When a med runs out

[CYoungLPN]

What do u do when u run across a med that ran out for instance Lasix 20mg to be given at 8am for ms.xyz u've called the pharmacy to make sure it's coming on the next run but what do u do?

I know borrowing is a big no no...but what do u do? Ms.xyz needs her lasix what would ur solution be?

I'm new to LTC I was just wondering what y'all do

[morte, LPN, LVN]

Yup, this is the way to do it, but unfortunately many places don't. If you are not a "high user" of the Ekit, it may not be financially viable.

"Use the e kit AND make sure that a request for replacement for the ekit is sent to the pharmacy. Nothing is more irritating than going to the ekit to find multiple use slips inside and empty med slots because no one faxed a replacement request to the pharmacy."

Pretty sure we do ekit exchange daily.

[AngelRN27]

txredheadnurse is precisely right about everything in her post. I know that many times we dread using the e-kit because of the required paper work and fear of getting behind during medpass. To be honest, when I have to borrow from the kit in the middle of morning med pass, I take out what I need and write an "e" on my hand. I handle the paperwork after my medpass is complete (including what previous poster said: e-kit slip, request med, request e-kit refill, etc.).

Luckily, I have picked up the habit of skimming through my cart at the beginning of my shift to anticipate any issues like this. I've missed something occasionally and then done what I described above... same thing for narcs. If you have a quick eye and more or less know the frequency at which your residents take their narcs (even if they don't take them at all on your shift) it's actually quite easy and efficient to "pull tabs" on narcs that may need to be ordered during your narc count. This has really kept my (our?) narcs in check without much extra time or effort on my part.

[lucinda1518]

"Borrowing" medications is not an accepted standard of practice. It is also considered misappropriation and reportable to the state. A nurse at my facility did this, and state did catch it, and we did pay the price with numerous tags, fine, probation, and went into extended survey which was very ugly. We learned our lesson. You may get by with it for years. You get caught one time and you will be very, very sorry.

[OhioTry]

I'm surprised by the answers here, as a relatively new nurse myself, the only meds I heard it was a no-no to borrow was the narcs- they can be dispensed by the supervisor from the Pyxis if necessary. If I've got the same med and same dosage for a different resident, I've administered that. I do always make sure that the appropriate order has been placed, but to special delivery a Flomax when I've got six residents with the same thing, seems a waste of resources. I think I've had to do it only twice in the four months I've been there, so it's not a regular occurrence, but it was the least of my worries as I adjust to the whole new world of LTC, and nursing.

Are you using "narcotics" as a shorthand for all controlled substances or do you specifically mean only narcotic pain medications? I'm only a CNA so obviously in my facility I have nothing to do with med pass. But I am prescribed a powerful stimulant to medicate my ADD, and I was under the impression that it was a serious no-no to give any of my medication to someone else, even if I know they have legit AD(H)D. It's not a narcotic but it has similar abuse potential in the opposite direction.

[systoly]

there is no such thing as borrowing

the meds belong to the resident

does anyone ever ask the resident if it's ok

to borrow, i think not, so it's theft

i ask the pharmacy for a stat run or

if that's not possible, i ask if anyone from

activities or the office can run to a pharmacy

[beshacohen]

It makes me INSANE to go to get a dose of a scheduled medication and find that there is none, or even worse, that the card is still in the cart, empty. This stuff happens because people don't reorder. I always wonder about the nurse who took popped the last pill. If I see that she re-ordered (I can see the re-order date on our eMar) I calm down a little bit. But if I see that the last pill was used and no-one bothered to reorder, steam comes out of my ears and nose.