probably a very basic med question.....

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I have patients who take gel capsules (both colace and b12) but because the patients can't swallow these, I'm asked to open them and squirt in with their crushed meds. (Why they don't get these in pure liquid form, I don't know.) Does anyone know the best way of opening these gel capsules? One nurse said she pricks it with a needle, and others have told me they cut the capsules open with scissors. I feel there must be an appropriate way of getting the gel out and I wonder what anyone here might suggest. Thank you to whoever takes the time to answer this :)

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Specializes in Trauma Surgical ICU.

Colace does come in liquid.. Not sure about B12, call and ask pharmacy then have the MD change the order.

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Specializes in Emergency Nursing.

U know I encountered a very similar situation a while back. I'm curious to see how others respond too.

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Specializes in Geriatrics, Transplant, Education.

Colace definitely comes in liquid, and I am fairly certain I have given/seen B12 in a crushable tablet form. Check with your pharmacy and see if the doctor can change the order.

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Colace comes in liquid, cap, and crushable tab; the liquid comes in different strengths. Frankly, I have never seen B12 in a cap, always tabs, and they are crushable. Best to give B12 away from food, ie empty stomach.

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Specializes in Emergency Nursing.

What are u to do when all u have are gel caps and management is very adamant that they not miss a dose while u put in an order for a converted liquid?

Do you...

1) STEAL from another resident (as is common practice)

2) pin prick or cut open the gel cap to drain it?

3) risk a write up for not administering a med?

4) FORGE the mar signature saying you gave it but really held it and are waiting for the liquid to come

There are too few facilities that have an understanding policy.

Obviously the correct answer is to hold the med (presuming there is none in the EDK), contact the doctor for clarification. Document the discrepancy, contact pharmacy, notify the patient, and wait until the new med arrives, all the while documenting every missed med dose.

Sigh...

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Some of my patients DO have the liquid colace. I asked my charge nurse if I could give the liquid to the patient in question but she said "no, we want her to have the gel cap." When I told her it was difficult to open, she got a pair of scissors and said, "Just cut it -- like this." The Vit. B gel cap also comes in liquid, and it was the same thing with that. I don't know why my facility is insistent on the gel cap over the liquid but anyway, I just wanted to know the proper way of opening up these gel caps. Thanks to all of you who responded.

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Specializes in Emergency Nursing.

Wow... That just doesn't seem right

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I don't think it seems right either, libran1984. Based on all your comments above, you seem to understand what I'm going through and I want you to know that I appreciate it. Thanks!

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Specializes in Leadership, Psych, HomeCare, Amb. Care.

Needles are expensive, scissors seem messy.

How about a safety pin or even a paper clip that you clean before and after each use?

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Specializes in Emergency Nursing.

When I try the safety pin idea the med doesn't drip out very well. What if I just crush it with all the crushed meds and then pull the hard gel cap remnants out of the crushed medication? That's gotta be accurate enough for government work, rt?

There was the razor I tried using but when the gel cap slipped I cut my finger and I couldn't tell the colace or b12 from my own blood. Le sigh.

They need to create a scored gel cap!!

Ok ok I'll stop trying to be funny...

Lolol!!

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there is NO appropriate way to do it. Inform the doc, see if he will order the appropriate form. Short of that, melting would be the way to go.

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