Medication Administration: Nurse as a caregiver

[Balder_LPN, LPN]

I have a friend who is an RN. Her friend works as a caregiver (unlicensed). This friend routinely passes out meds to her clients that have been put in the weekly pill cases by either a licensed person (RPh, RN) or the clients family member. Please, no discusions on unlicensed personel passing meds, this has been gone over and over here and is unrelated to my real question. This is legal in WA as long as she is just handing the person the pre dispensed meds, and the person is conscious and aware and able to self admin the medication (ie the caregiver cant put them in the clients mouth).

Well, with her friend on vacation my nurse friend did the med passes for one of the cargivers clients last weekend. She just dispensed the meds from the prefilled weekly box w/o even knowing what they were. The pt is lucid and aware but has a severe shortterm memory deficit and could not remember to take the meds w/o someone coming to help.

I told her she was exposing herself to a huge liability and risking her license. What if the family member put the wrong meds in the box? or what if there is an assesment that needs done before administration? how about if there is a new med the pt turns out to be allergic to or has an adverse reaction? She will be held to the standard of practice of her license regardless if she is performing to a lower level.

I think she needs to review the persons medical record and dispense the meds from the original packages recieved from the pharmacy or she is taking to much liability and should refuse the job.

What do you all think?

[Altra, BSN, RN]

I can't say I know for sure the legalities, but I think it bears remembering that the vast majority of non-hospitalized, non-institutionalized patients self-administer meds or receive help from family/friends/neighbors/whomever.

When I visit my grandmother and administer her eye drops or open a new Rx bottle and slide a pill into her hand, I do not review her medical records. There is no indication for me to do so - I am not employed to provide care for her. I am simply functioning as any other family member.

I personally would also do the same for a neighbor that I was not related to.

[Balder_LPN, LPN]

I can't say I know for sure the legalities, but I think it bears remembering that the vast majority of non-hospitalized, non-institutionalized patients self-administer meds or receive help from family/friends/neighbors/whomever.

When I visit my grandmother and administer her eye drops or open a new Rx bottle and slide a pill into her hand, I do not review her medical records. There is no indication for me to do so - I am not employed to provide care for her. I am simply functioning as any other family member.

I personally would also do the same for a neighbor that I was not related to.

Different story if you are not being paid. She is being paid though. In our state what you are describing is excluded from the definition of nursing practice, buy when you receive compensation it all changes

[catlynLPN]

Personally, I wouldn't want to do it, unless I could review the medication list.

Can she look on the bottles? That might not help tho, if there should be something, in with all the other containers, that might be dc'd.

And isn't it true that if you are a nurse....LPN or RN and if you're getting paid, then you're held to the standards that your license dictates?

I mean, If I were working in the capacity as a CNA.....if something went wrong I'd still be held to the standards of an LPN.