Dropped pills - page 3

by mandaaRN

17,290 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 SCSTxRN
    Ultimately - if it will keep me up, I chart it.
    Good rule of thumb!
    NutmeggeRN and Esme12 like this.
  2. 6
    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.
    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.
    justgottabe, corky1272RN, Hoozdo, and 3 others like this.
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    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.
    sunny3811, smurfynursey, wooh, and 1 other like this.
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    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...
    wooh and mandaaRN like this.
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    I document that behavior because I am signing responsibility for administering the med, and using a med off the floor is outside of my policy/procedure and training.

    In my setting pills get dropped on the floor frequently. In my setting, pets frequently get ill and sometimes die because of those dropped pills...for instance chihuahuas and oxycontin don't mix well! I am just glad that the dog and not the toddler found it!! Another consideration is the patient who routinely takes pills from the floor. I observed a patient drop a tea bag, reach down to pick it up and found a pill by the leg of her chair...so she took it. I was alarmed and asked her what it was and she actually had no idea, she just presumed it was one of hers and that she should take it.

    I suppose that these scenarios are more specific to those patients who are not in the acute care setting, but I hope they provide another perspective as to why we might want to make a note as to the habits or behaviors of our patients related to their meds.
  6. 3
    I don't view this as irrational, erratic, or worthy of documentation. The patient is simply dulicating what would be common behavior at home. And ... please consider that the patient may very well be worried about the cost of being "double-charged" for 2 pills.

    We're talking about a dry pill coming into probably less than 15 seconds' worth of contact with a (presumably) dry floor.
    OfficialWarmBody, Miss Lizzie, and wooh like this.
  7. 1
    The decision to administer a pill that had dropped on the floor should be based on the circumstances at the time. I deal mostly with the elderly, and they can frequently drop the pills. If the medication is a floor stock, or a medication I know to be a cheap medication - I would not hesitate to get new medications. Additionally, if a verbal response from the patient is to give them the pills anyway - and there is not an obvious contaimination - it's probably ok to give them.

    On the other hand, many people still believe that cleanliness is next to Godliness - so you have to base it on your circumstances. If in doubt, don't consider anything other than getting new medication.

    Documentation on this subject is a personal choice.
    wooh likes this.
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    I would have documented what happened.
    wooh likes this.
  9. 1
    Quote from wooh
    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 ......edited for brevity.......
    OMG, I just made this weird snorty sound when I laughed! You are now my favorite charter, hands down, lol......
    wooh likes this.
  10. 2
    Quote from hiddencatRN
    ....or starts doing other bat poo crazy things......
    enjoying this thread tonight! And then imagining what might constitute Bat Poo Crazy Things, lol....!

    BPCT: The Other White Meat.

    I think I worked too long today....
    Last edit by RNsRWe on Oct 4, '12 : Reason: fixed html snafu
    hiddencatRN and wooh like this.


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