Med error yes or no

You had a patient that was to be NPO starting at 5am. They had oral meds due at 8am which you did not give or give early. I am not sure it was a med error. Did you contact the doctor about switching the oral meds to IV meds (if possible) when the order was put in to make them NPO at 5am? If there was no IV equivalent or the doctor said to skip the dose, then it is not a med error.

If there were no specific orders related to what should be done with morning meds and there are no policies that cover such a situation then heck no it is not a med error. The meds were due at 0800 and the patient was NPO at that time. I agree it would be most prudent to have reviewed the meds ahead of time and discussed with the physician if any of them could/should be administered by a different route - but the failure to do so isn't the accusation being made as the basis for the write-up. It also would have been prudent for the responsible physician to have addressed this in orders ahead of time - but that didn't happen either.

I would ask to see the related policy or order that you overlooked.

You're being written up for a med error because....why? Is there more to this?

Where I work, if the Dr. neglects to specify whether or not to give (or hold) meds, then the nurse usually gets called into the office ( a write-up). It's not fair, but in the world of nursing you have to cover your tail.

I just went through a lengthy ordeal today, where the previous nurse didn't do something properly on a BID order... now I have to make sure I don't walk into a trap. It required me to write good documentation so that I should be ok, just in case there's an investigation. I'm not trying to get the other nurse in trouble or anything. It's to cover me.

Pre-op orders usually cover what, if any, meds are to be given during NPO status. I've always seen the order written "With sips of water."

If there was no pre-op order for meds, the nurse should call the MD and clarify.

Pre-op orders usually cover what, if any, meds are to be given during NPO status. I've always seen the order written "With sips of water."

If there was no pre-op order for meds, the nurse should call the MD and clarify.

but it should be the nurse that took the NPO order doing the clarifying, not the night nurse.

Usually, I ask the nurse scheduling the procedure or test if the doctor wants the patient to have medications, if so, then which ones. Need a doctor's order following documentation. But, if you didn't give the meds make sure the doctor's nurse is aware. Document.

This is a teachable moment.

but it should be the nurse that took the NPO order doing the clarifying, not the night nurse.

Agreed but if the nurse who took the order failed to clarify then the night nurse should have.

Pre-op orders usually cover what, if any, meds are to be given during NPO status.

Assuming you have preop orders.

Without knowing more I'd say this sounds more like a technicality. Could just boil down to facility policy but also depends on what meds, what frequency and what surgery.

Yuuuup