Medication Administration Question/Concern

[kland]

I currently work at a psychiatric PHP program. For my patients' medications given while they are here, I have an order from the doctor, I count the medication in, lock it up, watch the patient self-administer the medication, and document.

We currently have a camp for MHMR patients sponsored by the hospital I work for. These patients are not patients of the facility, so they are therefore not my patients. I can not give any prn meds such as ibuprofen or anything.

One patient apparently had a medication sent from home that is supposed to be given at 11:00. I informed my boss (who is not medical) that I refuse to touch the medication to lock it up or to watch the patient take it. She referred me to the CNO who stated "it wasn't a big deal." When I expressed my concerns over not having an order and thus not knowing if the medication was supposed to be continued as is and not knowing medical history or other current medications, she stated the bottle served as an order and I was only watching him/her take the medication. I informed her I was uncomfortable doing so as I didn't have an order from one of the facility's doctors. My concern is patient safety, and of course, my license. She told me it was more about customer service than practice and that I was over-thinking it. I told her my job is to over-think medication. She disagreed. She said she would come herself to watch the patient self-administer the medication.

My question is, was I in the right to refuse this? Or should I have given the patient his/her medication?

[wyogypsy, RN]

You are not giving the medication. The patient has a physician ordered medication in a bottle clearly marked with the instructions that came from a pharmacy. The patient is taking the medication by himself/herself. You putting the medication away in a cupboard and taking it back out do not make you responsible for this medication. If you have questions you can contact your State Board of Pharmacy.