Dropped pills - page 2

by mandaaRN

16,610 Views | 47 Comments

So last night when I was giving my patient her meds in the med cup of course, she dropped them on the floor. It was her synthroid and oxycodone. I told her I would get new pills for her but she insisted on taking them and even... Read More


  1. 2
    Quote from ~*Stargazer*~
    The patient can complain that the nurse made her lick the doorknob or some equally silly thing. Should the nurse document in order to prevent every potential complaint? The answer is no. That is not the purpose of the patient care record.

    The mouth is not a common site for MRSA infection, due to the mouth's own defenses. Sure, it's possible but not highly likely. If the person did develop a MRSA infection in her mouth at some later date, there is no way to know whether it was caused by taking those pills or drinking from a contaminated faucet, or touching her friend's oozing pustule and then sticking her finger in her mouth, or any other cause. The cause would not change the course of treatment anyway.

    If the patient starts behaving erratically, then it would be worth documenting. But an alert and oriented person choosing to take pills that have been dropped on the floor is not really "crazy". People drop pills on the floor all the time at home and still take them. That doesn't make them mentally ill.

    You're free to document whatever you like, but I don't think it was necessary in this case.
    You have a good sense of humor Stargazer - I am still laughing after reading this post and your previous one.
    joanna73 and wooh like this.
  2. 4
    Quote from 1pinknurse
    I wouldn't have documented it & as Stargazer has said, where would you document such an event?
    We have a place to chart narratives everywhere I've worked. "Patient updated on plan of care, given meal tray, ate pills off floor at own insistence. Family at bedside."
    Sparrowhawk, tewdles, NutmeggeRN, and 1 other like this.
  3. 8
    I have a nurse who documents whether the television was on or off and for how many hours of the day, and what channel the television was on....so I suppose if you want to write a note that your patient ate pills off the floor, have at it! lol
    Sparrowhawk, Miss Lizzie, nursel56, and 5 others like this.
  4. 2
    OMG....my job would then consist of everything but patient care? None of that has anything to do with the health of my patient. Every nurse has their own opinion & technique but I am more concerned about the welfare of my patient than a pill falling on the floor. Now if he/she was eating off the floor, then we have a problem but a pill falling once isn't going to cause concern.
    joanna73 and TJ'sMOM like this.
  5. 1
    Quote from 1pinknurse
    OMG....my job would then consist of everything but patient care? None of that has anything to do with the health of my patient. Every nurse has their own opinion & technique but I am more concerned about the welfare of my patient than a pill falling on the floor. Now if he/she was eating off the floor, then we have a problem but a pill falling once isn't going to cause concern.
    Idk, I manage to chart patient education and activities and incidents in short narratives on my patients while still providing patient care. I must be a wizard.
    redhead_NURSE98! likes this.
  6. 5
    If this person was AAO, and picked them up by herself, then this is a non-issue. She was offered clean pills and refused them. That's it.

    I have certainly picked up my own pills from the floor!

    Be thankful she did this of her own accord!

    Best wishes!
    Miss Lizzie, Aurora77, tewdles, and 2 others like this.
  7. 0
    Quote from hiddencatRN
    Idk, I manage to chart patient education and activities and incidents in short narratives on my patients while still providing patient care. I must be a wizard.
    Come on now. Charting patient education & activities is not the same as not charting an instance of a pill falling on the floor. It's not like this patient is now preferring all her meds to be dirty before he/she ingests them. Sorry but poor comparison.
  8. 1
    Quote from 1pinknurse
    Come on now. Charting patient education & activities is not the same as not charting an instance of a pill falling on the floor. It's not like this patient is now preferring all her meds to be dirty before he/she ingests them. Sorry but poor comparison.
    My sample note included those things though and the whole thing seemed time consuming and irrelevant to you. A quick note barely takes any time, and that's not really a weak argument for whether the incident should or shouldn't be charted. If it's inconsequential, fine, but my goodness if it seems important, find the 15 seconds to type it in the chart.
    tewdles likes this.
  9. 28
    This is now my new favorite thread.

    Quote from hiddencatRN
    We have a place to chart narratives everywhere I've worked. "Patient updated on plan of care, given meal tray, ate pills off floor at own insistence. Family at bedside."
    My note would then continue: "Educated patient that she should not continue to eat pills off of the floor. Informed patient that nursing staff would not purposefully administer oral meds via the floor. Patient voiced understanding. Educated patient to not lick doorknobs. Informed her of the risk of mouth MRSA. Patient also educated not to lick faucets, toilets or friends' oozing pustules. Continued to educate patient on the risks of mouth MRSA. Informed patient that after touching friends' oozing pustules that she should wash her hands prior to putting fingers in mouth. Informed patient regarding hospital policy to deliver meals on trays rather than on floor. Patient will likely need further education regarding risk of mouth MRSA. At this time, patient does not appear to be open to education on mouth MSSA. Hospital system approved "Things to not lick while you're in the hospital!" handout provided to patient with relevant passages highlighted. Patient voices ability to read. Encouraged patient to request assistance as needed for avoiding inadvertent tongue to doorknob, toilet, floor, faucet contact."

    (For the record, I'm completely undecided if I would chart patient insisting on taking pills that fell on the floor or not. Probably would depend on my mood that day.)
  10. 1
    I'd probably chart it - but I'm psych.

    Ultimately - if it will keep me up, I chart it.
    wooh likes this.


Top