Taking Call

When taking call I received a message from a patient with an electronic medication planner. Her morning drugs had been dispensed in the evening in error. I was unable to reach her assigned nurse, so I went to the patient's home to check out the situation. The patient had 22 different medications taken in different combinations three times a day, with some dosages varying from day to day for Coumadin management. Some of the pill bottles were empty. Some of the labels on the medications no longer matched the so-called updated medication list. The medication list in the home did not reflect recent changes (and her nurse had been to the home today). Cups of medicine with lids were sittting around the table near the machine, no label as to what was in the cups. I was a little confused about all of this.

What would you do as the on call nurse?

Here is what I did, and I would like to know what your feedback is. I removed everything from the machine and put them in a bad with all the random cups of medication that were sitting out on the table. The patient has mental confusion and lives alone; I put that plastic bag aside so she would not take any of those medications by mistake. I then metered out the correct medications for the rest of today and the next three days and loaded the machine correctly. My plan is to contact the assigned nurse and tell her she needs to go back within the next 3 days to load the machine properly.

Please let me know your thoughts. The other option would have been to dissect each and every cup of pills, trying to figure out what was in them, and if it is correct, etc. Already I knew the machine had been loaded incorrectly so how am I to trust what is in the machine?