Med Error question......what do you guys think?

[sasha2lady]

We had our monthly nurses mtg yesterday & some of pharmacy issues came up. Our pharm is 3 hrs from where we are fyi....ok so anyway...I asked the DON what we are supposed to do when say...we are to give a med at hs and we dont have it ...that pt is out and we dont have it in the back up kit....so duh...we call the pharmacy who is SUPPOSED to call it in somewhere else and get it delivered...but most pharms are closed by 9 and sometimes you cant always catch that someone is out til you get to that med and that pt.....she said to just have the next shift give it....but I think thats a med error.....if its due at 8pm...and wont be delivered til the next day then how can a 3rd or 1st shift nurse sign for giving something that was due technically yesterday??????? What I have done in the past is just circle it and write on the back that its been ordered UNLESS I can find a valid honest reason to hold it.....other nurses say its a med error to put that on the back but i call it cma...(covering my a**).....we have alot of problems with our pharmacy..always have and the way i see it is..either way...you cant give a med that you dont have and you cant sign for it if u didnt give it...or I wont anyway. And also....we have always redorded meds when we get down to a 4 to 7 day supply so they wont run out...well now the Don says to not pull it til they get down to 2 pills....i think thats absurd..esp if that med is given bid, tid, or qid......it wont arrive in time. So my ? is this....what is worse...a med OMISSION , falsifying that MAR by signing that you gave something you did not give......or what??? How would you guys handle this type of situation? I myself dont think that missing a dose of say aricept is gonna kill anybody as long as you have reason why it wasnt given whether they're out of it or they refused it.....any advice would be helpful.

[Jolie, BSN]

Falsifying a medical record will get you into legal trouble and may result in BON action.

If a med is not available, I would chart the following: Med. not available in patient supply. Pharmacy notified and unable to provide med in time for dose. Dr. So and So notified. No alternative orders received. Then fill out an incident report.

Of course, your administration does not want this information documented. They would much rather blame the nursing staff for missing meds than explain to the State and JCAHO why they dont have an appropriate system in place for obtaining meds in a timely manner.

[RochesterRN-BSN, BSN, RN]

Jolie is right on here! I worked in a LTC facility for a short time and like maybe a year after I left they were closed down by the state--one of the big things that was found was signing for meds never given and those nursing were brought to the BON...... waiting till 2 pills for a BID or tID med is stupid and your DON is showing her inability to manage basic things and oh........do math!!! lol

[sasha2lady]

I fully agree....she absolutely did not wanna hear me out on this matter at all....which isnt unusual. I have filled out quite a few reports on this very thing...never really got anywhere with it..I think for her to suggest something like that is just....really sloppy..now mind you if we were to actually do it...she would be all over us for it.....I wonder sometimes if she has a memory problem b/c she has told me things before and then when I ask about it later on ...i get a completely different answer...every single time. I dont know how to take her sometimes. I have never signed for a med I didnt give and dont plan to start now...regardless of who says its ok to do that.....if it doesnt feel right....its most likely not. She has also told us before that we had to call her if we were going to send someone out to the er.....for basically her approval.....now..come on?????? A nurse...don or not is not gonna tell me not to send someone to the er if i feel like they need to go....(sob, cp,fx, loc change etc)....I take those type orders from the md. Have you ever heard of such CRAP in your life??? and besides....what in the world can you possibly do for someone from your house??????????? just cuz ur tha boss? i dont get it.