Giving tylenol to a family member.

[Tiaj72187RN]

So I just got home from work and I had a frustrating incident. A family member asked if I had some tylenol for her. She had a headache and her husband was very sick and it was 2am. I told her I probably had some in my purse. When I mentioned it to one of the older RNs she said it was outside of my scope of practice because I was then "prescribing"??? It was my own personal supply of tylenol, its an over the counter medication, it was an adult who had a headache, I had already clocked out and was getting ready to leave. I gave it to her despite this other RN telling me I could lose my license. Was I wrong? I live in the state of Texas, I've read my NPA and I intepret it much differently than she did. Thoughts? Advice?

[Esme12, ASN, BSN, RN]

For those saying this is "prescribing," how? The OP didn't say "Oh, you have a headache? Here, you should take some tylenol." The family member ASKED for an OTC medication. If this was her personal supply, then that means it was purchased OTC and has all of the drug information on the bottle. This is like saying the cashier at the grocery store is "prescribing" the tylenol when you go purchase it.

Also, I don't know about texas, but I'm in NC and it is within the RN's scope to recommend OTC and herbal/dietary supplements.

The key word here is RECOMMED............not GIVE!

[Flying ICU RN]

The scenario I referred to as ridiculous did not include any medication, but was the one you posed about refusing to check the blood sugar of a visitor who said they were diabetic and felt dizzy ".

Where my motivation in this thread is to hopefully educate the uninitiated, I suspect your motivations are simply an obtuse attempt to remain on the right side of an argument. I'm off work today, have an aircraft to build, and am wasting entirely too much time spinning my wheels unnecessarily.

In closing, and simply for an apparently necessary clarification.

A visitor outside of the ED dept, is not a patient admitted to your service by a licensed physician. Therefore, short of rescue (ABC's CPR) it is unnecessary to know the underlying cause of outward appearing symptoms (glucose, Blood pressure, etc) as it is unlawful for you as an RN to admit, diagnose, and treat without protocol in any state.

Timeliness of receiving appropriate care by appropriate personnel, is the standard of care for visitors in distress.

[Esme12, ASN, BSN, RN]

Additionally, what I am trying to relate to the membership in posts 18 and 30, is that opposing council in such a scenario would place doubt on precisely "what" medication was administered, eluding to the possibility of further unnecessary harm. The primary focus however, would have been an unqualified provider and a missed opportunity for proper standard of care.

Folks, let me tell you that I understand and admire the mindset of the ambulance chasers, my mind is likewise wired so I use that to my advantage in practice. It is only by happenstance that I became a nurse.

Judge for yourselves, heres my graduation picture from nursing school.

:hhmth::hhmth::hhmth: My brother from a different Mother!

[HamsterRN, ADN, RN]

A visitor outside of the ED dept, is not a patient admitted to your service by a licensed physician. Therefore, short of rescue (ABC's CPR) it is unnecessary to know the underlying cause of outward appearing symptoms (glucose, Blood pressure, etc) as it is unlawful for you as an RN to admit, diagnose, and treat without protocol in any state.

Timeliness of receiving appropriate care by appropriate personnel, is the standard of care for visitors in distress.

I don't see how making a potentially acutely hypoglycemic patient find their way to the ED without checking their BG is prudent or legally safe.

In my state it is lawful according to my BON and our Good Samaritan law to provide personal tylenol to a competent person if you are not being paid for that act, regardless of what building you are in or what you are wearing.

I agree that on the clock or dependent on your state laws, BON interpretation of those laws, or facility policy then things change.

[Zookeeper3]

Prove it.

Link us to a statute that supports your statement.

Otherwise, this is unsubstantiated opinionated rabble, and a potential danger to the uninitiated and or gullible membership.

Your strong opinions worry me about you. Not this quote in particular. In nursing, not always the instance in this post, most is gray periods of decision making mostly based upon evidenced based practice, policy and knowledge as well as expertise with practice and outcomes. Your black and white posts are as startling as you wished them to be, my concern is that you are actually a provider that lives in black and white. Food for thought as my years of exp. have taught me that black and white equals a patient that never read the rule book, and they will suffer through you for this.

Re-read your strongly voiced posts and consider the gray. It's easy to post on a black and white thread, but your thought process speaks more strongly...perhaps years in later... the gray will make more sense. I hope it does.

[Flying ICU RN]

Your strong opinions worry me about you.

No need to worry about me, I'm just fine.

On the issue of whether or not a RN within the walls of a health care institution, has independent prescribing or dispensing authority under license in any state, there is no Grey. Those in support of the notion of dispensing meds in this environment (from your purse or otherwise) as being allowed by law, have as yet failed to offer up evidence to the contrary.

upon evidenced based practice

*Where's your evidence to the contrary on this issue?

Your black and white posts are as startling as you wished them to be, my concern is that you are actually a provider that lives in black and white. Food for thought as my years of exp. have taught me that black and white equals a patient that never read the rule book, and they will suffer through you for this

For a poster who freely uses the words "Evidence Based," You offer an opinion (frank supposition) that was formulated on the bases of interpreting some bits and bytes typed by a nameless and faceless stranger, transmitted over the INTERNET, and then read on a computer screen from the comfort of your chair. Would that be an accurate supposition on my part?

I will identify the following statement then as an opinion formulated by my own personal "evidenced based" experience.

Fortunate is the critically ill patient (and his or her loved ones) to have me assigned to his/her care for the next 12 hours.

[Flying ICU RN]

In my state it is lawful according to my BON and our Good Samaritan law to provide personal tylenol to a competent person if you are not being paid for that act, regardless of what building you are in or what you are wearing.

.

A statement of fact as presented by you, now support it with a link to this supposed statute and or B.O.N. practice act.

My money is on you cant, which should put an end to the discussion.

[mtdnk]

No way is that out of scope.

People do that without a thought to nursing. My roommate and I gave each other tylenol and ibuprofen throughout college years before I became a nurse.

Does this also mean mothers who give their children tylenol without a doctor's approval are practicing without a license?

If you had a child that complained of pain or was experiencing a temp, I would hope you would be calling their doctor to determine the cause and appropriate treatment. Once that has been determined and the dentist says "take motrin for pain", "use tylenol to decrease the temp", etc. Besdie that, the difference is obvious. They don't have a license to protect. We hopefully all do what we do mindfully, by applying formal and informal education. Since you have graduated and have been able to get your license, I would believe your knowledge level and awareness of safe nursing practice has improved radically. Whatever action you chose, be prepared for the consequences.

[mtdnk]

"*RN's do not have legislatively granted prescriptive or diagnostic privileges in any State, correct"

Actually not totally correct, in my state RN's can initiate diagnostic procedures in which they have "proven and maintained competency", but still irrelevant to the scenario at hand or the original scenario since the nurse was not prescribing or diagnosing.

There is a new book out called "The Florence Prescription". I'm not a huge Florence Nightengale fan since I have a hard time seeing how the Crimean War relates to the modern healthcare setting, but there is one quote I enjoyed that seems relevant:

"Proceed until apprehended".

Formulating a medical diagnosis is what was being discussed, I believe. That is not a privelege a RN has.

Food for thought about Flo and the Crimean War. If we do not learn from our history, we are destined to repeat it. Florence was instrumental in facilitating change in the sanitation procedures, thereby significantly decreasing the rate of infection/mortality (inportant information for yesterday, today, and tomorrow, right?). She proved herslef not only as a warrior promoting respect for nursing, but established herself as a solid and innovative mathematician via her documentation demonstrating her new techniques of statistical analysis of the incidence of preventable deaths in the military during the Crimean War. She focused on the holistic needs of an individual and the importance of many components required to promote health. She experienced a hostile work environment, as the docs did not particularly care for her views on their military hospitals and identification of needed improvements (doesn't that still happen today). By embracing our gallant past, we can find to the stength to fight todays health care battles. Florence used her experiences to author books (Notes on Hospitals and Notes on Nursing) raising money to found the Nightengale School and Home for Nurse's at Saint Thomas Hospital, and she was a strong proponent on women's rights (is this not a current struggle as well?)

The history of the nursing profession is militaristic (remains so today). Consider the impact of the hospitalers (important history re: men in nursing). There are important lessons to be learned from our past.

[caliotter3]

This thread has provided more content and food for thought about my profession than any random three months of classes at my nursing program.

[AgentBeast, BSN, RN]

Whether or not it is illegal or I have no idea and don't really care because I don't walk around with much of anything save for my keys and wallet. I'm going to guess it is not illegal, but if it is then the law is wrong and not the action. Otherwise you'd have the ludicrous situation where it's fine for Joe Q Public to give Betsy a Tylenol (not a controlled substance) however if Joe Q had an RN license and was not in a nurse>patient relationship with Betsy now it is illegal? I can see where the lines start to blur when Patient X is/was in your charge and person Y (patient's spouse) asks you for a Tylenol. I can also see that the hospital isn't going to want RN's employed there passing out Tylenol even between staff. I just can't fathom that it would be illegal outside of a health care setting that it would be illegal to give someone a Tylenol if you have an RN license.

[mtdnk]

Whether or not it is illegal or I have no idea and don't really care because I don't walk around with much of anything save for my keys and wallet. I'm going to guess it is not illegal, but if it is then the law is wrong and not the action. Otherwise you'd have the ludicrous situation where it's fine for Joe Q Public to give Betsy a Tylenol (not a controlled substance) however if Joe Q had an RN license and was not in a nurse>patient relationship with Betsy now it is illegal? I can see where the lines start to blur when Patient X is/was in your charge and person Y (patient's spouse) asks you for a Tylenol. I can also see that the hospital isn't going to want RN's employed there passing out Tylenol even between staff. I just can't fathom that it would be illegal outside of a health care setting that it would be illegal to give someone a Tylenol if you have an RN license.

Well, the most important thing YOU can do is get the answer to make sure you are practicing correctly, really doesn't matter what someone else says, right? You do not turn your license off and on, that's one of the reason the "Good Samaritan Law" came into effect.