At the beginning of your shift , your med cart was counted. When the nurse going off duty said the pills came out of the pack on her …the count should have stopped and the nursing supervisor should’ve been notified. At that time if the pills were in the pack then the pack should be wasted, they fell out of the pack becoming contaminated Once wasted the risk of “re-losing” said pills is nullified and there should be three witness to wasting and two signing.
Med Errors occurring with narcotics are serious offenses, facilities that have dealt with impaired nurses are very strict with narcotic control.
That being said when you sign for your narcotics you are accepting responsibility of control of said narcotics and are responsible for that cart.