? re unlabeled meds

[OklaLPN]

Hi,

Have a question to present to all of you. Had a patient's family attempt to give me unlabeled meds to place in the medcart for the patient. I told them that I would not accept anything that wasn't labeled from the pharmacy. They said " Oh, it doesn't matter, it is the same thing, only generic". "Just put in the original bottle in the medcart that you have". The med is a narcotic. Told them no way would I accept anything that was not labeled from the pharmacy. Sorry..no how, no way, am I going to accept anything that is NOT labeled from the pharmacy.

So, I was called to the ED office and told the family was unhappy that I would not accept the unlabeled meds and that I was "just splitting hairs". So, I told her that I would not accept any unlabeled meds from anyone...period!

What are your thoughts on this?

[Rose_Queen, BSN, MSN, RN]

I know I'm going out on a limb here but what if the unlabeled med is harmful? Perhaps someone is after insurance money?

When I was in clinicals, any meds a patient wanted to take that came from home had to go to the pharmacy and be verified as the med they were labeled as. There was no mixing whatsoever of hospital supplied meds and patient/family provided meds. No meds from home allowed where I work now.

[sunnycalifRN]

Policy where I work is: No home meds, period . . whether labeled/unlabeled, over the counter, from outside pharmacy. Nada.

[pennyaline]

You done good :)

It's pathetic that the burden of customer service now means that the potential for harm means less than the potential for a sub-optimal Press Ganey.

If you ever get written up for crud like this, get copies of everything and save them. They might mean a great deal someday.

[ellakate]

They said " Oh, it doesn't matter, it is the same thing, only generic". "Just put in the original bottle in the medcart that you have". The med is a narcotic.

I hate to think of where they might have gotten this "generic narcotic."

When people accuse me of splitting hairs on nursing issues, I tell them that I have a license to protect. It isn't their license, it is myyyy license!

No question at all -- you did the correct, appropriate, legal, ethical thing.

[Scrubby]

Wow whoever tried to reprimand you is truly idiotic.

Of course if you'd given the med and there was a nasty side effect you would have been in trouble over that as well.

[FLArn]

In a similar circumstance, I told family I would send med to pharmacy to be labeled and if pharmacy was unable to identify med it would be destroyed. All of a sudden they decided they would "save" them to give at home.

[midinphx, BSN]

Any place I've worked, the policy has been to go through pharmacy. Even if it is labeled properly. And you still need an order from the doctor that the patient may take home meds with the appropriate orders.

You did right by not just popping them in the bottle. Your manager is really wrong. If it is an actual write up against you, I would look up the hospital policy and write a rebutal to the write up to protect yourself. Crazy that medical care has come to the "customer is always right" mentality.

[Jolie, BSN]

You did the right thing, and everyone (family, DON, etc.) knows it.

When I read stories like this where a nurse is being pressured to do something that so obviously violates accepted practice, and a supervisor states that the nurse should have gone along, I question whether the nurse is being "set up." I've found myself in some similar situations and immediately thought, "Candid Camera."

Don't ever allow yourself to be drawn in. It's not worth the trip to the BON.

[chelynn]

You absolutely did the right thing. My sister was sure she knew what some pulls were that she came across. When she went to an identification website and put all the info in she was very surprised to find out what they really were!

[RoxyDi]

I would offer to report anyone who suggested you take meds from home and use them without verification to their respective licensing board. Of course, you would have to have proof, and that would be difficult to get. I agree it sounds fishy.

[cjsbaskets]

There should be a hospital policy regarding medication from home. Ours included verifying that the patient did not bring any medication to the hospital. If they did it was requested that the family take it home. If there was no family, medication was logged and sent to pharmacy where it was stored until discharge. If a Physician ordered a medication that the pharmacy did not carry and that has no safe substitution, med brought from home, in labeled bottle, verified by pharmacy and then sent to unit to be administered to patient. Never give a patient a medication that is not properly identified and dispensed by your pharmacy. You were 100% correct not to given in to the family request. You might want to consider documenting (for yourself) what occurred in the event it comes up in your evaluation. Also check with pharmacy to inquire about a policy. they might be very interested to find out that some one in a position of authority believes it is acceptable to put unidentified medication in a hospital bottle. But of course that might start another problem. But when you know you are right, stick to your principles.