Safe Practice for Injectables

[debmelv]

I am a retired R.N. Today I took my Mother in to a neurologist for a nerve block in the occipital area as treatment for head ache, and neck pain. The P. A. was assigned to administer. Here is my concern. We were ushered into a room with a nurse carrying to syringes. She laid them down on a table with a sheet of paper. on the sheet it had my Mother's name, her diagnosis, and the plan for nerve block. After 30 minutes, the P. A. came into the room. She planned to administer the injections. I told her I did not think it was a good practice to leave filled syringes in a room unattended by the person who drew them up, and I personally would not administer an unknown medication injection into a patient. My understanding is that if you are drawing up a medication for someone else, another pair of eyes should be verifying, and it should be labeled. It should then be given to the person administrating, if they feel comfortable to administer, but never leave it unattended, unlabeled, and unverified, for future administration. The P.A. 's response was that she was too busy, and she had to see a certain number of patients, so the nurse just got the injections ready for her. I tried to explain my point but she became flustered and somewhat insulted, all the while my mother's headache became worse. She spoke with the Neurologist who at first, questioned why I thought it was wrong to draw up medication in advance, but upon getting a clear understanding of my concern, he said he would try to look into a better way to handle it, and asked the nurse to draw up the meds in my presence. Apparently no one working there quite saw it from my point of view, but I believe this is exactly how serious medication errors occur. I explained to the Doctor, P.A., and Nurse that ultimately the P.A. would be held responsible for administering the med, so there should be steps taken to protect her from making mistakes. Since that incident today, I considered some ways this could be remedied. Perhaps two people( one observing and verifying, and one preparing med and labeling), could then take it into the treatment room and locking it in a cabinet or drawer. In this manner, it would be safeguarded, and the P.A. could unlock it, verify the label, and proceed in a safer manner. Personally, it takes such a small amount of time to draw up 2 syringes, I would do it myself if I were injecting it. Any thoughts on this?

[OlivetheRN, ADN, BSN, RN]

The syringes weren't even labeled? What the what? I mean I guess the PA could try and justify it by saying this is what we always use for this type of block, yada yada yada, but still, you're correct. That is how mistakes are made. She would have absolutely no way of knowing if the nurse had a brain fart and drew up the wrong medication since she didn't see the medication being drawn up and since it was in no way labeled. As a nurse I also wouldn't feel comfortable just leaving drawn up medications in a room with patients. The entire scenario just seems off to me.