Given another patient's medication to satisfy MAR.What do you do? Orientee

Specialties LTC Directors

Published

On my 2nd week of orientation, I saw this happen under 3 different nurses.

The patient's medication packet was empty and the trainer pulled the drug from another patient's medication packet to satisfy the MAR; because as we all say, if it's not documented, it was not done.

The 4th incident was a patient's NPH, no NPH bottle, and the 4th nurse said to me, "I know this is wrong but this is how you do it, take this NPH (another patient's NPH) and draw what you need." I refused and asked for the emergency kit, and it was also empty.

What would you do? Where to report other than LTC Ombudsman? This is criminal and they have to be punished.

Up Vote Up Vote ×
This is criminal and they have to be punished.

Whoa, whoa, whoa!

The residents need their meds.

The nurses should be ordering meds on time.

Meds are being "borrowed" to take care of the residents.

There's a system problem here, and, while this is illegal, it is far from criminal in the way you are using it. Start getting meds ordered on time.

1
Up Vote Up Vote ×
Specializes in Hem/Onc, LTC, AL, Homecare, Mgmt, Psych.

I wouldn't report it to state or ombudsman. Go to your director of nursing with your concerns first and foremost. Obviously the policy on nursing's role in reordering meds needs to be reiterated. Or maybe it's not nursing, maybe the pharmacy needs to be updated on the delivery problems. We are strict about not "borrowing" meds in our facility. If the pt is out we try to get it from the E-kit. If that med is not in the E-kit we call the pharmacy and ask for a stat delivery.

Up Vote Up Vote ×
Specializes in Gerontology, Med surg, Home Health.

Technically borrowing meds is the same as stealing. You're not supposed to do it. But, jeez, what good will it do to call the ombudsman??? We have a rotten pharmacy...they are notorious for not delivering meds on time. THAT is out of my control. The ombudsman can't make them deliver any quicker....we are getting a new pharmacy but that in itself is a huge issue.

Up Vote Up Vote ×

is your pharmacy pharmerica?

Up Vote Up Vote ×

Having worked in long-term care, I :mad: ALWAYS anticipated dealing with missing meds. Before my med pass started, I would pull out the pharmacy reorder sheet. I ordered meds stat in between giving medications to 30 patients. The system of communication between nurses was broken and complaints fell on deaf ears. I saw nurses verbally insult each other over meds missing or not ordered! One nurse was solely responsible for ordering medications, but the duty for all of us nurses was to reorder meds regardless of who was assigned the official task of med ordering for the unit. If a nurse complained about missing meds to the DON, he/she was told to simply reorder them. On the cycle continues...

I no longer work there.

Up Vote Up Vote ×

And by starting a ruckus over this what do you expect to accomplish as a new employee? Why would you not bring this to the attention of management if you are concerned? The way to handle problems is to bring them to the attention of those that can do something about them. And you could have taken the time to go through the cart, find other examples, and make phone calls to reorder the meds. Employers like employees who take action when they see that something needs to be done.

Up Vote Up Vote ×
Specializes in Gerontology, Med surg, Home Health.
is your pharmacy pharmerica?

Yes. They are not good.

Up Vote Up Vote ×
Specializes in Long term care-geriatrics.

I agree the system is broke at your facility. I wouldn't report it to the state. The DON should be notified of the problem. Pharmacy should be notified of the problem, but that is not for the floor nurses to do, but the DON. When you start passing medications, you need to take a medication pull sheet. As you pass medication you need to note if you are missing medications on your pull sheet. Borrow meds only after there are none in the emergency box. When you are done with your medication pass, fax or send the copy of the medication pull sheet. You may want to give a copy to the DON, keep a copy for your needs and you may want to slide a copy under the administrator door later. Call pharmacy and make sure they actually got the medication pull list and verbally tell them you need all of those medicationa and that the ER box need replacing. Another problem that occurs is that the pharmacy can not sent mediction early. If a resident's medications were sent on August 1, the physician increased the med, nurse double the meds etc. The pharmacy may not send an increase of the meds. Pharmacy will come up with all kinds of reasons to not send medication. You need to let the DON know if a person isn't their medications because the meds are reordered before 30 days. Good luck.

Up Vote Up Vote ×
Specializes in LTC, Psych, Hospice.
On my 2nd week of orientation, I saw this happen under 3 different nurses.

The patient's medication packet was empty and the trainer pulled the drug from another patient's medication packet to satisfy the MAR; because as we all say, if it's not documented, it was not done.

The 4th incident was a patient's NPH, no NPH bottle, and the 4th nurse said to me, "I know this is wrong but this is how you do it, take this NPH (another patient's NPH) and draw what you need." I refused and asked for the emergency kit, and it was also empty.

What would you do? Where to report other than LTC Ombudsman? This is criminal and they have to be punished.

WOW! That's all I can say.

What do you hope to accomplish by reporting this to the state? As the others stated, you need to talk to the DON. When I worked LTC, I would order anything with one week left on the card. That gave pharmacy plenty of time to deliver. Some nurses are lax about med refills, sometimes it's the pharmacy not delivering in a timely manner, sometimes the pharmacy would state they never received the fax. It's always a good idea to follow the fax with a phone call to pharmacy.

Up Vote Up Vote ×

Welcome to the "real world" of nursing. I can't tell you how many times I have had to "steal" in order to give the required medications. Yes, some nurses think they don't need to re-order meds like everyone else. I always seem to get the "pharmacy from hell" no matter what job I have. There were a few times when I didn't need to steal. It was when they put the "Dc'd meds" in a pile in the med room. When I needed a pill and pharmacy said they wouldn't send it to me I would go thru the pile of dc'd meds and 80% of the time I would be able to get the pill I needed.;)

Up Vote Up Vote ×
Specializes in LTC.
Welcome to the "real world" of nursing. I can't tell you how many times I have had to "steal" in order to give the required medications. Yes, some nurses think they don't need to re-order meds like everyone else. I always seem to get the "pharmacy from hell" no matter what job I have. There were a few times when I didn't need to steal. It was when they put the "Dc'd meds" in a pile in the med room. When I needed a pill and pharmacy said they wouldn't send it to me I would go thru the pile of dc'd meds and 80% of the time I would be able to get the pill I needed.;)

Sad to say I am glad someone is in the "real world" with me. We have to care for our patients.. not call the state and the ombudsman because we have to take x amount of insulin from someone elses vial.

Coumadin is a big borrower in our facility. I could go on and on about this. The doses are changed if needed after the results of the PT/INR gets in and we don't have the dose in from pharmacy yet as this is done in the early afternoon. 3.5 is the dose that I can never find. I couldn't find any 2.5s either. So I had to take a 3. Cut it in half to get a 1.5(It was scored). And hunt down a 2 mg.

Up Vote Up Vote ×
+ Add a Comment