Splitting pills outside of nurse's scope of practice? | allnurses

Splitting pills outside of nurse's scope of practice?

  1. 0 New at my hospital - nurses are no longer allowed to split pills. So, if we have a half dose to give, we have to call pharmacy and they have to split it for us/send it up to us (which takes approximately 100 hours because they are so swamped).

    Do you split pills where you work?
  2. Poll: Are you allowed to split pills where you work?

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  3. Visit  thesundowner profile page

    About thesundowner

    thesundowner has '2' year(s) of experience and specializes in 'Rehab, Neuro, geriatrics'. From 'Florida'; Joined Apr '12; Posts: 46; Likes: 143.

    45 Comments so far...

  4. Visit  Epic_RN profile page
    1
    Nope, pharmacy splits pills for us too. Had a pt this weekend who was getting 50 mg of Nucynta every 4 hours and they were splitting 100 mg tablets. Pharmacist finally called and suggested Dr prescribe 100 mg every 6 hours lol... I guess he was tired of the hassle, too! :spin:
    lindarn likes this.
  5. Visit  classicdame profile page
    1
    we have recently instituted a pharmacy waste program that includes wasting the other half )or whatever) in an appropriately colored bin. Cannot imagine what a hassle this must be. Have you checked to see if the BON considers it outside nurse scope of practice or is there something else behind this new rule?
    lindarn likes this.
  6. Visit  Been there,done that profile page
    2
    I have split pills for a gajillion years. However. I can certainly see where it should be a pharmacy responsibility.
    The strange shaped pills are impossible to split evenly and there are plenty out there that shouldn't be split at all.

    Plus ,I'm all for sharing that responsibility... pharmacy will just have to develop a plan to deliver them in a timely fashion.

    P.S. I love your hair!
    *4!#6 and lindarn like this.
  7. Visit  Ashley, PICU RN profile page
    4
    What state are you in? It's certainly not outside the scope of practice of nurse's in my state.

    Are you allowed to draw up an IV medication from a multi-dose vial? How about measure doses of liquid medication? We frequently crush medications, mix with liquid, and draw up the dose that we need. We also split our own pills, and draw up IV and PO medications from multi-dose vials.
    BuckyBadgerRN, lindarn, LTCangel, and 1 other like this.
  8. Visit  beckster_01 profile page
    8
    On our floor we recently found out we are no longer able to IVP metoprolol, labetalol, ativan, morphine, hydralazine.... the list goes on. Basically any medication that is usually needed quickly, we are now required to call an MD and have them push it for us, because a nurse isn't capable of watching the second hands on a clock to ensure that the medication is being given safely. In the words of our night float last night "how fast do I give it? They don't teach us this stuff in med school."

    We are allowed to split our pills. The only reasonable explanation I can see for your policy is to reduce waste, which I can understand. But is cutting a pill in half really rocket science?
    Purple_Scrubs, opossum, wooh, and 5 others like this.
  9. Visit  PCU_RN9 profile page
    0
    Beckster, That is CRAZY! What type of floor do you work on? A general floor? Are ICU and ER nurses still allowed to push those drugs? I think that is so ridiculous!
  10. Visit  jrwest profile page
    3
    Quote from beckster_01
    On our floor we recently found out we are no longer able to IVP metoprolol, labetalol, ativan, morphine, hydralazine.... the list goes on. Basically any medication that is usually needed quickly, we are now required to call an MD and have them push it for us, because a nurse isn't capable of watching the second hands on a clock to ensure that the medication is being given safely. In the words of our night float last night "how fast do I give it? They don't teach us this stuff in med school."

    We are allowed to split our pills. The only reasonable explanation I can see for your policy is to reduce waste, which I can understand. But is cutting a pill in half really rocket science?
    omg that is the most rediculous thing I have heard. if thats the case they better plan on hiring more doctors. so if someone is seizing or on ciwa your supposed to just stand there and watch??until a dr decides to come strolling in? calla code on all these people with a HR in the 160's? bullcrap. talk about liability. i would have to quit if that was my place's policy. anyhow, sounds like they dont need nurses anymore.
    whoa-now, wooh, and LTCangel like this.
  11. Visit  not.done.yet profile page
    4
    That is goofy as heck. Pharmacy can't manage to get things to us on time as it is.
    whoa-now, wooh, beckster_01, and 1 other like this.
  12. Visit  jrwest profile page
    0
    where I am not only are we expected to split our own pills, now they want us mixing up some of our iv meds also. we used to get the amiodarone bolus made up for us in pharm- now theysay we have to mix it. a few other meds now too.
  13. Visit  rita359 profile page
    6
    So we will have the pharmacy tech splitting the pills or do you really think with all the pharmacist has to do that it will actually be the pharmacist doint it?
    Orange Tree, KelRN215, lindarn, and 3 others like this.
  14. Visit  MN-Nurse profile page
    1
    Quote from thesundowner
    New at my hospital - nurses are no longer allowed to split pills. So, if we have a half dose to give, we have to call pharmacy and they have to split it for us/send it up to us (which takes approximately 100 hours because they are so swamped).

    Do you split pills where you work?
    They are trying to cut down on med errors. My facility tries to have pre-split pills in the pyxis and for the most part succeeds. They implemented this along with bedside scanning of all the meds.

    We were told that if we do have to split a pill, we have to do it in the patient's room. Which is a drag if the pill is a narc because you have to pull the meds, go to the room, split, administer, bring the med (and the opened package) back to the pyxis to waste with a witness.

    I abandoned this practice when I had a patient on 7.5mg roxi Q4 for a couple days. I split and wasted in at the pyxis before going to the room.
    lindarn likes this.
  15. Visit  That Guy profile page
    16
    Do they hold your hand while giving the pills too?
    Aurora77, Purple_Scrubs, wooh, and 13 others like this.


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