I work in a small hospital that is in the middle of nowhere - as a result, there is only 1 pharmacist in the area that is willing to oversee the functioning of the pharmacy. She has written the policies & procedures in such a way as to revert any responsibility for pharmacy related errors on to the nursing department & this is tolerated by the admin because she is the only one they can get to work for them. It is pretty much the norm for the nurses to be expected to put meds for pts. who are going out on pass into the labeled bottles so that neither she nor her techs have to be disturbed, & if a nurse is not comfortable doing so, the DON does it. I have 2 questions:
1) Is this practice not called dispensing meds, & isn't this out of nursing's scope of practice?
2) Where & how would one go about notifying the Board of Pharmacy of this and other unethical practices? Is there a website where one could obtain this information?
I am almost afraid to post this, as she is a very vengeful person & if she sees this post I will most likely lose my job, :uhoh21: but I refuse to tolerate this any more, as this woman needs to be stopped. Thank you all for any help/suggestions you can give me.
At our hospital, when a patient is going out on a pass, the nurse will write out the meds needed with the dose and time for administering on a doctor's order sheet, after the doctor has written an order for permission to go on pass... the pharmacy prepares the meds in unit dose baggies, with the name of the med and the time to dispense it typed on the individual baggy... We also will write them out with instructions to the patient... this can be done ahead of time... usually if a patient is going on a pass tomorrow, we will write the request today... the system works well, but our pharmacists are all dears...
That is the correct way to do things, the meds need to be dipensed by a pharmacist.
All of you, make sure to check out what your Board of Pharmacy states for your particular state, just because that is the way that you have always done it, or your facility has, doesn't mean that it is legal, and it can actually come back to haunt you.
Specializes in Psychiatric, Home Health, Geriatrics.
Thank you all for the input... I notice that lately she has changed her routine - maybe it got back to her that we nurses had been discussing the dispensing issue, but I am going to watch her & report her the next time - I plan to keep an ongoing record of the times she does this so that I have some concrete info to report with dates, specific meds, etc. She has also been sending in her pharmacy tech to look at our MARs to see if anybody failed to initial when they gave a med, then she has the tech write up an incident report about it, calling it a med error. That is why I labeled this thread the way I did... sounds like a power trip to me.
My first job we also placed the meds in an envelope for passes and i had no idea that it was illegal but i found out that it was when i worked subsequent jobs. At my facility if meds are needed for a pass or discharge the dr must write an order ahead of time and it is sent to the pharmacy and labeled and then given to the patient. If this does not happen before pharmacy leaves for the day then i make the doctor give the meds to the patient and just explain to them that legally iam not allowed to do this. We have one dr that is infamous for waiting til the last minute (after pharmacy is closed) and she was surprised when i explained this to her but when i explained that i was not trying to inconvenience her that it was a legal issue she was cooperative and stated that where she had worked before the nurses always just gave out the meds. As nurses we need to now legally what we are able to do and not do according to our state's scope of practice and noone else is going to do that for us. And trust me if anything untoward occured you can be sure that we would be the ones to take the blame! Cardinal rule of nursing CYA!!!! Sad but true
Legally speaking, what you don't know will hurt you. I guess it's time to get educated and not find about the law haphazardly. They teach computer in kindergarden so it's a good place to get started with the basics and go from there. I am dead serious. Lawyers make a fortune out of our ignorance.
My first job we also placed the meds in an envelope for passes and i had no idea that it was illegal but i found out that it was when i worked subsequent jobs. At my facility if meds are needed for a pass or discharge the dr must write an order ahead of time and it is sent to the pharmacy and labeled and then given to the patient. If this does not happen before pharmacy leaves for the day then i make the doctor give the meds to the patient and just explain to them that legally iam not allowed to do this. We have one dr that is infamous for waiting til the last minute (after pharmacy is closed) and she was surprised when i explained this to her but when i explained that i was not trying to inconvenience her that it was a legal issue she was cooperative and stated that where she had worked before the nurses always just gave out the meds. As nurses we need to now legally what we are able to do and not do according to our state's scope of practice and noone else is going to do that for us. And trust me if anything untoward occured you can be sure that we would be the ones to take the blame! Cardinal rule of nursing CYA!!!! Sad but true
I did house supervisor 1 day /week at a very small rural hospital in the middle of nowhere. This included the responsibility of running the pharmacy at night. Now The ER docs routinely would send some of therir patients home with medications. I was shocked when i was asked to set this up. I had worked as a nursing supervisor in another facility in the same state prior to this, and they were very strict about following the law about nurses not dispensing. We couldn't even mix a piggy back for the floor or give more than a single dose of meidcation to the floor. I told the head of the pharmacy that giving meds for home to patients was considered dispensing and therefore illegal by the nurse practice act,and he told me, "we bend the rules a little here". I stepped down from the position.
Wise Woman RN
289 Posts
At our hospital, when a patient is going out on a pass, the nurse will write out the meds needed with the dose and time for administering on a doctor's order sheet, after the doctor has written an order for permission to go on pass... the pharmacy prepares the meds in unit dose baggies, with the name of the med and the time to dispense it typed on the individual baggy... We also will write them out with instructions to the patient... this can be done ahead of time... usually if a patient is going on a pass tomorrow, we will write the request today... the system works well, but our pharmacists are all dears...