How do I peel pill packets without meds flying everywhere!

Nursing Students Student Assist

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Hi all! I have a silly question that keeps tripping me up at clinicals. Anyhow -- the way our meds are distributed in the hospital are in these sticky individual foil packets, and I feel that when I peel the foil back, it can cause the pills to pop out and fly off and on to the floor. Has anyone else had this problem?

I try to keep my thumb over the pill as I peel back, but at my last shift when I tried to do that, I had a controlled substance just tumble on out onto the floor -- and not only did I feel like an idiot in front of my preceptor but it was the end of the world with the pharmacy. Do you have any suggestions, such as opening inside a plastic bag? Or keeping a scissor with you? I appreciate any tips or tricks with med pack opening!

Specializes in Med-Tele; ED; ICU.
:woot: Yes.................:yes: This is the only solution. Seriously, who invented them? Not a nurse, obvs.:no:

As a former engineer with experience in production processes (read 'how to empower the workers to go as fast as possible while eliminating defects'), I've noticed that there are many system inefficiencies that were created because nobody appears to have had usability and efficiency as primary design criteria.

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I feel so much better knowing I'm not the only person with this problem:sarcastic:. Thank you all so much and LOL about these blister packs being harder to open than jumping the White House fence -- you're absolutely right. They're totally not user friendly. I honestly felt like I was so incompetent and just wanted to promise my preceptor that indeed I *am* able to successfully get by in normal, everyday life. I'm gonna look for a little scissor to buy online and try the trick with pinching the blister. These little details. Again, thank you guys so much.

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Specializes in Pediatric Hematology/Oncology.
Colace can be pushed through the packet.

It must be my bad luck but the pill squished and all it's contents squished out as well.

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Specializes in Burn, ICU.

My hospital changes who the buy their meds from daily, I think, so the packaging is always different. Currently, our colace packets have no peel-away edge and the foil/paper back is rugged enough that I haven't tried to push the capsule out through it. I can usually slide my thumbnail along the back of the foil right at the edge of the plastic indentaion and tear through it enough to then tear open the packet. (My nails are usually very short, and this still works.) I open all med packets at the bedside and most of our patients are on contact precautions, so carrying a pair of scissors isn't the easiest option for me. We do stock lots of meds in green plastic blister packs with a foil-and-really-sticky-paper backing, and I always wind up with some of it stuck to my gloves or (rarely) the pill stuck to it! With those I do try to push the pill out through the backing if it's a hard pill, since trying to peel the backing seems to make the layers pull apart and makes it harder.

Also, nearly everything is easier when someone isn't watching you!

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I've had pills crumble into powder when I tried to push them through the packaging. It is very frustrating! And a good reason to wear gloves when handling pills. If it's in a peel back package I just try to control opening it over the med cup, and resort to scissors otherwise, as others have suggested. It's rather ridiculous. No need to beat yourself up.

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Specializes in LTC, Rehab.

I don't have one right in front of me, and haven't thought about it exactly, but I had a few problems with those as a student too. I think what I do is hold the packet with one hand on one end, with the index finger of the other hand on the other end, holding it over a paper or plastic pill cup, and push the pill through the foil with the thumbnail of the same hand I'm using the index finger of. If that makes any sense. :^) (So I don't peel the foil at all, unless it's a particularly stubborn one).

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If you try opening over a med cup, have a second med cup for storing the already open pills. At least three times I was overly forceful trying to open one of those awful (must be made of steel) blisters pacs into an already full med cup and lost a whole cupful of meds all over the floor. Now I use scissors for the bad ones.

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Specializes in Critical Care, Med-Surg, Psych, Geri, LTC, Tele,.

In my current acute care setting, I try to peel slowly. I also break out my clean scissors, PRN.

in the past I worked in LTC, far more meds, all in 30 day supply individual blister packs. I recall that my thumb nail would bleed under the nail due to the amount of meds i had to pop out.

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Seeing that this is a problem for others makes me feel not so terribly. Two weeks ago during my VERY FIRST med pass, I popped the pill right out of the packaging onto the floor, and was absolutely mortified. Of course my clinical instructor was right there observing, and seemed so disgusted, and probably perceived me as being an incompetent fool. I'm going try out some of these tactics, such as the scissors and Dixie cup methods. Thanks to all for the input!

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You can also try taking a needle and perforating the foil all around the inside edge of the plastic bubble, then pushing the pill out through the weakened lid. Or pilfer a pair of suture removal scissors, the ones with the little hook on the end of one blade, and hook into the foil to cut it. Easier than regular bandage scissor blades.

Finally, check to see if the peel-away part is a single or double layer. Sometimes the hard paper top layer peels off without peeling away the flimsy tinfoil layer on the bottom. See if you can separate them with your nail first. With the tinfoil in place you can be as vicious as you need to be pulling off the paper layer, then the foil is easy-peasy.

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On 9/27/2016 at 5:11 PM, AliNajaCat said:

You can also try taking a needle and perforating the foil all around the inside edge of the plastic bubble, then pushing the pill out through the weakened lid. Or pilfer a pair of suture removal scissors, the ones with the little hook on the end of one blade, and hook into the foil to cut it. Easier than regular bandage scissor blades.

Finally, check to see if the peel-away part is a single or double layer. Sometimes the hard paper top layer peels off without peeling away the flimsy tinfoil layer on the bottom. See if you can separate them with your nail first. With the tinfoil in place you can be as vicious as you need to be pulling off the paper layer, then the foil is easy-peasy.

This is probably the worst advice, I'm sorry. Not a good idea to use a needle to try to open these meds, can already see the needlestick injuries now. 

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Specializes in Burn, ICU.

I know this is an old thread but someone was sweet enough to like my post and so I came back...and I have another trick to suggest!  Use the corner of one packet to slit open the back of other packets.  I specifically do this with our gabapentin capsules where there's usually no "start-peeling-here" tab.  I take the corner of some other packet with fairly rigid plastic and use it like a tiny blade to make a slit.  I haven't (yet!) accidentally damaged a gabapentin capsule by doing this!  Meds that come in cards of 5 or 10 pills to a card and you tear them apart usually yield some nice sharp corners.

(See also the day I sliced the tip of my finger open in the med room separating a pill from the card of ten!  At least we kept bandaids in the med room.)

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