Leaving meds at bedside in LTC

Happy New Year !

Many new nurses, entering LTC, are faced with this dilemma. They observe seasoned coworkers leave medications at bedside. Furthermore, some residents demand it, arguing that the other nurses do it. While this may or may not be true, it is rather irrelevant. Unless a specific may leave at bedside order exists, it is not ok to do so. The risks are harm to the patient from omitting the dose, doubledosing at a later time (oding), mixing the medication, etc. etc. Other patients are at risk due to sharing, rummaging, or being medicated by the first patient. There are a number of ways to address this. When first faced with the situation, validate the patient. Instead of immediately citing that this is against the rules you might say something like I'm sorry I didn't know this, this seems very important to you. Try to find out why it is important to the patient. Is it a control issue, is it a convenience issue, etc. Try to accomodate as much as possible such as returning at a later time, getting a different drink, more or less ice, anything to show that you are not trying to take control away, but rather operating within the law. If the patient gets upset, that's ok, change can be upsetting. If the patient becomes very unreasonable, then this person is most likely not safe to self medicate anyway. The point is, there's no easy button. However, no matter how difficult the situation is, do not leave meds at bedside. In some situations it might be ok to leave some or certain meds (perhaps a vitamin) at bedside and an appropriate physician's order can be obtained. Please share your experience and how you feel about this issue.