the accudose narcs for a once a week check, we use two from the same shift. If we have a narc locked in the narc closet, we use the out going nurse and in the incoming nurse. I would not be comfortable not counting the myself at the beginning/end of shift and being the med nurse.