I have your meds, please take them:)

[makes needs known]

A good friend of mine at work got fired yesterday. She had been warned about leaving pills at a patients bedside and not making sure they took them. They warned her that they were watching her and it happened again. This pt always said 'yeah, thanks I'll take them when I get up in a while" well apparently he slept all night and brought it to someones attention. She assumed he would take them, but she forgot that he was a patient because he was sick, and maybe a little forgetful. I will miss this friend but I also worry that in this fast paced work atmosphere anyone can make a mistake. I always worry that I miss something.

[boushie87]

I don't think this is a case where she forgot to do something. You go in the pt room to give pills. Unless she has some sort of memory loss or some issue going on, she purposefully left the pills with those pts, which from her first clinical she was told not to do. If she can't remember that, I wouldn't really want her as my nurse.

[vald96]

you even have to make sure the patient swallow his or her medications if refused

do not leave it at the bedside.....waste it and document the reason for refusal, just my 2 cents advise.

[nurse2033, MSN, RN]

Just never leave them at bedside. If the patient won't take them, chart it as a refusal and put them somewhere safe. You might try again to give them, but you have legally covered yourself if it never happens. Her example is exactly why. Don't put your license in the hands of the patient.

[sharpeimom]

a nurse never leaves meds at the bedside or in a patient's room.

sometimes there is a valid reason a patient refuses a pill. six years ago when i was hospitalized and my admitting orders were written, they were not administered as written and after explaining to this one meds nurse exactly why the order had been written that way, i chose to reuse that dose when she was on.

keppra is usually given morning and hs. if i take the morning dose all at once, i get dizzy, my ears ring, and i'm nauseated. therefore, i take half when i get up and half with my lunch and am fine. this unyielding nurse kept saying "but that isn't how the pdr says to give it!" fine, but this is what works for me.

it never hurts to ask why they're refusing the med(s) because the reason might just surprise you.

[Horseshoe, BSN, RN]

i will leave meds at the pt's bedside, but never narcotics. also, i always go back in to check on my pt to make sure the pills were taken. if you co-worker never went back in that room the entire rest of her shift to see if the cup of pills was there, then she was negligent in checking up on her pt.

if you have not witnessed the patient taking his medicine, you have no idea what happened to it once you left the room. he could have taken it, dumped into his lunch tray, thrown it down the toilet, or given it to a visitor. another employee could take the medicine; any number of things could happen to those meds. the patient will not necessarily be truthful when you question him about it later.

i'm surprised you would actually admit to doing this.

[Ashley_RN]

I agree to never leave meds at the beside & in my own practice, I will not leave the room until I've watched my patient take them... however, it did always confuse me as to why a patient who is A&Ox3 cannot be held responsible for taking their own meds if I do place them on their table.. This includes making sure their visitors do not get hold of them, taking them in a reasonable time frame and making sure theyre not accidentally taken or thrown out when tidying up rooms as well. I always inform my patients which meds I have for them, the reason theyre being perscriped & the importance of taking them.. Is it so crazy to ask for adults to display some responsibilty?

Also, before I get reemed out... I am of course referring to the A&Ox3 pt who is independent with ADLs, no risks for aspiration that will need my monitoring, no question in their judgement or risk that they will forget AND I do NOT mean narcotics.. Of course these dream patients sound too good to be true But it does seem silly I cant expect my patient to take something as simple as their nightly cholesterol meds that THEY DO AT HOME EVERYNIGHT if I place at the bedside cause theyre on the phone. If youre going to be irresponsible in taking your meds in the hospital, what makes me think youll be compliant at home with your own care? A previous poster said they could have 'thrown them down the toilet' or 'give to a visitor' which sadly could happen but if thats their attitude towards their health & the care theyre receiving while in the hospital, theyre taking up a bed that could be used for someone who actually wants to get better & be proactive about their health. Just my 2cents.

However, regardless of what I think... I will continue to watch all my patients take all their meds before stepping out of the room. It was just something I thought about :)

[Horseshoe, BSN, RN]

I agree to never leave meds at the beside & in my own practice, I will not leave the room until I've watched my patient take them... however, it did always confuse me as to why a patient who is A&Ox3 cannot be held responsible for taking their own meds if I do place them on their table.. This includes making sure their visitors do not get hold of them, taking them in a reasonable time frame and making sure theyre not accidentally taken or thrown out when tidying up rooms as well. I always inform my patients which meds I have for them, the reason theyre being perscriped & the importance of taking them.. Is it so crazy to ask for adults to display some responsibilty?

Also, before I get reemed out... I am of course referring to the A&Ox3 pt who is independent with ADLs, no risks for aspiration that will need my monitoring, no question in their judgement or risk that they will forget AND I do NOT mean narcotics.. Of course these dream patients sound too good to be true But it does seem silly I cant expect my patient to take something as simple as their nightly cholesterol meds that THEY DO AT HOME EVERYNIGHT if I place at the bedside cause theyre on the phone. If youre going to be irresponsible in taking your meds in the hospital, what makes me think youll be compliant at home with your own care? A previous poster said they could have 'thrown them down the toilet' or 'give to a visitor' which sadly could happen but if thats their attitude towards their health & the care theyre receiving while in the hospital, theyre taking up a bed that could be used for someone who actually wants to get better & be proactive about their health. Just my 2cents.

However, regardless of what I think... I will continue to watch all my patients take all their meds before stepping out of the room. It was just something I thought about :)

The simple fact is that you cannot chart a med as given when you have not observed the patient taking them. People who are in the hospital are sick, they are vulnerable, they may be A and O, but that does not mean that they will not forget, that someone else might not take advantage of their situation, or that they are being truthful about taking them (they may lie and say they did just to avoid the confrontation). When they are your patient, YOU are responsible for their care, THEY are not. When they are at home, then they are responsible for their care once again and their carelessness or noncompliance falls at their own feet. When you are on duty, the responsibility has legally been placed in your hands. If they are noncompliant and refuse, that's their right, but you have covered yourself by observing this and noting it. You cannot do that if you have set them on the table and left the room.

[3dayRN]

I never leave meds anymore at the bedside. I tell them if they do not take the meds before I leave the room I will take them with me. Then if they call out and decide they NOW want to take them they have to wait for ME, because by then I will probably be doing something else.

[Ashley_RN]

I fully understand the implications & reasons for not practicing this why, which is why I dont... I was only suggesting a perfect world scenerio, I'll just keep on dreaming :)

[deboraclark82]

I have never nor will I ever pass a med with out watching the patient take it in front of me. I can not sign off that a med was given unless I have witnessed it myself. That is the way I was trained to give meds and I will continue to follow that policy. Better safe then sorry.

[carl5480]

Is it so crazy to ask for adults to display some responsibilty?

This is a case of a few bad apples ruining the bunch. No, it's not crazy to ask adults to display responsibility for their own health, but there will always be a select few who can't or won't. Not to mention that the vast majority of our patients do not have our knowledge base when it comes to medications.

This is a very obvious statement, I'm well aware, but I for one do not want to be held legally responsible for that one patient who DOESN'T take their medications and then is somehow able to convince a court of law to hold me (or my facility) liable for their noncompliance. If I'm entrusted with a patient's care, then I have to do everything in my power to make sure they are getting the care they require. And that includes making sure they take their medications, including their home meds. Errors and mistakes in this process is, of course, why we have the intricate and detailed documentation processes that we have.

It's just irresponsible to leave medications at the bedside, period.

[JSlovex2]

i see medications left unattended all the time and while it's definitely an issue, i'd hate to throw someone under the bus for it. i know how crazy things can get and mistakes can be made. i only hope if it ever happened to me that someone would have some sympathy. when i was working as a CNA i would open up the UNLOCKED cabinet where the patient's charts are and find medicine quite often. i would never tell on anyone, but i would say to the nurse (usually young or new nurses) "i wouldn't do that if i were you." they would say, "i know, i just had to go do (fill in the blank) and i was going right back." i explained to one new,young nurse that i was a trustworthy CNA but had i not been...she would've been in big trouble. also, a patient or family member could've easily opened that cabinet looking for a blanket or something. one time a nurse left a loaded syringe lying on a bedside table. again, i delivered it to her and said nothing to anyone else. i know it wasn't intentional. something else that i saw a lot were medications in the patient's beds. they had dropped them instead of actually swallowing them. these things are all issues and could have detrimental consequences, but i hate to see someone get in trouble or even fired when nothing bad ACTUALLY happened. i personally don't make this mistake. i'm very aware of what the implications could be and i learned a lot working as a CNA which is helpful. i'm also not condoning the practice. it's a bad habit and needs to be fixed, but it's also a mistake that many, many nurses make especially when they're young and/or new. it's unfortunate.