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
I have worked mass shot clinics where one fills and one shoots which given the nature of how zany the clinics get is the only way to get several hundred people through in a few hours. But - you work in a team and nurse A draws the shots in front of nurse B
nah, I wouldn't. Only in a code situation when meds are drawn up and then given to the nurse administering. That's the only time I'd give meds not drawn up by me.
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" ...
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I have done this as well. Have also rarely done this for conscious sedation procedures,, if the meds were drawn up in the room. Happens when someone is "trapped" by equipment on the far side of the room where the IV access is and can't get back over to the meds & syringes.
Specializes in med-surg, psych, ER, school nurse-CRNP.
The only, ONLY way I will do this was the way I did it when I worked psych, and we left the pills in the wrappers, in a cup with the room # on it. That way, I had to open them myself, but I still re-verified them on the MAR before I even did THAT.
I guess I can pull my fuddy-duddy card out as well.
Specializes in ER, OR, PACU, TELE, CATH LAB, OPEN HEART.
COUNT ME IN the "uptight and old fashioned" club. I got in trouble with a preceptor one time for NOT giving meds he had poured and taken out of package. Just recently, NOT EMERGENT, in ER another nurse gave me a cup and said, "here's 2 oxycontin for Mr. Jones", I said, "I can't give that it's out of the package" She went ballistic, reported me!!!!! New nurses don't seem to understand, or perhaps they were not taught the dangers!!!!
another cautious nurse here (much to the annoyance of some of my coworkers). sometimes compromises can be made...but i wouldn't consider this one of those times! i wouldn't have done it either, vito.
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'm a card carrying member of the old fashioned and uptight club too. the only meds i would give would be unopened and i would be double, triple checking the mar before i did.
me too! i would never ever give a med i hadn't drawn up or poured myself.
some people thought i was strange for insisting that i sent up and give all meds
that i was responsible for but it wasn't a negotiableissue to me. it was my license and i worked too ...... hard to get it. there have been two or three times that in the midst of a violent psych patient acting out and i was helping hold down that i was handed a prefilled syringe, and i quickly looked to check the name of med and dosage, then administered the injection. those exceptions were few and far between.
I'm not allowed to give medications in my CNA position in the ER, but being a mental health tech sometimes nurses ask/tell me to give something they hand me because I have a repoire with the patient. I am very uncomfortable doing so and will agree to help by going in with the nurse, talking to the patient, etc..but not only would those be meds *I* didn't prepare, but administering them would be out of my scope of practice! And yes, I've had nurses ****** at me for it. I don't care. I won't do it :)
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. 
Flare, ASN, BSN
4,431 Posts
I have worked mass shot clinics where one fills and one shoots which given the nature of how zany the clinics get is the only way to get several hundred people through in a few hours. But - you work in a team and nurse A draws the shots in front of nurse B