Short-cuts and bypassing protocol


How do you feel about bypassing checks and scans during med pass? What about not scanning a patient and bypassing that check point in order to speed things along or for whatever reason? What about other short cuts nurses may perform because they don't want to take the time to do them? Is this normal? Is it just part of the trade? If its just a Tylenol or some zofran does it really matter? And if you "know" the patient should you HAVE to perform all the 5/6 rights? What do you guys think? I don't want to hear what the books say....I would rather hear about reality.

MunoRN, RN

8,058 Posts

Specializes in Critical Care. Has 10 years experience.

Nurse has become the art of the shortcut and making it look like things were done that actually weren't. There are certainly things we do that don't make good use of our time, but as long as we refuse to acknowledge that some things may have to be cut out, things that shouldn't be like barcoding meds and patients will continue to get skimped on.

SoldierNurse22, BSN, RN

13 Articles; 2,058 Posts

Med checks are in place for a reason. The method varies, but it is absolutely essential to complete your 5 Rights. You'd be suprised the errors you can catch on a check like that.

However, Muno is right--there are a lot of extra steps added because nursing is getting dumbed down by the second. In some hospitals, someone decided that we can't be trusted read properly, so they decided to make us scan patients like you'd scan a gallon of milk at the grocery.

Just zofran? Just Tylenol? Just because they're commonly used drugs doesn't mean they somehow escape the check process, or that they're exempt from the potential to cause serious harm.

"Accidentally" giving Tylenol or Zofran (because you didn't check them) could be potentially detrimental to a patient, especially if they have a condition(s) or they take other medication(s) that coud interact with those drugs.

We've found workarounds for barcoding too. We find labels and scan ahead of time or in the med room. Bar coding for safety was born out of human factors that we may have slips, lapses, interruptions, distractions, "bad days", burn out, fatigue, name alert issues, etc. Try to view it as an added line of defense from med errors. Ultimately, nurses are the last line of defense and have the final say before administration.