I work a medicare/LTC unit. We do not have an in house pharmacy, nor a Pyxis. Many times, our admits come in after 1500.. We get the orders, transcribe and fax to pharmacy. The pharmacy delivers tid..approx 1000, 1500 and 2100. The DON wrote orders last week for a homeopathic <what ever>OTC for C-Diff, to be given bid. As I transcribed, I put 0800 and 2000 for times (standard on my hall..adjoining hall woulda been 0900 and 2100)
OTC didn't come in until 2130, so I began the med the next AM.
Today I was "written up" because I didn't give the med. I have been taught from day one in nursing school
that the "Right Time" is an hour before to an hour after, in this case 1900-2100 would be correct.
I raised that to DON and she stated " But you give the initial dose anytime. You could give it at midnight, and it would still be the 2000 dose"
Am I wrong on this one?? I anm pretty upset...doing what I was taught to do, and get slammed in the head for it...
If she (DON) is correct..I think education and discussion instead of punishment was more appropriate .
I think I'm going to write the BON and get a written opinion
Mar 1, '05
The DON wrote orders last week for a homeopathic <what ever>OTC for C-Diff, to be given bid.
I'm just dying of curiosity--what was the med?
Because if it wasn't a prescription med, if it was an OTC med, I wouldn't think it was a really important one either.
Lots of times we don't give meds to patients coming into the ER because they already took the med at home. So if you didn't have knowledge of the last dose taken, I could understand your reticence to give the med.
However, if it was a start-dose, then I would've given it if it was available.
Last edit by UM Review RN on Mar 1, '05
Mar 1, '05
LPN1974....most LTCs don't have a pharmacy in house. Our pharmacy is about 30 miles away or at least 45 minutes. They don't do stat drug deliveries only for rare emergencies and its dificult to get them stat at that is 2 hrs? We have an E Box for some cardiac and abt meds
Last edit by CoffeeRTC on Mar 1, '05