Borrowing medication from different patients

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    New grad working in ltc. I've notice that during med passes, if the pt does not have the prescribed med, they are "borrowed" from another patient (particularly narcs) and then documented in narc book as "wasted"... seems weird to me, and it makes me a little uncomfortable..my nurse educator said its "perfectly" legal.. is this common practice in LTC's?
    Last edit by Joe V on Jun 22, '12
  2. 13 Comments so far...

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    First thing off the bat: it is NOT "legal" to borrow meds....especially controlled drugs. Let me describe it this way. Say you ran out of your hypertension med would you go to your neighbors' house and take one of hers? I would hope not. It is unethical and not in accordance with guidelines in any state. Your facility should have an Ekit to use if meds run out. You can call the pharmacy and ask for a stat refill. Most importantly the nursing staff needs to be consistent in reordering meds in a timely fashion: generally when there is 5-7 days left. This way if there is a change in insurance coverage for the med or a shortage there is sufficient time to get an order for a different med. If the pharmacy fails to deliver a med refill within 48 hours and does not send an explanation to the facility about why a refill is not being sent as requested then the nurses must follow up with the pharmacy. You can't just tell the on coming shift the med didn't come in. Find out WHY it didn't get refilled. Pharmacies screw up but usually there is a problem with insurance not paying or the refill is being requested too soon (maybe because someone was borrowing it for another patient, hmmm?) or it is a controlled drug and a written prescription is required from the doctor. You should also let your supervisor...not just the charge nurse but the unit manager, ADON, DON know that a refill has not been received in a timely fashion.
    nursecap18 and silverbat like this.
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    Ummmm I have not even started nursing school yet but I would say that your nurse educator is a liar!!! That can not be legal.... narcotics are strictly regulated. I think that the CEO and CFO of that company would be very interested to learn about the money being wasted, the laws being broken and finally the liability issues that the staff are causing by doing this. If the patient does not have a prescribed med, it is for a reason. If the patient gets sick or dies because they are being given narcotics that are not prescribed by a healthcare provider with a valid DEA number then the facility and the staff involved can be held legally responsible and/or loose their licensing.
    You need to speak with the DON.... the nurse educator is putting you in a bad position
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    Do not 'borrow' meds from one patient to another. Not aspirin, not furosemide, and especially not narcotics!!

    This is how serious errors are made. And this is why the person responsible for ordering meds and refills is not being held reponsible. Most facilities require about a 5 day lead in refills as there is usually a 2-3 day turnaround time. There should be a tracking system. Anything not there 2 days prior to actual need should get a reminder call to the pharmacy.

    I know that sometimes a med refill slips through the cracks but 'borrowing' breaks rules that are there for patient safety.

    Let HER borrow and document. See how she feels with her initials in all those boxes!!

    Best wishes!
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    Ive seen the same thing too, but not with narcotics, mainly with coumadin and aresols. coumadin orders get changed so frequently that it is sometimes difficult to. Re-order so quickly, as a new nurse myself i wondered what should i do in situations like this. give from the starter and stat order for the night drop ship. sometimes a. fax doesnt do and you have to call when your doing charting for the shift. dont feel intimidated by some of the seasoned nurses to go against the grain of policy. to me it is better to be the trend setter risk loosing a job than to be a follower and risk loosing a license
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    Our pharmicist gets upset when we "borrow" any medication from another resident. It is considered dispensing meds to another resident which is not legal. If we call and get his ok to borrow we must document it. Especially with Narcotics it is not allowed. We do have some meds in our back up including every dose of Coumadin and most ATB's. I would question the facilities policies if they are allowing you to use other residents Narcs and then documenting you wasted it. How do you keep an accurate Narc count?
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    thanks everyone..it seemed to violate the Five Rights, with the very first being RIGHT PATIENT... ajacob, that was an issue just last week... nurse gave last narc --- NONE left, and wrote zero... she didnt contact the physician for a reorder, yet the narc continued to be signed out as given...!!! DON seeking answers... long story short had to flip thru narc book for another pt with SAME med, and they were "wasted." on the same dates that they were signed as given... this type of stuff scares me as brand new nurse.. .. the only thing I can do is be check narc book daily to see whose running low, and make sure to get the refills BEFORE we are at zero... i just dont feel comfortable giving a med prescribed for someone else even if its the same dosage....
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    Quote from Isitpossible
    i just dont feel comfortable giving a med prescribed for someone else even if its the same dosage....
    I don't blame you. As some one else said that is dispensing which is illegal if you do not have a valid DEA number/license.
    Not the same situation, but a while back I worked at a veterinary hospital. My job title was receptionist. I have never taken a pharmacy technician course. 2 nights a week, I was the "pharmacist" (their words not mine) I would fill prescriptions, call in authorizations to pharmacies for meds we did not carry in house or were out of stock. One night they started having me handling some opioids /narcotics which made me rather uncomfortable (butorphanol, buprenex, tramadol). I brought my concern to the medical director and after he did a little research, the hospital had to change it's policy because by having 3 of us "receptionists" handling these drugs was putting the hospital and the DVM's in jeopardy of losing their DEA licensing for prescribing and dispensing. The hospital had to hire an actual pharmacist and pharmacy techs.
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    Wow....that nurse educator needs some education.
    ajacob likes this.
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    As a DON if I noticed a trend of the same nurse repeatedly "wasting" narcs I would soon become suspicious that she was actually diverting narcs for her own personal use. Anyone can drop a pill once in a blue moon but shift after shift - there would have to be some great explanation going on or I'd get rid of the nurse to protect my own license.
    michelle126 likes this.


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