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

JZ_RN · May 2, 2012

LOL I am not gonna pop a new narc then have to waste or whatever or go get a new pill if it falls on the patient's gown, Heck half the time they have god knows what under their nails.. So, no. You get the gown pill, sorry.

canned_bread · May 13, 2012

This might be taken badly by some members on here, but I strongly believe this so will say it anyway. What you do in front of your facilitator is supposed to be 100% best practice, what happens on the field is COMPLETELY different. This is so we learn best practice, and then we can integrate into the field.

A medication that has been dropped on the gown and not on the floor is okay to give, it's "clean" (we aren't talking dressing clean here, but clean enough), and if the patient isn't susceptible to infections, as you said, I would believe the stomach juices would kill the bacteria.

When I was learning, with my facilitator I did 100% best practice, everything was anal-retentive. In my last clinical practice I even was told by a nurse I was a bit slow because I was doing things by the book, and to take safe short cuts.

So basically, maybe what you have to do is be anal whilst learning, and then take those safe short cuts.

Seriously, going to the med cupboard and getting that one pill out all over again, which nurse has time for that?!!

I think it's really great that you are questioning this and taking it seriously though, it sounds like you are going to make a fine nurse.

Seas · May 16, 2012

Lol, that's ridiculous. I wonder if your instructor has ever worked in real life. It happens every day.

I understand school wants you to do everything as the book says, but come on, this is not like you are dropping a sterile thing or something. This is not even an issue. I never thought a falling pill could cause such trouble!

By the way, I don't think any of my clinical instructors would ever make a big deal out of such case. They had enough common sense.

JEN077 · May 27, 2012

Sounds like an instructor I had in school. She just liked to throw her weight around and let the rest of us lowly students witness the glory of the Queen of Nursing that she was. Nothing we ever did was ok.

lumbarpain, ADN, RN · May 27, 2012

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?

I would give it, If the gown was clean, as long as there is no food, no vomit, body fluids, etc. on or near the pill. Dropping onto something noticibly dirty, or even ASSUMED dirty I would replace it....the floor, a soiled bedsheet, or if it falls near a covered wound area I would replace it. Common sense or if you hear a little voice in your head, replace that, replace that, I would. I get those little voices alot on the floor.!!!

lumbarpain, ADN, RN · May 27, 2012

ONE THING I always loved when I worked in LTC. when the Pharmacists came into check the MARs for errors and corrections...I loved talking with them usually its on days and I found that if you ask them the most pertinent questions in regard to proper med handling, etc. it really really helps you. such as the pill dilemma. Or how to open up a sterile bottle without contaminating it, etc .....I would write questions down for them. Nothing like feeling safe on the job thats for sure!!!!

lumbarpain, ADN, RN · May 27, 2012

Food isnt sterile, neither is the water we drink or the drinks we drink......seems ridiculous.

Zookeeper3 · May 28, 2012

LMAO, as a patient in my own home, I drop my own pills on the floor, (5 second rule), pick it up and take it. My mouth and gut is not sterile. But I do NOT depend upon an instructor to pass me for a clinical experience. You are screwed and need to go with the flow of this crazy person, or go through administration of your school. A pure headache and may not be worth it once you can take a deep breath and realize this issue will blow over. having been through nursing school, I've had to swallow my pride many times when instructors were all jacked up and full of it to graduate.

keep you eye on the prize, and know in the real world, patients drop their meds and yes, they do swallow them after and survive, but ya knew this. Smooch. Choose your battles wisely. You could easily win this one, the question is... is it worth the fight in the end?

Stay the course, you will be done soon. Loose the battle and win the WAR of graduating. These people will be long gone and a brief memory once you start nursing. it is the best advice I can give, it's how I survived.

MB-mom.RN · Sep 20, 2013

that's the difference between the "RIGHT" way to do things and the "REAL" way to do things!

nurse2033, MSN, RN · Sep 20, 2013

I don't let patients take their own meds unless they are completely A/Ox3. I pop them into their mouth (with a gloved hand of course). I've spent too many times trying to find a narcotic that got dropped into the bedding. I once had to roll a 400 pound patient to find a vial of dilaudid that fell out of my pocket when I was turning them earlier.

nurse2033, MSN, RN · Sep 20, 2013

Oh, and if the gown wasn't clean it should have been changed, but of course, I would have given the pill. The floor is another matter...