Pill falls on pt gown...is it safe to give?

Nurses Safety

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I am a student nurse in the second med-surg clinical of my BSN (two more quarters!) The other day I had an agitated pt who put his med in his hand and missed as he flung it into his mouth. The tablet just landed on his gown near his collarbone. Both the pt and reached for the tablet and I picked the tablet up with my clean glove and better positioning to make sure it didn't slip and fall on the floor. My pt took the med after it touched his gown. My instructor reprimanded me upon leaving the room, she said that I had made a med error and that the drug was contaminated. I understand this completely and took it seriously. When I told my fellow nursing students about it they all said that they would have given it, as long as the pt was not neutropenic and the pill did not land on the floor. What would another RN do about a tablet landing on a gown?

Specializes in PACU.
Nursing students are not allowed to give medication without supervision. Doesn't matter what rotation you're in.

In my experience that supervision wasn't necessarily present in the room for routine medication administration, particularly near graduation.

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I don't even know why we're supporting the idea that this is the correct answer "in nursing school"

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Specializes in Ante-Intra-Postpartum, Post Gyne.

Say "ok ol' wise one" to your nursing instructor; but know that nursing school is not always like real nursing...I'd give the pill, try explaining to administrators that you wasted a narcotic because the pill fell on the patients gown; unless the gown is dirty I see no harm in giving the pill.

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Specializes in CICU.
I don't even know why we're supporting the idea that this is the correct answer "in nursing school"

Welllll, I see your point, but I am not going to encourage a student in clinical to "argue" with the instructor... especially about whether a pill on a gown = contaminated.

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Specializes in 1st year Critical Care RN, not CCRN cert.

Nursing students are not allowed to give medication without supervision. Doesn't matter what rotation you're in.

Well I just graduated. From RN school on the 13th of April and in care of the adult patient II and our CC and leadership rotation the Meds were handed to us with a small "mar" that prints from the pixsys (sp) and you go administer the Meds. No over the shoulder supervision. Maybe it is not supposed to be that way but that is how it is done here in southwestern Florida.

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Specializes in ER, ICU.

That's ridiculous. Pills are not sterile, the patient's mouth is not sterile, the gown is not sterile. How about other things that go in the patient's mouth like food and Pepsi? The floor is a different matter, or if the gown was soiled. This is why, if I have any doubt about the patient's dexterity, I put each pill in their mouth with a gloved hand. It is actually a hazard to lose the pills in the bed as the patient might find and take it later, after you have already replaced and given the dose. Tell your instructor to read this post! ;)

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Specializes in none.
That's ridiculous. Pills are not sterile, the patient's mouth is not sterile, the gown is not sterile. How about other things that go in the patient's mouth like food and Pepsi? The floor is a different matter, or if the gown was soiled. This is why, if I have any doubt about the patient's dexterity, I put each pill in their mouth with a gloved hand. It is actually a hazard to lose the pills in the bed as the patient might find and take it later, after you have already replaced and given the dose. Tell your instructor to read this post! ;)

Sir, you are bringing reality into this thread and we are talking about wonderland. You know the month is not sterile, I know that the mouth is not sterile. Most of the poster know the mouth is not sterile nether is the pill now the bed linen. But this will be a shock to the teacher. Please sir, do not upset the White Queen. I like you have learned to always put the pill in the patients mouth. I've done it for 40 years. Because pills do fall and if you gave someone a cup full of pills the one that would hit the floor would be the narcotic.

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Specializes in Psych ICU, addictions.

In the textbook/ivory-tower NCLEX world of nursing, you would not give a med that dropped on the gown. You would miraculously have a replacement dose readily available or available in the next three minutes so you could complete your med pass on time. There would be no repercussions for having to waste the dropped dose, birds would sing, flowers would bloom, and sunlight would smile down on you.

In the real world...as long as it landed on a clean part of the gown, IMO it's fair game. Though you could always first ask the patient, "I'm sorry, this dropped on your gown, do you want me to get a new one?" Most will say "No, that one's fine."

And that's fortunate for you, because if you had to waste and replace, odds are that another call bell will ring or a patient will de-sat on your way to get the med, the Pyxis will not have any more in stock and the pharmacy will take forever to get the dose to you, you will complete your med pass late, and you may be reamed by management for wasting an expensive medication dose or controlled substance. Because with your luck, it will be either the most expensive drug in the cup or a Schedule II med that you drop on the gown.

When you are in nursing school and the CI is hovering over you, you need to play by nursing school/NCLEX rules.

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Specializes in Med/Surg,Cardiac.

In this situation, I let the patient decide whether or not to take it. I don't have a problem giving it as long as them don't mind taking it, unless it is grossly contaminated. We put things a lot worse than a pill off a gown in our mouths all the time.

Not a med error.

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Not a med error. For the most part, the patients' hands are far dirtier than their gowns!!

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Nursing students are not allowed to give medication without supervision. Doesn't matter what rotation you're in.

I'm graduating in May and give all medications on my own including injections such as Lovenox and Insulin, except for IV meds (I flush without supervision but can't hang meds or push). I go to the med room with my instructor and she watches me take them out of the Pyxis and check them then I'm on my own.

As for the OP, I'd give it if it fell on the gown.

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Specializes in Emergency.

Not a med Error, your instructor is searching for something to say. I did this all the time. On the floor no...thats just gross.

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