Many new nurses, entering LTC, are faced with this dilemma. They observe seasoned coworkers leave medications at bedside. Furthermore, some residents demand it, arguing that the other nurses do it. While this may or may not be true, it is rather irrelevant. Unless a specific may leave at bedside order exists, it is not ok to do so. The risks are harm to the patient from omitting the dose, doubledosing at a later time (oding), mixing the medication, etc. etc. Other patients are at risk due to sharing, rummaging, or being medicated by the first patient. There are a number of ways to address this. When first faced with the situation, validate the patient. Instead of immediately citing that this is against the rules you might say something like I'm sorry I didn't know this, this seems very important to you. Try to find out why it is important to the patient. Is it a control issue, is it a convenience issue, etc. Try to accomodate as much as possible such as returning at a later time, getting a different drink, more or less ice, anything to show that you are not trying to take control away, but rather operating within the law. If the patient gets upset, that's ok, change can be upsetting. If the patient becomes very unreasonable, then this person is most likely not safe to self medicate anyway. The point is, there's no easy button. However, no matter how difficult the situation is, do not leave meds at bedside. In some situations it might be ok to leave some or certain meds (perhaps a vitamin) at bedside and an appropriate physician's order can be obtained. Please share your experience and how you feel about this issue.
We only left them if there was an order. If no order, i would stand there until i saw the pt take them or i would leave with the meds and tell them i would return at a later time when they were willing to take them.
i'll nly combine say 6-8pm meds if it 7pm otherwise i'll d a 2nd rund
oh i have 8 patients. if patients are in the same room iill give the med dot the drug card as dispensed and start the 2nd patients med card etc and once the first pt has swalloewed the tablets i;; inital the drug card as adminstered. all my patients are elderly and at times stepping back slightly they seem to take them.
in long term care shortcuts in med passes are almost impossible to do. most of which ya cant do when state surveyors are watching. but in order to complete the med passes on time.... you do what you have to. i dont like leaving meds at bedside....thats just me.... if they dont want it right then,...... its like ok im busy it may take me awhlile to get back to you. but it is thier choice. they have right to refuse. dr order will allow to leave meds at bedside. had to beg for that on one resident.... she just wanted one dose of tylenol to take during night.....in assisted living.... no nurse on the unit.... but emergency nurse available from connected snf. after i went through a lot of hoopla and a lot of teaching with the resident and pestering the dr..... i did get my way.,..... the resident was so happy she could take her tylenol when she wanted.... each am i would check with her.... ok what time did you take it.... she didnt always write it down.... but could tell me within an hour of time that she took.... like between 2-3am
this also allowed follow up that regular tylenol was not controlling her pain so she could get a good nights sleep which they ended up changing her bedtime med routine so she could get better rest.
Unless it is ordered that a patient may self administer x, y, or z medications then is not legal in my province to leave any medications at the bedside.
I will NOT leave meds at bedside and it annoys me and angers me when I follow a nurse who has done so.
On a different note, I am one of those nurses who can get through my med pass fairly quickly. However, I work the same unit five days a week with very few med changes. I also have the meds arranged in my med card in the same order they are printed on my med sheets so I don't waste time searching for them. And yes, everyone gets exactly what is ordered: eye drops, inhalers, insulins, pills.
luvmy2angels
755 Posts
We only left them if there was an order. If no order, i would stand there until i saw the pt take them or i would leave with the meds and tell them i would return at a later time when they were willing to take them.