giving meds late when it's not in pixis

[Birdy2]

So several times I've had a patient that needed a med, even important ones like BP and antidysrhythmics, and I couldn't give it because pharmacy hadn't sent it up yet. Well you know how on the emar you have to give a reason for why you gave it late? I was going to put not available. A nurse told me I wasn't supposed to put that because they don't want it to be pharmacys fault. So basically I'm supposed to take the blame for it and get in trouble if anything goes wrong? How is that fair and why in the world should I be forced to lie about something? She said I was supposed to put pt refused or something else. I don't like this rule and don't get it either

[Rogueglitter]

When that happens I type "given when medication available". I would put the real reason because if they do audits a pattern might show ways to improve patient care (ie more pharmacy/transport staff to make supplies available in a timely fashion).

[Birdy2]

Well ya I was going to. I was gonna select the option hold and then in the text box write that. But I was told not to. Crazy if you ask me. I told her I was gonna talk to someone about this and she said good luck and acted like I may get in trouble.

[Sun0408, ASN, RN]

So ultimately they want you to falsify the pts medical record. Not gonna happen. If the med was unavailable that is what I will chart. I will Also send a missing med message to pharm; paper trail.

[Birdy2]

Ya I did that the first time and she got mad. I agree it isn't right and don't know who I could talk to about another option. I guess they aren't wanting to make pharmacy look bad but why don't they care if it comes back to me? Confusing.

[ixchel]

That's ridiculous. If the med wasn't available, it wasn't available. Pharmacy SHOULD be put on the spot for that (if it ends up being a big deal).

[nurseprnRN, BSN, RN]

"A nurse told you they don't want it to be pharmacy's fault" isn't reliable. "They" who? Ask if that's a policy and to see it in writing. You won't. Then put in the "missing med" documentation. If it keeps happening, drop a dime to the hospital Risk Management officer. Believe me, they want to hear about it.

[SubSippi]

If "they" didn't want you to use that option then trust me...it wouldn't be available.

That nurse probably has misinformation that has cycled through one of the long streams of misinformation that floats around hospitals.

At my first job, it somehow became "policy" that we didn't give long acting insulin if a patient's blood sugar was below 100. It took months to get everyone back on the same page.

[skyler20]

We have an option that says "med not available from pharmacy"

[llg, PhD, RN]

I agree with GrnTea: Why are you letting any old nurse tell you what to do? Was this nurse "who told you" your boss? If not, I would ask someone in authority (e.g. your boss or your unit educator) what you should do in such a situation. If the answer that person gives involves falsifying the medical record, tell them that you are uncomfortable lying about it and see what they say.

If you believe that falsifying the medical record is happening on a regular basis ... then you have an obligation to report that to the institution's Risk Manager.

[toomuchbaloney]

Additionally, if important and necessary care is delayed by a pharmacy issue an incident report would be in order. These tools often require that the involved disciplines and departments discover what happened and why and then are charged with developing a plan to correct.

[KelRN215, BSN, RN]

Ya I did that the first time and she got mad. I agree it isn't right and don't know who I could talk to about another option. I guess they aren't wanting to make pharmacy look bad but why don't they care if it comes back to me? Confusing.

Who is she and why is she looking at your documentation? If the med wasn't there, it wasn't there.