I let the patient took his medications without water. Is this a medication error?

LovingLife123 · Nov 7, 2017

It's not a med error, but why don't you automatically grab a drink when you are giving oral meds? Like grab it with your meds and take it all into the room together?

I always ask my patients what they want to drink with their meds and then grab it all together. I couldn't imagine having to swallow whole pills without at least a water. And it seems like a choking risk to me.

**NICU Guy, BSN, RN** · Nov 7, 2017

Unfortunately, There was no available water at the area at that time so I couldnt give him water. I was also attending to other patient that's why I couldnt leave the floor. When the patient's wife arrived I asked her to buy some water for the patient.

Are you a US nurse? It is hard to believe that there is no water available on your unit and that the wife needs to buy a bottle of water for his pills.

macawake, MSN · Nov 7, 2017

I let the patient took his medications without water. Is this a medication error?

I'm not a U.S. nurse but in my country the answer to your question would be that it depends on the type of p.o. medication. There are some meds that can cause injury to the mucosal lining of the esophagus and they shouldn't be taken without water and the recommendation where I practice is that the patient takes them standing or sitting up and that they remain standing/sitting for at least 30 minutes after administration. These meds can cause esophagitis, esophageal ulcers and strictures and should be taken with at least a half glass of water and sometimes the recommendation is even a full glass of water (240 ml/8oz) to minimize the risk of the pill getting stuck in the esophagus. Examples of meds are clindamycin, tetracyclin, potassium chloride supplements and various bisphosphonates (osteoporosis prophylaxis and treatment), but there are more. These are the recommendations where I practice and I'm just sharing how we do it. Please note that I'm not telling anyone how you/they should do it, I recommend that everyone always read the manufacturer's drug guides used at their individual facilities and adhere to all applicable/pertinent guidelines/policies on how each medication should be administered.

I placed him on a sitting position before giving the oral meds. Unfortunately, There was no available water at the area at that time so I couldnt give him water. I was also attending to other patient that's why I couldnt leave the floor. When the patient's wife arrived I asked her to buy some water for the patient.

The patient is still in a good condition. But the wife made a complaint letter indicating the purpose is not to demerit someone but to improve the services of the hospital. This incident happened 3months ago and I think this is for investigation and I don't know how to defend myself. I am truly sorry for what happened.

I think it's a good thing that the patient's wife complained. It really isn't acceptable that there isn't water available in a hospital/clinic. As a previous poster mentioned there might be a choking risk and access to water seems like a very basic requirement for any healthcare facility. In what country do you work OP? I'm sorry that you're going through this right now but hopefully this will result in some changes/ improvement at your place of work. I hope that that the environment you work in isn't punitive, but rather that this is viewed as a chance to make positive changes. Apart from the fact that you didn't have access to a glass of water, being alone on the floor and caring for a patient with chest pain to me really doesn't sound like an ideal work situation for the individual healthcare professional nor from a patient safety perspective.

Best wishes OP!

oceangirl1234 · Nov 7, 2017

I would never ask my patient to dry swallow a pill. If they choose to do so, and it is a small pill then whatever.

I would also never ask a family member to buy the patient water....if I was in her shoes I would probably have complained as well....

Sour Lemon · Nov 7, 2017

I'm also interested where this situation occurred ....disaster area? It sounds very unusual.

Ben_Dover · Nov 7, 2017

The hospital water may have not been potable anyway. Hence, asking the family member to buy some.

Shouldn't be a big of a deal cause it's been months. But I'm assuming those who complained has some power or authority or even money.

Sorry this has happened to all parties.

Again, it shouldn't be a big deal since there was no mention of pt. Being greatly affected.

Ben_Dover · Nov 7, 2017

I would never ask my patient to dry swallow a pill. If they choose to do so, and it is a small pill then whatever.
I would also never ask a family member to buy the patient water....if I was in her shoes I would probably have complained as well....

Have an open mind. Nursing in the U.S is like being at the Ritz hotel so you can complain as much as you want.

Try practicing nursing in a third world country or from what I've heard even in some parts of Europe, where nurses are treated as a third class citizen.

Now I can say, here in the U.S. our patients do like to complain over minor things. What more if your patient is a registered nurse.

P.s.

The guy's 47 year old patient and able to say he can take the pill w/out water.

I just truly sense the family member is showing power more than anything else.

If the pt's 85 year old with CP... my views would have been different.

Lastly, it isn't a med. error but more of a safety issue than anything else.

:woot:

Wuzzie · Nov 7, 2017

Having traveled to some third world countries for medical missions I can assure you this isn't that unusual. Some hospitals require family members to bring food for the patient as it is not provided. Ditto for linens. In Peru you have to pay for an xray before it will be done. Many don't have a clean water supply. One hospital I went to did have water and they had the most beautifully clean, pressed linen I have ever seen but there were massive holes in the roof and some walls in the wards were caving in. It was surreal.

jodispamodi · Nov 7, 2017

Technically, its not a medical error but it could potentially be negligence. Ideally PO meds should be given with a glass of water to help them break down and prevent injury to the stomach lining. Applesauce or pudding can be used as a weak substitute but pills should never be swallowed dry, something like clindamycin, or the larger pills can stuck in the esophagus and cause big problems. Why wasn't there any water available?

LovingLife123 · Nov 8, 2017

Have an open mind. Nursing in the U.S is like being at the Ritz hotel so you can complain as much as you want.
Try practicing nursing in a third world country or from what I've heard even in some parts of Europe, where nurses are treated as a third class citizen.
Now I can say, here in the U.S. our patients do like to complain over minor things. What more if your patient is a registered nurse.
P.s.
The guy's 47 year old patient and able to say he can take the pill w/out water.
I just truly sense the family member is showing power more than anything else.
If the pt's 85 year old with CP... my views would have been different.
Lastly, it isn't a med. error but more of a safety issue than anything else.

I think then the poster needs to specify that they are not in the US. That would give us a better understanding.

KelRN215, BSN, RN · Nov 9, 2017

I regularly take my meds without water but I would never expect a patient to do the same. In the US, it would be unheard of for there to not be potable water readily available on any floor. When I worked in the hospital, we had a kitchen on the floor stocked with various juices and milks, a water machine and for formula fed children, there were infant and pediatric formulas in the stock room.