Sometimes the five rights make us look dumb

Nurses General Nursing

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Do you REALLY ask every patient to state their name and date of birth before every medication that you administer? I was doing it for a while, and I always prefaced it with "for your safety, can you please state your name and date of birth", check against the wrist band and go on. Part of my problem is that I work nights, and sleep is hard enough to come by in the hospital as it is. But, early on, I had a few patients respond with different variations of "how dumb are you that you can't remember who I am?" And I see their point. Once we've done the initial identification, and they haven't even moved out of bed, I am pretty sure that I can identify them accurately- at least for the next eight hours, and especially when I've had them 5 days in a row. Additionally, I've got some patients on antibiotics spaced two hours apart all night- I can scan their bracelet, the IV bag, and start it without even waking them, so the name and date of birth part- not so much happening every time. I've got an orientee now, and I want to set someone else off on the right track, so I just want to know how others practice. And what are your thoughts on balancing common sense with the by-the-book safety aspect.

Better safe than sorry

Specializes in Geriatrics, Dialysis.
I work in long term care. Until you know the patient inside and out, use your 5 right and guaranteed you will never make an error!

7 Rights:

1)Right Patient

2)Right Medication

3)Right Dose

4)Right Time

5)Right Route

6)Right Purpose

7)Right Documentation

I found about the last two after about 7 years of nursing experience.

I work in NY.

I am glad somebody else posted that also works in LTC. It's bad enough learning a med pass for 20+ people, add in the fact that you don't know them yet when you are new to the unit and it adds to that stress. The new nurse is going to be slow as it is, then add the time making sure you are giving these meds to the right resident and it just adds more time to an already stressful med pass.

Problem is, LTC usually has a unique issue with making sure we have the right resident. The facility is considered their home, so there are no identifying arm bands or other form of identification on the resident. Many of them have dementia so severe that they either can't answer if asked their name or might answer yes [or no] to any question about their name you might ask. There is supposed to be a picture of the resident attached to their EMAR, but those pictures are small and often so bad that they look very little like the resident. I know my people so it's not a problem for me, but for a new employee, yikes!

Even for me when I switched to day shift after 15 years of nights I had a hard time which I didn't expect. Those people didn't look the same when they were up and dressed for the day and I had to get to know them all over again. There were many occasions I asked the CNA to confirm I actually had the right resident. The CNA's looked at me kind of funny, like why don't I know this? But I'd rather look like a clueless nurse than accidentally give a bunch of pills or an insulin injection to the wrong person.

As some of the above posters stated. I do on a case by case basis. I always do (at least if they are not a code/trauma/ otherwise unable to answer) if they don't have a wristband or if I wasn't there when the wristband was placed. (Sometimes Dr orders beat registration in the ER). Sometimes I print my own wristband if I beat registration.

I always do when I'm labeling specimens for the lab. The stickers don't always get shredded between patients like they should and I may have had the previous 5 patients in that room, so their names would be familiar too.

I have nightmares about sending things to lab that have the wrong label on it. I've never sent anything mislabeled, but I did forget a label altogether once on a urine sample. Lucky I had more urine to send.

Specializes in Pediatrics, Pediatric Float, PICU, NICU.

At the beginning of my shift, I always ask the patient/parent to verify the name and date of birth to ensure it matches the wristband. From there on out, I am visually confirming name/DOB on the wristband (not waking anyone up to verbally confirm identity) with the medication I am giving, and THEN scanning it. I was around before we started scanning meds, so this has been engrained in me and I believe the scanning process was added as an extra safety measure rather than to replace us also checking the med to the wristband.

I scan the medicine and the bracelet. That's all.

Five, ten, eighty rights. Check your workplace policy.

I am really quite satisfied with scanning and don't understand why some colleagues don't have high scanning percentages because it has saved me a number of times i.e orders change while just before giving a med. Once a nursing assistant put the wrong pt bracelet on the wrong pt and it caught it for me.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Five, ten, eighty rights. Check your workplace policy.

I am really quite satisfied with scanning and don't understand why some colleagues don't have high scanning percentages because it has saved me a number of times i.e orders change while just before giving a med. Once a nursing assistant put the wrong pt bracelet on the wrong pt and it caught it for me.

One reason might be that the blankety-blank scanners don't work.

Specializes in critical care, ER,ICU, CVSURG, CCU.

Un fortunately going thru all the "rights" is best practice

Specializes in critical care, ER,ICU, CVSURG, CCU.

I posted a comment on wron thread, sorry

How come they don't have a bracelet? What if they run a ay?

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