Angel McGarrity-Davis, RN, CDONA, NHA

Long-term care facilities all seem to do narcotic destruction a little differently.  Could you tell me how to do it to make sure I protect myself?

That is a great question. Let’s go over a few general practices to ensure you are covered, no matter what company you may work for.

It definitely is not something that you can take lightly. You worked hard for your license so let’s make sure you keep it. Unfortunately, there are nurses out there who are, for various reasons, trying to find weak links in the narcotic system.

Do not become distracted. It is your responsibility to make sure the patient has the right number of narcotic pills. Pay attention to the patient’s count down sheet AND the number of pills you are counting. Remember: After you sign for the count, it is your responsibility.

Never guess. If there is a discrepancy, stop and call the director of nursing and/or administration.

Most facilities are counting the number of cards on the cart. Pay close attention to what medications are coming in and out of your cart. 

Never, EVER, give your keys to anyone. I do not care who she/he is. If someone wants to take narcotics off your cart, make sure the person is authorized to do that.

If there is no per se form that has a spot for the person taking them, make the person sign anyway. This is your responsibility to have a chain of custody.

Another good practice is to sign or initial at the bottom of the count down sheet and have them do so as well. Then no one can write anything after you.

For further questions, review federal regulations F425-F431 and the Comprehensive Drug Abuse Prevention and Control Act.

You can never be too careful!