Wasting Unused Meds

[LilPeonNo1]

I would like some other input on this particular situation, because I feel it is an important issue and would like to know if I'm alone in my thinking or if others feel the same.

The other night I got report from the eve shift nurse at work, during report she informed me of having to give a resident a dose of Ativan 0.5mg po for increased agitation. This particular resident was out of his own med so she got the dose from the E-box. The E-box only contained Ativan 1mg po doses so she halved it and left the other half in the top drawer of the med cart. She said she didn't waste/destroy it because there was only one dose left in the E-box If the resident needed another dose, there wouldn't be any doses left for any other patient in need. I told her that I would not accept any loose meds, and preferred to waste/destroy it. If the resident needed another dose I would take it from the E-box myself and call the pharmacy and notify them of immediate replacement need. Otherwise replacement could wait until the usual pharm delivery next day.

The look I received from the eve shift nurse was like I'd grown a second head or something. She argued that it would be a waste of medication to just get rid of a "whole dose" and it might be needed later. I explained that I wasn't comfortable accepting the unused portion, and it is supposed to be destroyed if not used. I also told her I didn't want the reponsibility of having to waste it later, especially since I didn't sign for the med in the first place. I know this is a practice with other nurses, but I never do this. Was I being too anal? Should I have left it there and wasted it with the day nurse in the morning?

Your thoughts?

[pagandeva2000, LPN]

I believe that each nurse has responsibility towards their personal practice. Keeping this in mind, if you were not comfortable doing this, then, I can't say that you were too anal. I can see several things spinning out of this action and can see why you chose not to be involved.

What I am curious to know, however, is how long you worked there. I am asking because I have seen some nurses do many things to survive if they are not receiving support or needed items when they are supposed to. Maybe this nurse was burned in the past by 'trying to do things by the books' and was without any medication at all...who knows? If you are new to the facility, you may not have seen what they have to go through to get what they need. It doesn't make it correct, mind you...I just see what makes people do weird things.

Bottom line to me is that if you weren't comfortable, don't do it, the end.

[vashtee, RN]

I don't like the practice of wasting meds you know you will need later for the same patient. I do it, but it REALLY bothers me, especially if it is in vials. I wouldn't want to accept leftovers from another nurse, though.

[ktwlpn, LPN]

That "half " pill could have been anything.I would have done what you did-and I would not have sined as a witness to her wasting it either .She would have had to call the supervisor for that.

[PAERRN20]

I would have wasted the medication too. Yeah, that Ativan (or any other controlled substance) might be expensive but it is a heck of a lot cheaper than losing a license. I wouldn't trust any medication that isn't sealed. Especially narcs.

[travel50]

We have had this come up at my nursing home where I am the DON. I understand and am okay with the nurse who got the med saving the other half in case she needs it sometime during the remainder of her shift. However, at the end of the shift, she is supposed to destroy it with a witness. If I didn't get the med in the first place, be it vial or pill, I will not give the leftovers. You should not either. I do understand running out of something. During regular hours, I go to our backup pharmacy for meds if we run out. We keep our e-kit well stocked otherwise. Matter of fact, I have it stocked extra well b/c I ran out of something important at midnite one time too many.