Nurse giving discontinue medications to other patients

1. 1 Hello all,
   I work as Director (RN) in a small unit ( assisted Living)of about 21 residents. A female patient was admitted yesterday to my unit. I made sure that all her meds were coming as the patient has some psych issues, confusion... However, one of my nurses got there this morning, got a report that patient only slept 2 hours all night. Patient has order for Haldol and ativan prn. Nurse said that she could not find patient haldol, so she went to med room were we keep overflows and d/c meds and she found d/c haldol of a former resident and gave it to the new patient!!(scary). I know this is unacceptable, however what is the policy of the nurse practice act for such issue? There was no harm cause. Can the nurse be fired for this? please help

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2. 64 Comments

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3. 
   #1 16

   Mar 7, '14 by sapphire18, BSN, RN Guide

   Why would she be fired? This sounds like you need to look at your own facility's policy on that. The pharmacy should be providing the patient's meds- why didn't they? In theory if it's the right drug/route/time/dose/patient, it shouldn't matter.
4. 
   #2 10

   Mar 7, '14 by Pangea Reunited, RN

   I don't see anything wrong or scary about it. Even pharmacy takes old patient labels off discontinued medication and puts new patient labels on.
   Company policy may have been violated, but that's the only possible negative I can imagine here.
5. 
   #3 7

   Mar 7, '14 by Silverdragon102, RN Admin

   I see nothing wrong as long as not expired, same dose, correct med and correct route. I have done this on a few occasions until I can talk to the pharmacy and make sure that the drug is coming
6. 
   #4 5

   Mar 7, '14 by nursegreene

   That's not uncommon in my experience at LTCs and ALFs.
   
   Sent from my iPhone using allnurses.com
7. 
   #5 13

   Mar 7, '14 by Esme12, ASN, BSN, RN Senior Moderator

   I think she used critical thinking skills. If the meds are not exposed to the previous patient and are sealed. I think it's ok.
8. 
   #6 19

   Mar 7, '14 by klone, MSN, RN

   You are the director of this unit, and you are asking us how your nurse should be disciplined? I find that a little disconcerting, I must admit.
   
   Actually, on further reflection, I find this a lot disconcerting.
   
   Nurse practice acts are state dependent. But this would not be an issue of the nurse practice act, but of your facility's policies. Why are you hanging onto discontinued meds if not for use in situations like this? If they're not meant to be reused, they should be returned to wherever they came from, or disposed of.
   
   How much training have you had? How long have you been a nurse?
9. 
   #7 0

   Mar 7, '14 by Esme12, ASN, BSN, RN Senior Moderator

   Even in Acute care...if the med is in the original bubble pack and the right dose it is a common practice. But I see your point is that dispensing.
   
   Hummmm...I am interested to others response.
10. 
    #8 0

    Mar 7, '14 by Esme12, ASN, BSN, RN Senior Moderator

    duplicate threads merged and moved for best response
11. 
    #9 10

    Mar 7, '14 by ClearBlueOctoberSky, LPN

    While, I think most nurses have done this in LTC and ALF occasionally, the potential problem of doing this is that it could be seen as a type of Medicare/caid or insurance fraud as those meds have already been paid for. If it was from a patient still in residence, it could be viewed as diversion by the BON.
    
    The question that needs to be answered is if the pharmacy didn't deliver in a timely manner, why? What can be done to prevent a future problem? Do you keep an e-kit that contains common meds that should be utilized in such cases? If you do, does the nurse know where it is and the procedure to do so? Did the pharmacy supply the med, and could the nurse just not find it? Was it placed on the wrong spot? If that is the case, simple re-education to slow down and look would suffice.
    
    I think jumping to the question "Can this nurse be fired for doing this?" makes me wonder if you are just looking for a reason to fire the nurse? Are there other problems with the nurse and are those well documented?
12. 
    #10 4

    Mar 7, '14 by Twinmom06, ASN, RN

    we do that inpatient...patient A needs Zofran PO but pharmacy's backed up - will borrow one from Patient B (same dose) and when Patient A's comes up we put it back in Patient B's folder. The way our EMAR works is that the patient is not charged for the med until we scan to administer at the bedside. OR if Patient B has been discharged and their meds are in the "Return to Pharmacy" bin, we'll just take it - still packaged etc, same dose etc...
13. 
    #11 5

    Mar 7, '14 by BrandonLPN, LPN

    OP, why do you think this is "scary"?
14. 
    #12 4

    Mar 7, '14 by BuckyBadgerRN, RN

    If the resident has an Rx for the medication, I don't see the problem. Now if there WAS no Rx, now you've got a serious issue....

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