Hi, I'm the Bad Guy

  1. Help me! I work in a nursing home. My problem is, that our policy states that no meds are to be left at the bedside. Simple. Problem: Some of my coworkers choose to leave the pills there and leave. One res. takes her pills at midnight (meds are passed at 8-9pm). So enter me, the bad guy, who insists these people take their pills or rings when they want them. "you're the only one....all the other ones do.....why do you have to be so difficult.....don't you trust me.....or.......you are such a b----" They become so rude and laugh when I try to explain the rationale. I am so tired of this. Trust me, I would rather leave the pills at the bedside and hope they take them, rather than argue daily with them, which I think is the reason the other ones do, but if someone finds pills at the bedside, it is considered a med error at my facility. So help me....what should I do?
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    About Paprikat

    Joined: Nov '01; Posts: 346; Likes: 26
    Nursing Home Administrator; from CA
    Specialty: Geriatrics


  3. by   Little One2
    I have had the same problem. But, I don't follow what other nurses do. I am aware of what the policy states and I try my best to follow it. If they insist on not taking at that time, then I would return later when they what to take it. I would never want to leave the meds at the bedside unless I was confident they would take them. I don't want to have to write an incident report because a patient didn't take the pills and I left them at the bedside.

    I tell them I'm not the other nurses. This is the way it is. You take them now, or I will have to bring them back later.
  4. by   ShandyLynnRN
    is it possible to get the order changed so that the times the resident wants to take their meds can be the time that is on the mar?
  5. by   Chttynurs
    I was going to ask the same thing that ShandyLynnRN asked, can you get the times on the MAR changed? I wouldn't think that would be a problem if it's what the resident prefers. Sorry about your situation, but I'm on your side on this one. I wouldn't feel comfortable keeping meds at the bedside for hours at a time, especially if there are other residents that walk around.....they may get their hands on them. I think having the resident ring when they want the med is very reasonable. Good luck!
  6. by   jurbyjunk
    I once did a "mat leave" in a retirement home in Vancouver, Youville Residence. We had different "ratings" for each floor. The top floor (and weirdly enough, the bottom floor) residents were "indpendent", the 2nd floor was "intermediate care" and the 1st floor was "total care". Since the top/bootom floor residents came and went, just as if they were in their own homes (which they were), we simply left their meds on their dressers. Patients on the intermediate care floor had me watch them take their meds, and the "total care" residents had me actually physically administering their meds. I never had a problem with leaving the meds at the bedsides for the independent residents, who were often "out and about" anyway. One sweet lady on the bottom floor did not haul out of bed until about 10-11 AM. She would read until quite late at night. Sounds like me. Often wondered if she had been a "night shift" nurse when younger. Of course, being a "night showerer", I've never understood the need to haul someone out of bed at 5AM to "go have a bath". LOL.

    I like ShadyLynnRN's suggestion. If you're uncomfortable with the times that they're taking their meds, maybe you can get the times changed to something that works for the resident.

    Even though they do live in an institution, it is their home.
  7. by   itsme
    At the LTC facility where I work alot of the alert residents have Dr. order that says "may leave meds at bedside" that really helps! Especially for those who insist there pills be brought in at 8:30 and wont take them until 10! I guess its there way of having some control!
  8. by   adrienurse
    Oh boy, have I been there. Stick to your principles. I work in LTC with a lot of residents with Alzheimers who GET INTO EVERYTHING - therefore a nurse leaving pills around would not be tolerated.
  9. by   traumaRUs
    Yeah - I agree - with above posters - supose someone else got into them. My father had lived in nursing home - where meds were given and taken under supervison. Then when he went to assisted living - they just set the pills up for him and he took them.
  10. by   duckie
    When we get such an order at our facility it reads, "Medications may be set up by appropriate medical staff member and may be left at bedside for resident to take per self." Hope that helps. Duckie
    Keeping your rules about meds and such are the reason your a RESPONSIBLE NURSE those that leave the medications at the bedside are nothing more than liars, in my opinion. If you didnt witness taking of the medications how can you say that you did. What will / would happen if the patients room mate took the medications by mistake but in the MAR its stated the med was passed and taken by the patient. If the patient wants the med at the certain time then take them in there at that time. Do Not leave meds at bedside..... The reason I feel so strongly about this a med nurse passed meds to a patient that was in the restroom at the time. So they were left at the bedside. For her to take when she came out of the restroom. Her daughter and 5 yr old grandson came in and waited for her, well the grandson took the pills because they looked like candy. Well the candy consited of dig, percocets, and coumadin . The patient didnt notice it until the family left ... she called the nurse and asked her were the meds? Nurse walked in and said right there when the Grandmother said oh god my grandson was just here, underneath the bed was the med cup empty not a pill around. Well the nurse was fired lost her license and we had to hunt down the mother and the child and then explain to the mother why we needed her to return to the hospital and asap. Admisitration was waiting for her in the ER. The hospital was sued and so was the Nurse and just about anybody and every body that came in contact with the child and the patient.
    So Thats why I feel the way I do.
  12. by   maggie7
    I've come across other nurses who leave meds at bedside, but it's my job to administer the meds and my initials they say they have or have not taken them and I explain to the residents I am not allowed to leave them, or occasionally, as I hand them their meds ask if they wouldn't mind taking now, just in case they would drop and need to be retrieved. Usually works. I've seen other residents eat fancy soap from another residents room and have an allergic reaction that required sending them out to be vented. So many residents with dementia could walk in and take them or give them to someone else. I would have a problem leaving them even with an order to do so.
  13. by   Jenny P
    After seeing DH's Aunt Hazel with delirium and knowing what she did after her ORIF hip fracture while in the rehab center; I'd stick to my guns like you do. She was a regular Houdini and could get into anyone's room even if she wasn't supposed to be weight-bearing! If some patient wants their meds at midnight; for goodness sake; get the times changed for those meds!
  14. by   emily_mom
    If you take them in the room and they don't want to take them, they should be put back in the patient's med drawer. My grandma has Alzheimer's and took 4 patients' meds. Three of the residents were on dig. Needless to say, we opened a can of woop-a*s and the hospital fired the two nurses who left it in the room.

    I agree with Zoe. How can you chart that they were taken if you didn't witness it?