Dropped pills

[mandaaRN]

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) :/

[FLmed]

This is now my new favorite thread.

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.)

Lol!!!!!! I'm laughing so hard. Don't forget to add in there that patient was able to teach back what you told them.

[wooh, BSN, RN]

What makes this one of the greatest threads ever on AN? Both funny AND informative with a good nursing debate!

BPCT: The Other White Meat.

It sounds like that pink gel stuff that was in hamburger. Can you get mouth MRSA from eating BPCT off the floor? Will have to add that to the education. Perhaps it could be part of our welcome packet!

Wouldn't the wording of "ate pills off floor" lead one to believe the person ate the pills directly off the floor? People do some strange things sometimes . . .

I assumed they were licked up. Were they not?

The worst thing I ever saw was a mom bite a pill in half, crush the other half and put it down kid's gtube.

Oh, that's nothing. Pancreatic enzymes don't easily go through a g-tube. No matter how much apple sauce you mix them with. I've seen MULTIPLE parents of multiple kids that when it clogs, stick their mouth on the tube and suck to get things moving again. I'm always of the opinion that if it works, and they don't expect ME to do the same, they can suck all they want.

[cougdogrn]

I would have offered to get her new pills and if she declined and wanted to eat them off the floor...fine by me! I would not have documented it anywhere and I probably wouldn't have given it a second thought.

[BuckyBadgerRN, ASN, RN]

A little OT, but this reminds me of when a co-worker had a baby several years ago and was in the hospital post-partum. The RN brought in the pain med she had requested and somehow the pill got dropped. The nurse said "I'll go grab another one" and my friend said, "no! 5 second rule works, I don't want to get charged for another one!", in a half-kidding manner. The RN laughed and said don't be silly, I'll be right back!

The bill comes a few weeks later, yup, she was charged for the dropped pill AND the one she took. And yes, they scrutinized the bill b/c insurance denied part of the claim. Seems the hospital submitted for a circ. For my friends baby GIRL!

[hiddencatRN, BSN, RN]

I actually had a dropped pill incident last night and thought of this thread. My patient must have read up on mouth MRSA because there was no argument in me getting a fresh pill for him.

[wooh, BSN, RN]

My dog spit out his lasix onto the floor. I gave it to him again. Bassets can't get mouth MRSA can they? Perhaps some studies were done with the chihuahuas earlier in the thread?

[darrell]

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. :/

It is one line in the progress note. And it is her right to to take her pills however she chooses. If you had interfered, you would have something to agonize over...:).

[Esme12, ASN, BSN, RN]

My dog spit out his lasix onto the floor. I gave it to him again. Bassets can't get mouth MRSA can they? Perhaps some studies were done with the chihuahuas earlier in the thread?

You are too funny.....but I gotta tell ya if my dog was at work I would not let her lick the floor....I love my dog too much than to allow her to be around that filth.

At home however.....we call her Hoover.

[RNsRWe, ASN, RN]

Y'know, I've never had a patient who wanted a pill that was dropped on the floor, but HAVE had ones that dropped a pill into the bedding. So there we go, searching through sheets and blankets and gown. Upon finding said pill, no matter where in the bed they found it, they always popped it back into their mouths.

Never occurred to me to write "pt dropped pill into bedding. Search by this nurse and patient revealed pill wedged under left thigh. This nurse retrieved said pill, patient then placed pill in his mouth and swallowed."

Frankly, considering some of the stuff I've found in patients' bedding, cracks and crevices, THAT would strike me as worse than the original scenario. :-P

[BrandonLPN, LPN]

If a nurse drops a pill on the floor and nobody else is there to see it, did it really drop?....

[BrandonLPN, LPN]

My dog spit out his lasix onto the floor. I gave it to him again. Bassets can't get mouth MRSA can they? Perhaps some studies were done with the chihuahuas earlier in the thread?

Until there's evidence based best practice, we'll never really know....

[PediLove2147, BSN, RN]

Patients usually drop them on the bedding but occasionally the floor. I always offer to grab another and they usually agree but if they wanted to take it I would let them and there would be no documention of it.

Now if it's a narcotic, I am on my hands and knees searching for that tiny pill. The other night, another nurse and I were searching a patient's room for an oxycodone. OMG, that was awful. We ended up finding in the closet, underneath the radiator. It was white and looked Oxycodone-ish, I was not looking anymore!

(We need the pill in hand in order to waste, if not it's an incident report)