Is this comon practice where you work?

[Amysuenu]

Hello all. I wanted to post a question to all of you and get some feedback regarding a situation that occurs on a regular basis at a facility I was recently employed at.

Ok, this facility receives it's medications from an outside pharmacy, but does carry certain commonly used floorstock medications. I was working as the med nurse on this unit and a new order had been written for a patient for a med that we don't have on floor stock due to it not being a common drug we use. I was told to remove this exact med from another patient's drawer and give it to this other patient. I felt very uncomfortable doing this and would not follow through the request. This goes against what I was taught in nursing school and also didn't feel it was ethical. My other concern was who is this patient paying for this medication that want me to give to this other patient. I addressed this and was given a look of a complete idiot! I was concerned with this fact. I was told not to worry about it and I could just replace it at a later time. This leads to another problem, the same nurse is not consistently the med nurse and we are often assigned to another unit, if the census is high.

Is this standard practice where you work? I never came across this situation w/ my previous employer. Also, since this situation arose I have since been terminated and the reason I was given was due to a med error; however, that med error was never discussed prior to my termination, nor did I actually see the paperwork related to this.

[FLArn]

It is never ok to take med from one patient for another. The med should be obtained either from a backup pharmacy or the doctor needs to be notified that the med will be given as soon as available, and the MAR marked to indicate that fact. The med should be initialed, circled, and noted "new order-not delivered from pharmacy yet." or similar facility approved language.

[ItsTheDude]

not common practice.

[crissrn27, RN]

I say, depends on what it is. Well, actually I agree, you should never have to borrow meds, your e-kit should be stocked with app. meds and it shouldn't be an issue, but if it was for a clondine for a bp 210/110 and the e kit was out and it was going to take 2 hours to get it and another patient had it..........I feel the risk of not giving a drug that is right there (and replacing it as soon as the other pts med comes in) would be bad.

If it was for a nexium that was a pharm rec that could wait, etc, no big deal, wait for it. Or even an ABT, 2 hours probably would be OK. Pain meds and BP drugs, nitro, etc, I don't think I'd wait.

Of course you can't "borrow" pain meds now, due to DEA regs, at least here in NC, so what I do is hound our back up pharm until the med is in my hands, lol. But pain is not life and death, not for an hour or so, although it shouldn't happen. BP in that range could be.

[Amysuenu]

I forgot to mention the medication. It was Buspar and they were a new admit. This was at 14:30 and the pharmacy generally delivers by 1800.

[crissrn27, RN]

Yeah, in that case, waiting wouldn't be a big deal.

[SuesquatchRN, BSN, RN]

We borrow. If you quote me, though, I'll deny it.

[makes needs known]

I have borrowed medications before, we get 3-4 new admits almost everyday, pharmacy delivers at midnight, hours after they arrive. Patients want and need their medications. When they come up with a better system for obtaining meds for patients, I won't have to borrow. This is common practice where I work, with the exception of narcotics, which we will not borrow.

[caliotter3]

We borrow. If you quote me, though, I'll deny it.

When I was new there were practices in place at my facilities that I later found out were against appropriate practice. I would never have known the difference except that little nagging voice in the back of my head was trying to tell me something.

[NotFlo]

Yes, borrowing has been standard practice and an ingrained part of the culture at every facility I've ever worked at. Does that make it right, no. Does it happen, yes.

[makes needs known]

Last week I got a med error for not giving a med to a new admit. Their med was not delivered until after I left at 1130. If I stop at 8pm and call a DR about EVERY med that I don't have yet for a patient he is going to get upset with me, with the DR who prescribed the med, with the nurse who ok'd this med (not me) and with our facility. Until they come up with a better system I will do my best to give the patient the med that they have ordered.

[loriangel14, RN]

The hospital that I work at gets it's meds from pharmacy located in the larger hospital in the next town. They deliver to us once a day.We actually have a form we fill out when we borrow from one pt for another which we fax to pharmacy so they know that the other pt will be short a dose. We do have a large stock of meds including narcs but sometimes we still have to borrow.