Administering Tylenol to a friend

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Hi everyone, I'm a second semester nursing student and today in class my professor said something interesting I had never considered. We are learning about medication administration currently and her question was: "Your best friend is at your house and complains of a headache. She asks you for some of your Tylenol. Do you give it to her?" Almost everyone said yes that it was ok because it was your friend, not in your job setting, and she was a consenting adult capable of making her own decision to take the medication. Our professor said that was wrong and that you can't give any medication to your friend because you are not a licensed prescriber and you could lose your license if something happened your friend. She also said that same applies to your own children. So what are you supposed to do if your kid is sick and needs cough medication? You're always accountable if something bad were to happen?

Specializes in School nursing.
When I worked on the medical team at the NYC marathon, only the nurses, resident physicians, physician assistants, nurse practitioners and physicians were allowed to distribute APAP, ibuprofen and the like. The team was comprised of many specialties including the above mentioned as well as EMTs, paramedics, ATCs, podiatric students and residents, PTs, and LMTs.

Only the licensed staff was allowed to document treatment and release as well.

It is the same way at the Boston Marathon. I've worked the tents and they do give us a some stock of OTC meds - but only the above licensed folks mentioned above could give it.

But as I read this thread, I often get a sense that there is a "screwed-if-do, screwed-if-you-don't" thought process in today's sue happy world. (Well, in the US - I can't speak for other countries.)

Adults have free will. They can read OTC instructions and side effects; they know if they have any allergies. They can open a bottle, remove a med, and decide to take it. I get requests for OTC meds from staff at work - I don't dispense, but do place the bottle in front of staff for them to dispense. And if they ask me about symptoms, my job as a school nurse does include them, but usually they end up unhappy with me when I state I cannot diagnose and that they will need to talk to their doctor about xyz.

Kids? Well, I would not give a child any med without parental permission. Again, in my job, I can give a few OTCs with standing orders, but never without parental permission. Kids may not know allergy history and frankly, even if I was not a nurse, I am not dealing with parental wrath outside of my office ;).

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I can see it now. You have a friend with STEMI symptoms at your house and you call 911. Oops you live in a more rural area so they can't get there right away. You're advised to give them aspirin if available. You give them the aspirin. Well then you just administered a medication without a physician's authorization. You may lose your license. People wonder why nurses leave the profession.

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Specializes in retired from healthcare.
what a bunch of baloney. right, can't give otc medication to your child.

your instructor is full of beans.

I was required to write a term paper on this subject a couple of years ago. According to my sources, Tylenol is thought to be one of the safest drugs to give to children and old people. Some OTC drugs can bring about medical emergencies. Check out LA Times. Aspirin and Deadly Reye's Syndrome: Warnings Can Be Missed - latimes

I just never knew about any laws saying not to give them to your friend or child. I do remember a nursing order not to give OTC drugs to my infant and I had to call them and get permission for this when she was sick. I can also remember begging aspirin off the med nurse when I felt ill at work and we never got in trouble for this.

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Specializes in ED.

Interesting that you both cite the same word. I don't know about NY or MA, but where I live, EMT-P are licensed (as opposed to certified) as well. I would wonder if the medics there would be included if that was the case in those states.

I also get asked often if, given XYZ symptoms and signs, is (whatever dx) possible. My answer: "Anytime you ask someone in medicine if something is possible, the answer will be, 'yes, it's possible.' That doesn't say anything about it being likely."

Like you, Jen-Elizabeth, I'll give only very basic advice, always including, "Someone with a bigger degree on the wall than mine will have to answer that for you. I suggest your doctor, because they know you and your history better than I do."

Thanks for your replies!

Bill

When I worked on the medical team at the NYC marathon, only the nurses, resident physicians, physician assistants, nurse practitioners and physicians were allowed to distribute APAP, ibuprofen and the like. The team was comprised of many specialties including the above mentioned as well as EMTs, paramedics, ATCs, podiatric students and residents, PTs, and LMTs.

Only the licensed staff was allowed to document treatment and release as well.

It is the same way at the Boston Marathon. I've worked the tents and they do give us a some stock of OTC meds - but only the above licensed folks mentioned above could give it.

But as I read this thread, I often get a sense that there is a "screwed-if-do, screwed-if-you-don't" thought process in today's sue happy world. (Well, in the US - I can't speak for other countries.)

Adults have free will. They can read OTC instructions and side effects; they know if they have any allergies. They can open a bottle, remove a med, and decide to take it. I get requests for OTC meds from staff at work - I don't dispense, but do place the bottle in front of staff for them to dispense. And if they ask me about symptoms, my job as a school nurse does include them, but usually they end up unhappy with me when I state I cannot diagnose and that they will need to talk to their doctor about xyz.

...

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Specializes in Mental Health, Gerontology, Palliative.

I realise this thread turned a corner into craycray about 100 posts ago:roflmao:

To the OP. In my current job we have a whole bunch of standing orders for various things, eg tylenol for pain, lactulose and microlax enemas for constipation, gaviscon for indigestion which we can give without having to run to the doc and get it charted.

Your instructor needs to stop scaring the newbies

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Specializes in Gerontology, Med surg, Home Health.

A more prudent nurse would do a thorough respiratory assessment and not just rely on a piece of equipment.

I've heard a nurse in LTC lost her license for giving a co-worker a couple of Tylenol in front of a DPH surveyor....don't know if it's true, but surely we ALL have given our kids, friends and family members OTC drugs without our licenses being revoked.

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Specializes in Critical Care.
Are you saying that, for example, you stop at an accident scene, render aid, and do not bill the person you help for your services that you are protected from lawsuit for proven error/doing something a prudent nurse would reasonably do in the same situation and the behavior caused harm?

Protection from liability refers to civil suit protection, a nurse is expected to not violate the standard of care in any situation, which is not a particularly difficult requirement to abide by. It doesn't mean you have to provide ideal care, it just means you have to avoid negligence. For instance, if you were to come across someone in distress and noticed they were breathing too fast and so you decided to tape their mouth shut to slow down their breathing, that would violate the standard of care. Otherwise, you're fine.

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Specializes in Critical Care.
I can see it now. You have a friend with STEMI symptoms at your house and you call 911. Oops you live in a more rural area so they can't get there right away. You're advised to give them aspirin if available. You give them the aspirin. Well then you just administered a medication without a physician's authorization. You may lose your license. People wonder why nurses leave the profession.

Giving someone a pill is not "administering" a medication, that's a very different thing. "Administering" refers to when a patient is under your care (not the case in this situation) and you are interpreting a doctor's order, etc. Handing someone an aspirin at the direction of EMS (which is working off of Physician approved protocols) is assisting with self-administration. Giving aspirin for out-of-hospital ACS symptoms is the standard of care. If you did end up in front of the board having to explain your actions, would you rather defend that you followed the standard of care which was in agreement with the Physician directed EMS protocols, or that you refused to follow the standard of care even when someone specifically told you what it was?

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Specializes in TBI and SCI.

OMG. Sounds like something my first level instructor would say! Your friend has a headache, no don't give her the Tylenol??? If she wants to say you can get your license taken away, you should have said. "good Samaritan law" the scenario was you aren't working, thus gsamaritan law. Wow, these instructors are horrible sometime.

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If a friend or family member is asking me for OTC medication for a headache or something trivial, I wouldn't think twice about it (unless I knew they shouldn't be taking it for whatever reason). If they asked for prescription medication I have, definitely not.

This. I wonder if the OP misheard, and the instructor was talking about dispensing Tylenol *with codeine*. OTC Tylenol I'd have no problem giving to a friend/family member, but if I have a personal prescription for Tylenol with codeine, and a friend asks me for some, I could get in a whole lotta trouble for handing it out w/o the friend having a prescription. And even if my friend did have a prescription, it's still a big no-no to just hand over my personal prescription meds.

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OMG. Sounds like something my first level instructor would say! Your friend has a headache, no don't give her the Tylenol??? If she wants to say you can get your license taken away, you should have said. "good Samaritan law" the scenario was you aren't working, thus gsamaritan law. Wow, these instructors are horrible sometime.

In my state, the Good Samaritan law does not apply to healthcare providers, on the clock or not. We are supposed to know more than the average lay person and should be able to act/treat accordingly without going outside our scope of practice.

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Specializes in none yet.

I love this thread. I'm laughing. Everyone is so witty. We were scared like this in nursing school. What a pity.

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