Giving residents non-prescribed meds?

[prinsessa]

Has anyone else heard of other nurses doing this? Several nurses have told me (or hinted without really saying) that they will give some of the residents medications that aren't prescribed to them or increase a dose (without a MDs order). When I first heard this I was shocked. I have told them that I don't agree with it and they better be careful doing it. Mainly it is done to help residents sleep. I'm just wondering if this is done at other facilities. Does anyone else think this is crazy?

[Kooky Korky, BSN, RN]

I have seen people give Mylanta/Tums....But never something for sleep and certainly not an IM med! That is crazy!! I am not sure why someone wouldn't call the DR if something was so desperately needed. Isn't that what they are there for? At our LTC facility, we do have several standing orders. They are great to have in place. But, now that I think of it...there isn't any standing order for anything like Tums or Mylanta....Hmmm

Perhaps these nurses are either lazy or have a desire to be prescribers without going to Med school, NP school, or PA school.

Stop these illegal practices at once if you're doing them. If it's not you doing them, these people need to be reported, via incident report that will make it to Admin, Risk Mgmt, and Nursing bosses.

Perhaps renal impairment explains why there's no standing order for Mylanta? Do nurses calculate the cretinine clearance?

[Kooky Korky, BSN, RN]

I've seen this practice before.

One of my former coworkers admitted to giving her sundowning residents IM injections of Phenergan to make them drowsy and "more quiet."

This might be a killer nurse. Report her/him at once - not only to your boss but to BON, police. She is doing a terribly illegal practice. Who knows what else she is injecting? Withholding? Altering? She does not belong at the bedside. Seriously. And if YOU are covering up for her or protecting her or not exposing her, what does that say about you - it says you are complicit.

[CapeCodMermaid, RN]

My first job was like onaclearday's description. I was being trained by an LVN and doing exactly that---pulling other patient's medication to supplement the lack of the other and it goes on and on. Including insulin.

And these nurses has no remorse! they looked at me in the eye, and asked me, "would you rather not give the patient their medication or use someone else's packet?" And I said, this justifies the means? And what happens to the next patient you encounter without medcs.?

Find a different place to work unless you're willing to be one of them.

Borrowing meds from one patient to give to another, while not good practice, is nowhere near as wrong as giving medications without an order.