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How can I get a ruling to have narcotics countersigned when they are delivered to my unit at the facility where I work?

Monday December 9, 2013
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Dear Nancy,

When the pharmacy where I work puts narcotics into the automated medication dispensing system, they are not countersigned by the charge nurse on the unit.

What happens if the pharmacy says they put in 20, but it was really only 10? How can I get a ruling to have narcotics countersigned when they are delivered to my unit?


Dear Nancy replies:

Dear Ruth,

You are right to be anxious about this type of practice. It is a perfect set-up for anyone who wants to divert narcotics, including members of the pharmacy or the pharmacy technician (or whomever delivers the narcotics to the unit), to do so easily. It also is quite odd that your facility, including the head pharmacist at the facility, would condone this type of arrangement. If there are narcotics missing, everyone who dispenses, delivers or administers narcotics in the facility will be suspect.

You might try speaking with your nurse manager, your CNO and your risk manager as soon as possible. This situation is ripe for a future problem. Moreover, it is unclear if the procedure even meets federal and state laws concerning the dispensing of narcotics by a pharmacy.

If you are fearful of talking with the above individuals for fear of some reprisal or adverse employment decision, you can consult with a nurse attorney or other attorney in your state who represents healthcare providers and who can advise you on the best approach to take.


Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.