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Not uptight at all. I wouldn't have given those meds. The only exception to "don't give what you didn't prepare", IMO, would be if a nurse is working with a preceptor and doesn't have their own access to the Pyxis/med room/cart. Even then, they need to watch what the preceptor does and double check that the right med was taken out. *shudder*
Nope, I wouldn't do it either. Once the meds leave their sealed packages there is no way of knowing what is really in the cup or crushed or whatever. Frankly, I would think that the nurse who had prepared the pass should have gone ahead and administered the ones she prepared, and the new nurse could of started on ones that were not pulled yet. Way to risky in my opinion.
Only time I have ever given meds I haven't pulled up myself - or pulled up meds for someone else - is in a crisis situation such as a code, emergent intubation etc. And those were paralytics or ACLS drugs - and we are all in the same room at the time. I've pulled up meds, labeled a syringe, and handed them off to someone saying - "this is 2 of Versed", "This is 100 of Sux" ...
I've gotten funny looks from my colleagues in the unit for refusing to sign off on meds I haven't witnessed pulled up and/or wasted. So I guess I'm among the uptight and old-fashioned as well.
I wouldn't have given them either,...ask the first nurse to go ahead and pass what she started or waste the meds,.....those rules are there for a reason,...BTW I don't take anything out of its original, labeled package until I'm at the bedside, unless it's ACLS meds and they are drawn up in a room full of people!
Vito Andolini
1,451 Posts
There are some things we learn in school that are not done the same way in the real world, right? We learn as we gain experience that some shortcuts are safe, even though different than what we were taught. We even design new procedures that are better in terms of patient comfort, cost, speed, etc. than what we were originally taught.
One thing most nurses I know never deviate on, though, is giving meds we did not pour. Well, the other day, a nurse did just that. She was at work unexpectedly. Another nurse had agreed to pour and pass meds and had set up about half the meds already, when in came the unexpected nurse.
The new arrival said she didn't mind giving the meds the other nurse had prepared!
Well, it's a compliment to the one who poured, but I think it is really risky to trust someone to that extent. The pills were opened, the liquids were poured, the new arrival wasn't verifying the pills, she just gave all the stuff.
Nothing happened amiss that I am aware of. All the patients are fine. Probably no pouring errors were made. But this just seemed so wrong to me. I just keep thinking what if the pourer put the wrong meds in the cup? Or the cup in the wrong patient's name slot? Or whatever other error you can think of.
Would you ever do that? Under what circumstances? Am I too uptight and old fashioned? :vlin::smiley_ab