Leaving Meds at the Bedside?

[joanna73]

Hi everyone

Although we are responsible to ensure safe, accurate administration of meds, I have noticed on occasion that some nurses will leave pills wlth the pt, and check on them after. This is never a safe practise, and I have had to explain to pts that I need to be present while they take their pills. Under no circumstances will I leave pills. During this time, I also have the opportunity for teaching, if required.

For rationale, some nurses have said: "I know the pt, and they will take the pills." Or, "I'll just be back in a min anyway."

I'm sorry, but if the pt drops the pills, hoards them, or another pt takes them, I have no way of knowing what the outcome is, should I walk away. I also cannot sign off in the MAR if I am not sure. Either way, it's my responsibility. What are your thoughts? Just curious...

[Belle Epoque]

Whether I leave meds at the bedside depends on the environment, the patient and the med.

In LTC we often had an order "meds may be left at bedside" for the cognitive elderly.

In the hospital, its depends largely on the patient, if they're A&Ox3 and can be trusted to take the meds in good time. If we are to involve patients in their care as we should be there has to be a measure of trust and responsibility that they can actively participate in various interventions.

Those with puffers, inhalers etc. often keep them at bedside as they are used to taking them at certain times as per their home routine.

All that notwithstanding, I never ever ever leave narcs of any kind NO matter the patient, and always insist I watch them swallow. You can just never be too careful with those narly narcs, they are a hot commodity and is negligence on the part of any nurse who thinks it's okay to leave them unattended. If you do this, you are just asking to get into trouble. Most patients have no trouble understanding that you need to observe them taking it, they are locked up for a reason after all.

[Up2nogood RN, RN]

The only meds I will ever leave at the bedside is ones I have an order for, inhaler or eye gtts. There is nothing so irritating to me than to find meds left from the previous shift at the bedside. I will say something the next shift I see that nurse or send a quick FYI email. We have to scan meds too and if you don't want it within the hour either way of administration I will chart refused. I only scan meds when I see them swallowed. I won't leave meds at the bedside even if the pt promises to take in a few minutes. The pt can call me when they're ready and I'll bring the med back if it's within administration time limits.

Leaving meds at the bedside is just asking for trouble IMHO.

[linearthinker, DNP, RN]

Have not, would never.

[sevensonnets]

We are ALL taught in nursing school not to leave meds at the bedside. I guarantee you that one of these days you'll be standing at the desk talking to your manager when a panicked family member will come flying out of the room to tell you mama is choking on those pills you left on the bedside table!

[sharpeimom]

meds at the bedside?

no way! never! :eek:

[joanna73, BSN, RN]

As others have pointed out, it isn't simply a matter of trust. If the pt, especially an elderly pt starts choking on an aspirin, and you are not present to intervene, then there will be problems. This happens. If Mr X comes by your pt, who maybe was planning on taking their pill and fell asleep, then there is no way of knowing who took what. I guess sometimes this depends on the situation. However, I would rather err on the side of caution. Because in the end, it might be only one time out of many that something happens, and they are still going to hold the nurse responsible.

[klone, MSN, RN]

I have been guilty of leaving meds at bedside on one or two occasions. I never leave anything more potent than Motrin or Colace, though. I would never leave narcotics, or BP meds or anything like that.

I work exclusively with otherwise healthy women of childbearing age. If I worked with peds or geriatric or dementia patients, I would not.

[flyingchange]

In first year, we cleaned a room after an AOx3 inpatient was transferred to another hospital. He had been there a few weeks. We opened the drawers and found a baggie FULL of all kinds of hoarded pills. Wonder how many made it into his mouth... no wonder his stay was so long. Taught me a lesson early in my career, for sure.

[OhBoy123]

We regularly leave enzymes, nasal sprays etc. in the rooms of CF adult patients.

[carolmaccas66, BSN, RN]

Lots of nurses leave paracetamol etc by the bed. I do NOT do it - ever. If the patient won't take them when I say so, I say you either take them now, or they go in the bin. I don't give in to them (especially psych patients). They then take them out of my hand, pop them in their mouth & swallow them.

Done deal.

[MunoRN, RN]

The only meds I will ever leave at the bedside is ones I have an order for, inhaler or eye gtts. There is nothing so irritating to me than to find meds left from the previous shift at the bedside. I will say something the next shift I see that nurse or send a quick FYI email. We have to scan meds too and if you don't want it within the hour either way of administration I will chart refused. I only scan meds when I see them swallowed. I won't leave meds at the bedside even if the pt promises to take in a few minutes. The pt can call me when they're ready and I'll bring the med back if it's within administration time limits.

Leaving meds at the bedside is just asking for trouble IMHO.

Where do you put the used inhalers if not in the patient's room? We used to put this back into the patient's pyxis until we got fined by the DOH (and rightly so), we're now required to leave them in the room if they've come in contact with the patient.

[BrnEyedGirl, BSN, MSN, RN, APRN]

I agree with the OP,..it's very poor practice to leave meds at bedside and chart that you gave them. I look at it this way, would I be willing to swear under oath, in front of a judge that yes Ms Jones took her Metoprolol at 2000??? Could I swear that the sweet little confused lady in the bed next to her didn't get it by accident? I never leave meds at the bedside.