Can you take a patient's medication without their consent?

Altra, BSN, RN · Jan 11, 2014

Thanks for the reply. Is there a website you can recommend for me to refer to with these issues? Or a book?

Please understand that legal issues like this need to be resolved not by "discussion" with other members of the team, nor books/websites. You need YOUR agencies policies & procedures. You need to ask this question of your direct supervisor -- the person to whom you report within the organization.

wooh, BSN, RN · Jan 11, 2014

Look at it this way: You do hold on to patient's meds. Where are they going to be kept until you return them to him? Is it secure? What happens if they're stolen? You've now "lost" 3 weeks of codeine. Get ready for drug testing and whole host of legal issues.

enuf_already · Jan 11, 2014

Look at it this way: You do hold on to patient's meds. Where are they going to be kept until you return them to him? Is it secure? What happens if they're stolen? You've now "lost" 3 weeks of codeine. Get ready for drug testing and whole host of legal issues.

OP--what IF the patient becomes angry with you and accuses you of stealing his medication for your own use? The police could be banging at your door wanting answers. Trying to explain your way out of this to the police and state board even when drug testing comes back negative could make your life a living nightmare--and your career as you know it disappear.

A contract with the patient as a previous poster stated, is a good suggestion. If overdose or self-harm is a concern, consider personal safety as part of the contract. Your employer should be able to provide you with some guidelines.

krisiepoo · Jan 11, 2014

This is an in home setting. I'm not working at a hospital. My agency is contracted by county to provide social work for mental ill patients living in their community. I'm an rn who provides medication support to mentally lll patients. And a new grad

I've done case management (non-RN) and in situations like this we either had them come in and get a weekly supply or there are med dispensers that open at certain times of the day. they have an alarm that sounds when meds are due, the slot opens and the meds are dispensed.

YOU cannot legally take the meds. However, you can work with his doctor, pharmacist and medicare (people on Medicaid and medicare can have a pharmacy restriction place) to moderate how much they can get at one time and ensure they only get the meds from one pharmacy

MunoRN, RN · Jan 11, 2014

As a general rule, unless you have reason to be sure you can take them, then you can't them (those reasons are usually confined to court orders). Otherwise, you're stealing someone's drugs, and not just any drugs but controlled substances. There aren't many things that will get you in more trouble as a Nurse than stealing a patient's controlled substances.

Guests · Jan 12, 2014

This sounds like an issue for the prescriber.

But generally, no, you can't take their meds.

And since you're talking about narcotics... um, that's an even bigger "no." Who's going to count them with you? Where will they be secured? And what happens when the patient says you took 30 of them but you say there were only 20?

CBYRN · Jan 12, 2014

I work for a hospice. We go out everyday to dispense 1 pill at a time if we need to. We also use a lock box in homes where there may be drug diversion or the potential for abuse. If it's pain meds we might leave a few at a time out and tell them to call if they need more. We have even used a neighbor already to take over 1 ambien every night. They would have gone over to check on him anyway. Good luck.

KelRN215, BSN, RN · Jan 12, 2014

Can an Rn legally take a patient's tylenol#3 without their consent? Lets say you have a mentally ill patient who was formerly conserved but not anymore. His judgement may not be sound but he is technically competent (but questionable). If the nurse is afraid that in his attempts to get high, he overdoses or gets liver failure, can the nurse take the patients medication? Let's say can the nurse take the patients 1 month supply of tylenol3 and dispense him a 7 day amount? So I asked the patient if I could do this for him and he declined. What can a nurse do?

Can you steal a patient's controlled substance? No, you cannot. This would be akin to diverting narcotics. The patient was legally prescribed this medication. You have no legal reason to be in possession of it. I think you could get in trouble even IF the patient gave you permission to take this medication from him. You should not be in possession of another person's narcotics. Document that you have educated him on the appropriate doses and the dangers of taking more than the prescribed amount. If the patient expresses to you that he intends to take half the bottle, call 911.

nurseprnRN, BSN, RN · Jan 12, 2014

Your liability is simple: If you take control of his medications, where will they physically be? At your house? At your office? Who is in DDD (damn deep doodoo) if they go missing from either one? Or if they are't properly labeled? (The patient keeps the original bottle, and the extras go ... in what?) Or if someone says, "What do you mean, you left them in the lockbox at work? I never saw them there." Or there is no secure storage for narcotics at work, because your agency does not ooperate a pharmacy. Then what?

You are not a pharmacist, so you can't repackage and dispense medications in this way, although you can fill a weekly med box, or a monthly med box. If I understand you correctly, I think you are concerned about him having access to more than one week's supply on hand. Consider looking into one of the many excellent devices that will dispense medications 1,2,3, or 4 times a day and keep them securely locked up otherwise, and will give you a report of when they were accessed.

As to his getting high on the codeine, well, he'll get wicked bad constipated, so perhaps your patient teaching can help him see why that might not be what he wants. If he wants to overdose in something for suicide purposes, he can get acetaminophen (plain) at the grocery store, and that will do it. If you have good reason to be concerned with this possibility, your responsibility is to notify the physician of suicidality.

Finally, it is his physician's responsibility to prescribe medications, including number of doses dispensed and refill intervals. The prescription can be written to dispense one week only, if the physician feels it is warranted for safety. But you can't take it upon yourself to remove medications (especially opioids) from the patient who is not under guardianship or conservatorship. Doing so would put you on very shaky ground.

balmybalmblam · Jan 12, 2014

Thanks so much for everyone who has replied. I'm so stressed and a paranoid over issues like these! That's what I thought so too. I thought I didn't have legal rights to take a patients meds even with good intentions. But I got thrown off when my rn colleague made me feel so dumb for not taking it away. Her rational was they have signed for treatment through our program. But higher ups said no. Then my rn colleague suggested that I just go ahead and take it away behind the higher ups back. She was just so adamant about taking the pills away from patient.

klone, MSN, RN · Jan 12, 2014

A week's worth of Ty3 can do plenty of damage, so there really isn't any good logic in doling out one week at a time.

WillyNilly · Jan 14, 2014

Another poster suggested what I was thinking...a time release medication dispenser. There are some that go on lockdown or only release a days worth at a time. Also, check local pharmacies. Some deliver home meds in individual packets for certain times and doses. Perhaps a follow up with his dr to evaluate pain management, psych ,etc . Do you screen for SI/HI, behaviors and mental status when you visit?