meds w/o order

Erin RN · Nov 2, 2003

Stick by your guns on this one...you never know what the outcome of a medication could be. Even something as simple as Tylenol..which by the way kills several hundred people every year by casuing liver failure. Get the order...you will never go wrong. If people give you a hard time just tell them that it is your license, you worked hard for it and plan to keep it. Erin

ktwlpn, LPN · Nov 2, 2003

Originally posted by robynrn2b
Personally, I have been given grief about not allowing people to give MOM without an order. Many nurses and med aids think, why not??? It's harmless.

Beides the fact that a patient just could have a bad reaction you never know who is looking over your shoulder...someone could just be biding their time..watching for you to do something like this...I have seen nurses loose their licenses in Pa for giving tylenol,MOM and cough syrup sans order...It is not worth it....

sjoe · Nov 2, 2003

"has some sort of rectal anomaly? I know I am stretching it,"

We'll overlook the joke for now.

Unless your facility has written standing orders to cover these drugs, you are doing exactly what you are responsible for doing. It would be YOUR license on the line, obviously, were you to authorize administering drugs, OTC or not, without written instructions to do so.

If this is too "inconvenient" for administrators or co-workers, let them see to it that standing orders are written or that relevant specific orders are written for each and every patient.

jenac · Nov 2, 2003

My facility has standing orders on every resident there for things like Tylenol, MOM,etc.

Despite that- I refuse to give a med untill there is a corresponding order (If the S.O. is on the chart, we just have to write the telephone order and send it out to be signed)-and that it is in fact listed on the MAR. Period. No exceptions. No argument.

I have witnessed a few too many nurses give meds- Narcotics even- without checking the MAR, or actually having a valid order for it. A med error is a med error. I sure as heck don't want one just because I didn't bother to get an order for something- or to verify if I have one. Not on my license.

Stick to your guns- your right.

RN-PA, RN · Nov 2, 2003

I can't imagine giving a med that hasn't been ordered. The only thing we're allowed to give without an order is a glycerine suppository. I even feel funny administering IT without an order due to the possibility of a "rectal anomaly' already mentioned.

I have cared for patients who have asked me for Maalox for heartburn or Tylenol for a headache and I see it's not ordered, so I tell them that I'll have to get a doctor's order for it. They then state that the med in question was given the previous shift or day before. (And this is an oriented patient.) It just amazes me...

barefootlady, ADN, RN · Nov 3, 2003

Get the order, even for MOM or Tylenol. It is the only way to protect your license. NEVER take for granted a patient can take the med requested, patients with liver problems cannot take Tylenol but usually request it. Even with standing orders, unless they are signed, call the doctor, he has the last word on meds.

PMHNP10 · Nov 3, 2003

Originally posted by robynrn2b
or maybe the person who you want to give a Tylenol supp. to and you only have the p.o. order has some sort of rectal anomaly?

Here is something that might not be a stretch...what if that person is bradycardic and you stimulate the vagal nerve ...you could very well be in a world of deep doo doo, so to speak.

I would think the KY nurses should be all the evidence one needs that MD orders are a must have before, not a will get after type of situation.

kids · Nov 3, 2003

Originally posted by barefootlady
Get the order, even for MOM or Tylenol. It is the only way to protect your license. NEVER take for granted a patient can take the med requested, patients with liver problems cannot take Tylenol but usually request it. Even with standing orders, unless they are signed, call the doctor, he has the last word on meds.

And never take for granted the doc actually reads those standing orders before they sign them, several times I have seen signed standing orders that included MOM for dialysis patients, ostomy patients with dulcolax supp per rectum, coumadin patients with PRN asprin and hepatic failure with Tylenol

Jaaaman · Nov 3, 2003

Just curious........ whats wrong with giving MOM to a dialysis patient?

Noney · Nov 4, 2003

"Just curious........ whats wrong with giving MOM to a dialysis patient?"

Magnesium:D

Noney

Rapheal · Nov 5, 2003

Murphy's law says once you give an unordered med and then you have the doc on the phone- he will tell you he want's something different or not to give it at all. Best to get the order first.