Dropped pills

Nurses Medications

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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 got down on her hands and knees to find the two pills. She ended up taking the dropped ones even after I said a few times il throw these ones away and get new ones. Now I'm just beating myself up over it for the fact that I don't know if I should have filled out an incident report or not. I asked another nurse I worked with and she told me not to worry about it, it's okay. Technically, it was all the patient but why am I beating myself up over a dropped and taken pill? Any suggestions on when this happens to you?! (If ever) :/

Specializes in Med/surg, Quality & Risk.

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

Specializes in 4.

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.

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.

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!

Specializes in 4.
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.

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.

This is now my new favorite thread.

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.)

Specializes in Psych.

I'd probably chart it - but I'm psych.

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

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

Good rule of thumb!

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
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.

While I'm all in favor of the 30 second rule at home....I am not at work. I would document that the patient insisted on taking the meds from the floor and did so against my advice. I would also call the supervisor and let them know so that when that crazy patient, or their family, comes back tomorrow and complains "that nurse made her take the pills from the floor and did nothing to stop her/me" I have proof that the crazy patient did it all by themselves.

We are taught as a standard of care and the med that falls on the floor is contaminated, should NOT be given to the patient, should be wasted, and new meds obtained for the patient. Not following this is not adhering to the standards of care that "another reasonable and prudent nurse" would follow.....and you could lose your job and reported to the board for not adhering to the standards of care.

Seems far fetched? In today's litigious society and the hospitals push for the patient is ALWAYS right/satisfaction....I see this being a real reason a facility can use to fire someone. Most patients will not pick a pill off the floor if you tell them to imagine what has and can be on the floor.....like the drunk who urinated all over the floor 3 days ago.........are more that willing to now throw those meds away.

Now more that ever documentation is to cover you own behind.

Now, do I believe that anything will happen to a patient if they take a med of the floor? NO, but it's not my opinion that counts.

Specializes in geriatrics.

I work LTC, and it's very common for residents to drop pills, pick them up off the floor, and eat them. I also think that's kind of gross, and I'd have no problem giving them a new pill. But if they don't care, we aren't going to be concerned, either. After what I've witnessed caring for 30 seniors, eating pills that they've dropped is the least of my worries.

Wooh!! I cant stop laughing... too funny.... but on the serious side, if you want to document a quick note it cant hurt, but I guess that would be up to the individual nurse...

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