Second guessing myself....

[RED1984, BSN, RN, EMT-P]

An adult patient I discharged today was given prescriptions that she flat out told me she couldn't afford... One of the prescriptions was 600mg ibuprofen PO q6h PRN pain control. I discharged her, she signed the paperwork and I charted her out of the computer system. She was waiting to sign out at the register (billing papers) and I felt bad that she couldn't even afford ibuprofen and it looked like she was in pain, I looked in my backpack and I had 3 200mg ibuprofen (generic in original container) and I walked up to the register where she was and told her that she could have my ibuprofen and gave her the bottle with the 3 pills inside. Even though ibuprofen is OTC medicine, I now think (that I've thought about it) that I was in the wrong for giving it to her and that I could be in trouble with my employer and the state board. I am planning on telling my director what happened tomorrow, I feel like me telling her exactly what I did and why will make me feel better about the situation. Nobody will ever know it happened if I don't say anything, but I think I should self report it.

Thoughts?

[rowrowyourboat]

I am not yet a nurse but I would have felt like you did and maybe offered her money to buy the meds. Can you lose your job over this?

I don't have any advice but I hope everything works out.

[RED1984, BSN, RN, EMT-P]

I could lose my job. Jobs are not guaranteed and if my director feels like it's worth terminating me then ya I'll lose my job. Honestly I'd be devastated as I LOVE MY JOB and enjoy going to work... I'm an honest person and that's why I want to tell her what happened- even if it puts my job on the line.

[Pangea Reunited, ASN, RN]

I suggest that you keep it to yourself and don't do it again. It's a fairly minor thing that could be blown up into something major. By telling your supervisor, you're obligating her to act or be "in" on the inappropriate behavior.

[Adele_Michal7, ASN, RN]

I wouldn't tell anyone. Don't do it again. You never know. If patient claims she has a reaction to it, etc...

[jadelpn, LPN, EMT-B]

Keep it to yourself, don't let it happen again, and in the future, if a patient tells you they can not afford their medication, then you need to have conversation with social work to go and see this patient so that arrangements can be made.

There are any number of patients who know that "I can't afford my medication" means that the nurse has to do something about that. Which means they stay longer until social work can get to them. Which means that they can get their medications for free. Which is low on their priority list.

I would be more concerned that this patient could come back with an exacerbation, and say "welllll I TOLD the nurse I couldn't afford my medication!!"

It is a duty to act statement. Otherwise, I wouldn't open a can of worms with your manager. Learn and move on.

[xoemmylouox, ASN, RN]

I am always one to be upfront and honest, but I would let this one go. Just don't EVER do this again. If there is an issue in the future for a patient involve your dept. social worker.

[Whispera, MSN, RN]

I've felt the same way in the same situation. However, you shouldn't have done what you did. There are huge potential liabilities in it.

It is a learning experience as well.

We can't help every patient who can't afford things, ourselves, no matter how deserving they are or how much we want to help. That's what the social worker is for. Also, there are lots of free and reduced-price medication programs that can be very helpful. You could collect this information to inform future patients. Often, too, hospitals can give one day's-worth of meds to help a patient until she can get to the pharmacy. See if your hospital does such things.

Warm hugs for being such a caring nurse! It's complicated, isn't it?

[Overland1, RN]

Aside from possible loss of job or other adverse reactions, my cynicism would keep me from giving a patient meds or (money to buy meds). I guess I have worked the ER's for too long.

[RED1984, BSN, RN, EMT-P]

Thank you ALL for your input. This was in the emergency department at a small hospital. We don't contact social workers is people say they can't afford meds, the local grocery store pharmacy provides antibiotics free for those without insurance.

[Jules A, MSN]

It sounds like the OP understands this is inappropriate so I just wanted to add the issue is actually dispensing medications without being licensed. In my state this is a big no-no. We can't even give the inhaler the patient has been using when they are discharged. Like everyone said consider this a learning experience and just don't ever do it again.

[RED1984, BSN, RN, EMT-P]

Hi Jules, I DO realize that it is not in my scope to dispense meds, it was a total lapse in judgement and a mistake I will not make again. When I worked med-surg, we would give the patients any of the inhalers or creams that they had been using. In the ED we can also give the bactroban or silvadene creams that we open for the patient to them when they leave. At night sometimes, we (the RN) dispenses a 8pk of Tylenol 4s to hold the patient's pain over until a pharmacy opens- the T4s are ordered by the doc as a nursing order... I'm definitely going to look into if all this is legit or not. I know that me giving a recently discharged patient some ibuprofen (or anything for that matter) is not ok though and will NEVER do that again...