Colleague asked me for a Tylenol from my med cart. What to do?

Nurses Relations

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New grad here. I started working two weeks ago at a SNF, as a med nurse. Today the treatment nurse asked me for a Tylenol. I said, "Sure, for which patient?" She said, "For me, my back is killing me."

I told her I didn't feel comfortable giving her some from the cart. She was shocked and gave me attitude! Later on I told her I felt uncomfortable about the whole exchange over the Tylenol and that as a new nurse, I am terrified of putting my license in jeopardy. She replied, very snottily, "Whatever. Next time I need some I'll know not to come to you."

Should I report her to the DON?

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When in the same position, I was told by an experienced nurse to place the stock bottle on top of the cart and "allow" the employee to obtain their own, while at the same time telling them that you were not allowed to dispense meds to employees. Never gave it much thought at the time.

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Specializes in Nursing Education, Public Health, Medical Policy.

Why in the world would you report her to the DON?

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He is my direct supervisor, its a small facility. And I dont know if I should. That's why I'm seeking the advice of more experienced nurses. If shes taking Tylenol, is she taking anything else?

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8 hours ago, FromMNtoCA said:

Should I report her to the DON?

Jeesh, you don't have to report her. Why don't you just ask him what to do if an employee asks you for a Tylenol.

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Okay, so you are new to all of this. The history here is that this sort of thing has been very common. It wasn't very long ago that RNs/staff in the hospital could remove OTC meds (medications sold over-the-counter) like Tylenol/Motrin from the pyxis if needed for personal use during a shift. This was okay'ed by the employers and as far as I know people didn't abuse it. At the time it was considered to benefit both parties (employee with sore back/headache feels better and keeps working rather than going home or something). The same thing was true in LTC - stock OTC medications (not those of a specific patient) would occasionally be used from the cart.

My guess is that it has been common in your workplace. It may or may not be now. The fact that your coworker walked right up and asked without any qualms might mean it's still common there, or the fact that she asked a very new nurse might mean that it used to be but isn't now.

As far as I know the main reason this ever changed was financial, with employers deciding not to provide free OTC meds for staff.

There is no law being broken (if your employer does wish to provide OTC meds for staff). The meds are not controlled substances and don't require a medical evaluation or prescription. Etc.

7 hours ago, FromMNtoCA said:

If shes taking Tylenol, is she taking anything else?

So from the history of the issue you can probably guess that being concerned that she could be taking other meds (on the basis of having asked for a Tylenol) doesn't follow.

You don't need to report anyone. But for your own knowledge you might ask the DON what the accepted practice is at your workplace.

You did the right thing at the time.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
On 3/25/2019 at 10:50 PM, FromMNtoCA said:

He is my direct supervisor, its a small facility. And I dont know if I should. That's why I'm seeking the advice of more experienced nurses. If shes taking Tylenol, is she taking anything else?

They might be taking something else -- ibuprofen or aspirin or perhaps even a naprosyn, but I doubt very much that taking a Tylenol means she's taking any controlled substances.

It used to be very common for staff to take OTC meds from the med cart -- in fact we always used to have a box of Tylenol and aspirin on top of our med carts just for staff use. In my current hospital, the policy says you call the pharmacy and have them tube up a dose for the employee. No one thinks twice about it.

I have colleagues who keep a bottle of Tylenol in their lockers, and if someone asks for something, they say "Locker 51 is unlocked, help yourself." Or whatever.

It appears that you've gotten off on the wrong foot with this person -- find out the official policy for your facility, and then go and talk to her about how you're new and this made you nervous and how the policy says to handle this sort of thing in the future.

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Try not to report your co workers unless you really have to for patient safety or serious professional issues. Reporting can and does lead to ugly work environments.

Your best action would be to ask the DON “what is our policy in providing OTC medications to staff if they request them”. Some places actually have a policy that it is acceptable. We could log into the pixis at one place I worked and select a patient called Staff.OTC and pull ourselves a one of a small number of pharmacy approved drugs.

If it is allowed be sure to read the policy to ensure you know exactly which drugs you can give. If there is no written policy you can tell the next person that asks “sorry we have no policy that would allow me to do that, maybe you could ask the DON to issue you some Tylenol.

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Not that many years ago, taking an OTC med off the cart was not considered a big deal.

Things have gotten a lot tighter since then. For one thing we have strict computerized access to med carts. And not just for controlled substances.

About 15 or 20 years or so, I started carrying whatever OTC meds I might need during a shift.

Like most rules, this was started after a small number of people abused it.

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Specializes in Psych, Addictions, SOL (Student of Life).
On 3/25/2019 at 8:50 PM, FromMNtoCA said:

If shes taking Tylenol, is she taking anything else?

Oh for Pete's sake She asked you for Tylenol! It's not like she had her hand in your cart and you caught her. It's also not like she came up to you and asked for a Norco.

Hppy

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One day you WILL need help. It may not be Tylenol or any OTC. You WILL make an error. You will make a mistake that will scare you to death. You WILL need the nurses who have asked you for a Tylenol! If you start reporting everyone for trivial things such as Tylenol, you will lose the trust of your coworkers. Your coworkers will serve as your family. Even your DON will be wary of you. You'll learn.

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I never heard of a facility providing free drugs of any sort for the staff. I guess it is a regional thing. I wouldn't report her though and I would try to find out if there is some sort of policy or something regarding it. One other thing, I have become a bit wary of what people tell me if it isn't policy. I write down who told me and what they said and when. Pocket notebooks are good for that sort of thing.

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