Pulling Meds For Another Nurse To Pass

allnurses Guide · Aug 18, 2021

15 hours ago, Nurse Beth said:

If nurses are unable to do their jobs without having another shift pull their meds, there's a problem that needs another solution.

As I'm contemplating this it occurred to me this is a no-win situation. Because of chronic short-staffing nurses must cut corners. It's just the way it is. We're left to decide which corners we can safely cut. Often this comes wrapped up with the knowledge our employer will cut us loose without a second thought if anything unpleasant hits the fan.

The solution requires more financial sacrifice than either I or many other nurses can take. It's a lousy impasse, that's for sure.

Perhaps if the ANA put as much effort into implementing safe-staffing ratios as they do thwarting such efforts, there would be a glimmer of hope.

I'd just like to echo what JKL said about your supportive work environment. I was absolutely shocked after over 25 years in nursing a certain group of colleagues proved themselves unworthy of the slightest trust. I'm just thankful it took that long before I experienced it.

jive turkey · Aug 20, 2021

On 8/14/2021 at 8:55 PM, Dudlydorite said:

I refused to pull meds for another nurse to pass. Although the meds would of still been in the sealed package and pill bottles placed in the patients box, I refused. I cannot guarantee the other nurse passing them will verify correctly and/or administer the right med to the right patient. I see this has been done previously on all shifts and I was told, “that’s what we do so the floor nurse can do her assessments right away when shift starts”. It doesn’t matter if the meds are still sealed, I’m responsible for verifying meds for another nurse I’m supposed to trust to verify again? No! Uh nuh! Excuse me, but I’m not going down under the bus if that nurse makes one human error. Am I wrong for refusing? I’ve never heard of such practice and have never done this in the 18 years of practice.

I used to not even let someone so much as Svan my badge so they can use the glucometer. Be my luck they record a big of 17 with my name on it, didn't do anything about it, patient dies and the chart says I was the one doing the assessment. Guarantee you the one who really scanned it would deny doing the check. Same goes for meds. Don't do it. Good for you

TippyTappyMeow, MSN · Aug 20, 2021

On 8/14/2021 at 10:55 PM, Dudlydorite said:

I refused to pull meds for another nurse to pass. Although the meds would of still been in the sealed package and pill bottles placed in the patients box, I refused. I cannot guarantee the other nurse passing them will verify correctly and/or administer the right med to the right patient. I see this has been done previously on all shifts and I was told, “that’s what we do so the floor nurse can do her assessments right away when shift starts”. It doesn’t matter if the meds are still sealed, I’m responsible for verifying meds for another nurse I’m supposed to trust to verify again? No! Uh nuh! Excuse me, but I’m not going down under the bus if that nurse makes one human error. Am I wrong for refusing? I’ve never heard of such practice and have never done this in the 18 years of practice.

On our unit we occasionally will be pulled to task. Part of those duties are to pass meds for a nurse who is doing an assessment on a patient. I am uncomfortable passing medications on a patient that I do not know, or have any sort of history on.

When I was first told to do this I did realize how stupid it was that the charge nurse wanted me to blindly go give all medications prior to the RN getting into the room.

I dread having to task for this reason. No one has been able to help me set healthy boundaries. I feel like passing a tylenol or miralax might be OK, but I don't want to be doing a complete med pass. I'd much rather be grabbing vitals, or assisting the floors in a different way.

Susie2310 · Aug 20, 2021

14 hours ago, TippyTappyMeow said:

On our unit we occasionally will be pulled to task. Part of those duties are to pass meds for a nurse who is doing an assessment on a patient. I am uncomfortable passing medications on a patient that I do not know, or have any sort of history on.

When I was first told to do this I did realize how stupid it was that the charge nurse wanted me to blindly go give all medications prior to the RN getting into the room.

I dread having to task for this reason. No one has been able to help me set healthy boundaries. I feel like passing a tylenol or miralax might be OK, but I don't want to be doing a complete med pass. I'd much rather be grabbing vitals, or assisting the floors in a different way.

I was wondering why you are not able to quickly review the information in the charts that would tell you the reason the patient is admitted, and take note of the patients' prior medical history, etc., I.e. gather sufficient information about the patients in order to be able to administer the medications safely when you will have the MARS in front of you?

speedynurse, ADN, BSN, RN, EMT-P · Aug 21, 2021

I think it depends on what unit you work in. When I was in the ER, I pulled meds all the time for other nurses, including having to pull controlled meds or even overriding meds. There is a trust factor that comes with working in the ER. You have to do some things unconventionally to keep those units running. The main thing is that the MARs matched up with what was pulled from the Pyxis. I never ever had any issue with a discrepancy in the ER.

When I came to the surgical field, it was considered taboo to pull meds for other nurses (well, controlled meds; other meds were OK to pull), but in all honesty, we generally have time to pull our own meds. I think it’s just different for every field and some fields you really have to rely on your team and your sense of trust with them.

BachRN, BSN · Aug 21, 2021

I do not pull meds for other nurses nor do I expect them to pull any for me. At any given time, anyone, including myself, can make a mistake and draw the wrong med. While intentions are good, mistakes are drastic. I will not take that chance. And it has nothing to do with not trusting my peers, it's moreso a "safety feature" I've ingrained in myself. And I do believe if you have the time to draw it, you can give it -- and this is coming from someone on a chronically short-staffed unit.

9kidsmomRN · Aug 23, 2021

In my CICU I do pull meds for other nurses if they are with a crashing or an isolation patient. But if I pull a controlled substance, I double check with them ( and the chart) that it was scanned and that the narcotic discrepancy report is reconciled. We bar code scan all of our meds, and a reconciliation report is electronically created. I also have pushed drugs for another nurse, though usually when the nurse is present and verbally verify “you want me to give 2 mg of Ativan?” This exact case happened last night. Medsurg ICU overflow pt was absolutely wild and in iso, 2-3 to hold him down. Someone else outside the room pulled ativan. I had the best ability to draw up and administer the drug since I had just started the new IV and others were holding him down. So verbal verification “2 mg?” (4 mg had been handed in) and med was given. Pt’s RN then scanned the 2 mg dose. As it has been said there is a degree of trust that you may (or may not) develop with your coworkers. I have also worked with a nurse that I reported several times about “ unsafe “ practices. ****was given several opportunities until I followed ****one PM to NOC shift. From a 7-11pm that **** had picked up I found 15 errors on the 2 patients that **** handed off to me. I wrote them all up. About 2 weeks later **** showed up for a day shift when ****was scheduled for a 12 hr NOC and was not, shall we say, safe to be able to care for patients. This is one nurse that I would not have co-signed wastes with unless I saw every step from pull to waste! I am meticulous about any co-sign. I look at the heparin, remodulin and insulin pumps for new bags, titrations, etc. and ask that others come see what I am changing, too. We all can make mistakes! It is a safeguard for our patients!!
It sounds like several of you don’t have med scanners and some don’t have med dispensers (Pyxis)?
The comment about giving meds for a patient that hasn’t been seen by the patient’s nurse… I also would prefer to help in other ways on the unit. Giving even Tylenol to a patient with elevated LFTs could be detrimental. That seems like a dangerous practice. What kind of unit is this? Unless critical care, is it that urgent that they get their medications right away—and all of them? There may be something that should be held for a change in condition…. that hinges on why they are being admitted… ?

Beserious · Aug 23, 2021

I don’t see the problem with this. It is the nurse administering the drug that is ultimately responsible for checking the five rights. And on top of that, aren’t we all using computer scanning as an extra safety measure to help override our human error potential? Really don’t see the big deal.

maggie0, BSN, RN · Aug 24, 2021

I pulled meds for another nurse when she was extremely pressed for time, but I didn't feel good about it and probably won't do it again, if I can help it.

On the other hand, when I'm floated I don't have access to the other floor's med room, so I've had to administer meds someone else pulled--sometimes already drawn into a syringe. Yikes! Do not like. But I'm a relatively new nurse and don't have a lot of "no" power...

JKL33 · Aug 24, 2021

20 minutes ago, maggie0 said:

But I'm a relatively new nurse and don't have a lot of "no" power...

Let me assure you that you do have enough "no" power to handle this situation.

There is zero reason, under normal/non-emergent circumstances, for you to be given medications in any state other than their packaging/unopened vials, etc.

You have a license and thus you have the power to pleasantly assert that the medication needs to be given to you in its packaging and you will prepare it yourself.

??

maggie0, BSN, RN · Aug 24, 2021

32 minutes ago, JKL33 said:

Let me assure you that you do have enough "no" power to handle this situation.

There is zero reason, under normal/non-emergent circumstances, for you to be given medications in any state other than their packaging/unopened vials, etc.

You have a license and thus you have the power to pleasantly assert that the medication needs to be given to you in its packaging and you will prepare it yourself.

??

Thanks for this reminder. I've finally gained the confidence to handle this kind of situation on my own floor, but when I'm floated to a new specialty floor I suddenly feel like an inept student again--but you're right, I'm not.

JKL33 · Aug 24, 2021

10 minutes ago, maggie0 said:

when I'm floated to a new specialty floor I suddenly feel like an inept student again--but you're right, I'm not.

It may be more comfortable to just ask nicely at the time that you know that someone is going to get meds for you. As opposed to having them hand you something already prepared...at that point it'll be uncomfortable to backtrack.

The fact that you don't have access to the med room is ridiculous enough, but that's a useless rant; the same thing happened at my facility. For a long time we had some unassigned access cards that could be signed out if people from elsewhere were down in the ED helping us but that was declared improper and they were taken away so then the helpers were in the same position as you when you float.

ETA: Besides, if you can be pleasantly assertive (in other words, demonstrate that you have your own appropriate nursing compass, your own knowledge and are taking responsibility for your own practice) you will probably fare better when you float. And when you don't float too I guess. ?