borrowing meds

I have 2 suggestions. The first is that the day shift nurse who gets the order needs to be more proactive in making sure that the medication will be delivered by the evening shift. The second is that the administration time needs to be changed to reflect when the medication has actually arrived for that patient. If the medication is not available at the "scheduled" time then it must be documented "not available". Unfortunately, as nurses we cannot predict when a medication will be delivered. As long as it is not a life threatening situation then waiting until the patients medication is delivered is the appropriate action to take. Please remember that it is YOUR LICENSE that you are putting at risk by "borrowing" medication from another patient. You will be the nurse who goes before the BNE for a hearing not the night shift nurse or the day shift nurse.

Our hospital pharmacy provides forms to fill out when we borrow from another pt. If no one is on that drug then we just write NA on the MAR and the pt gets it when it does arrive.

What about the EDK box? Every wing in my facility has one and we simply take the med out of there and put in a slip.

We take from our E-kit if the med is available in the kit. We have a rather sizeable one, so there's a lot in there, even a bunch of various IV fluids.

If you do paper charting like my facility still does, I'll generally date the left side where the order reads, and let the staff fill in the appropriate date/time box when the med does arrive, and 'arrow' after the fact. New admits' meds generally come on the late run from the pharmacy, so starting them the next day is the main option.

It might be just my geographical area but where I come from borrowing meds is just a fact of life. I would be screwed if I didn't borrow meds when necessary. The first choice is always the e-box, but if it's not there, then yes, we borrow.

This is accepted practice here. We have had inservices regarding proper med administration where we've been told by the staff development co-ordinator and DON that we are to borrow meds if possible rather than document not available.

One word of caution on 'borrowing' meds: NEVER attempt to do so if the med is a narcotic!!

Technically, borrowing from another patient is bad practice and, in the strictest sense, illegal. That patient, or his/her insurance, has paid for those meds and in a perfect world, they should never be given to some one else. IRL, however, almost everyone has been in a situation where a fax comes in from the PCP after pharmacy hours are over, you need to start the med at HS, the E-kit doesn't have it, and you just happen to have another pt. who's on the exact same medication........so you pop it out of that pt's bubble pack rather than write "on order" or "med unavailable".

The reason is, the state absolutely hates to see "unavailable" on the back of the MAR and will dump all over the facility where there is a pattern of them. They are all about making facilities as 'homelike' as possible, and part of that is making meds available to patients as if they got the script at their doctor's office, filled it on the way home, and started it the same day. So, we borrow. It's not right, but when faced with a choice between the lesser of two evils, we usually select the one with the least potential for harm.

In LTC borrowing is never acceptable. The nurse taking the order should either start the med at a time when they know it will be available or inform the physician of what is available as a substitute until the med is delivered. If you have a med to give and it isn't there, the supervisor needs to call the physician. Borrowing or indicating "not available" will get you in trouble.

I have also been told that if the resident you are "borrowing " from is on medicaid/medicare it can be viewed as medicaid/medicare fraud. Like VivaLasVegas stated, the ins. co paid for the meds with the intent for the designated resident to recieve it. I will get the med out of the EDK or call pharm and have it drop-shipped to the facility. Like dmb219 stated we are not allowed to put not available either, it is the "residents right" to have the meds available as ordered.