Second guessing myself....

Nurses Relations

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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?

Specializes in Critical Care, Education.

Your intent was golden & is a true representation of why nurses are the most trusted profession.... but as is so often the case, bureaucratic rules "for the common good" are often a barrier to doing the right thing. According to Kohlberg, you have a very highly developed capability for moral reasoning, but that doesn't fly very well in legal circles.

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Specializes in Med/Surg, Academics.
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.

I so hate this interpretation of the rule. The inhalers and creams that were given in the hospital and are on the discharge med rec have been lawfully dispensed and labeled by a pharmacist. How in the world has it been interpreted that handing over the dispensed and labeled items at discharge is a nurse dispensing them? I know that's the way it's been interpreted, but I just don't see how. Now if a nurse handed over an inhaler that was used in the hospital but is now not on the discharge med rec, I can see how that would cause problems...

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Specializes in ER.

Sadly, many pts who claim they 'can't afford' their meds, really mean 'I need to buy some cigarettes and a six pack of beer'. Call me another cynic.

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Specializes in Family Nurse Practitioner.
Sadly, many pts who claim they 'can't afford' their meds, really mean 'I need to buy some cigarettes and a six pack of beer'. Call me another cynic.

Agree and many low income folks in my state have state insurance that covers way more than anything I have ever had including federal benefits. Their medications are $1 each.

I have been on the receiving end of "no good deed goes unpunished" more than once and therefore tend try to be a rule follower, even the stupid ones, because I really take offense to being bit in the butt after going out of my way for someone.

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Use this as an opportunity to learn and don't report it. I would have told her to buy it OTC if it is cheaper money and maybe give her a few dollars. Some doctors will order a few extra doses for the patient take home with them.

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Specializes in ER / Critical Care.
Use this as an opportunity to learn and don't report it. I would have told her to buy it OTC if it is cheaper money and maybe give her a few dollars. Some doctors will order a few extra doses for the patient take home with them.

That's the thing (but clearly no excuse on my part) the patient had not a dime to her name (apparently) and could not even buy OTC ibuprofen...

I believed her and felt sorry for her- she wasn't one of those decked out iPhone holding Gucci purse bling wearing people you see at the grocery store using their food stamp card. She appeared to be poor and in pain.

Our NP was insensitive and wouldn't even order ibuprofen to be administered, she just wrote the prescriptions to be filled.

I have definitely learned from this experience as it has caused me a significant amount of personal questioning and grief over my lapse in good judgement.

Guess it's time to put my game face forward and be "the jaded nurse" again.

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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.

Then this is something that needs to be looked into. If the words "I can't afford my meds" come out of a patient's mouth, something needs to occur about that, even if it is the phone number of your social worker for them to call regarding their meds, or health care advocate regarding insurance. And I would ask--"What am I to do if the patient states they can't afford their medication?"

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Hello red1984! I found you through a thread left on "phoenixconnect". I joined this site so I could visit with you a bit!

My name is Julie. I am a Registered Nurse and have been practicing for 30+ years. I was forced in to early retirement about a year ago from my most recent position in Public Health.

I can tell how caring you are from your posts. This ridiculous hard world needs nurses like you! Upon review I have to agree with you. You made a slight error in judgement I don't believe you will make again.

Nursing is such a tough profession. Tough because it takes a toll on our mental, emotional, spiritual and physical health. With that being said I don't think I could not be a nurse!

I am returning to school after what feels like 100 years. My local Alma Mater is accepting all transcripts from University of Phoenix. BUT. I have to get through A&P I and II first.

When I graduated in the late '80's it was from a diploma program. I took that course there. They are waiving Micro for me (thank God) but there are just a few requirements I need to finish my BSN at the College.

I am terrified but encouraged by your dated A&P post! I need to address some technical stuff though. I don't know if it is still open book; I can't communicate with anyone in the Nursing department.

I have completed 3 workshops and am working through my MacBook. Tech support helped me download Microsoft Office. I am finally comfortable with these systems. I believe I will be using adobe acrobat reader for some stuff. Perhaps the virtual labs you speak of :). When I took A&p we dissected a cat........will certainly be different experience on line!

The fact you managed this while working and with a family inspires me. I have to plunk down $1,700.00 December 29th, class starts January 5th. That is a lot of dough for an old nurse!!

Thank you for reading my rather lengthy intro to myself and keep on fighting the good fight!! Any and all A&P tidbits you can throw my way are GREATLY appreciated.

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