What would you do?

I let patients know that (or used to, when I worked on a floor) I have many patients with many different times for medication and I have scheduled administration times so that I can get all of the medications to my patients in a timely manner. This would upset the balance and delay med times. It's true and many many patients have no idea what nurses do, so I believe informing them of your tasks can let them know (in a nonchalant way) that they're being picky. =)

unless i am really pressed for time with patients tanking or a new admit coming, i will generally try to accommodate the person. usually it is a prn sleep med or something like that and it really can wait but if not i try to be honest.

if i do have some really unstable patients or an admit/discharge etc then i tell them i can wait but will be tied up "with a procedure or admission, whatever applies, and it may be an hour or so until i can come back". most of the time the patient will take them rather than wait the extended time.

sadly with having scheduled medications they are not allowed to wait very much and i will explain that as well. we have people who do nothing but run reports and look for medications given out of the "timely window" so we can get dinged. like i need that?

"No, I'm sorry. There are many reasons to keep your medication administration on schedule so that your body can best make use of them for you to heal/keep condition x under control/whatever. Here are your 3 pills. Do you have something to drink or can I get you another glass of water?"

Remember your therapeutic communication 101: offer choices when there are reasonable choices, not when there are not.

As we are dinged for not giving meds during our allotted window, I usually say, "Actually, I need to have you take them now, or else I get in trouble for giving your meds later than scheduled." While I'm giving my explanation, I hand them their med cup and glass of water, so they know that it's kinda pointless to argue. With computer/pyxis charting, my personal leeway/nursing judgment to give meds a little later has been removed. I haven't had a problem after I explain my predicament, since my patients don't like the idea of getting me in trouble, as I try to do everything else to be compassionate and help them be more comfortable.

Depending on what type of med it is, you may be able to leave it there with a glass of water for your oriented patient to take later.

That's a big no-no, at least in my state. :)

Oh goodness, you are really setting yourself up if you let them tell YOU when they are going to take their meds. As a previous poster stated, I would gently and professionally tell them that their doctor has written an order for them to take XYZ medication at this time, and that you are following orders. If they still refuse, then tell them that you will document the refusal, and that they should speak to their doctor about perhaps changing the times of their medications if at all possible (this will give them some sense of control over their care.)

I personally would not mention that "I will get in trouble if you don't take these meds now." because the focus is not YOU, it is the PATIENT. The patients have enough to worry about, and they don't need the burden of worrying about their nurse getting in trouble.

Depending on what type of med it is, you may be able to leave it there with a glass of water for your oriented patient to take later.

OH no no no no no no! This is never ok, no matter where you work.

I have also stated to my patients "I may not be able to come back in half an hour" line. That seems to work the best. I have had patients who want to take the blue one now, the purple one in 30 minutes, and the "sleeper" at 11. I smile and approach them "Mr. Smith, I would love to be able to say I can do that, but I still have many other patients to give medications to tonight. I can't guarantee that I will be back in a half hour. Is there any way you could help me outand take these now? I can bring the sleeping pill back later if you wish"

If they are adamant, I ask why. Sometimes they say "Well, I take the pill twice a day - at breakfast and at bedtime." Then I can say "Yes, it is supposed to be given 12 hours apart. You took it at eight this morning, so it is actually due now."

As long as you are being genuine and pleasant, it shouldn't be too big of a problem.

~Sherri

"The new nurse thinks like a mom. The experienced nurse thinks like a lawyer."

Do not leave the meds on the table. Ask the pt to use the call bell when he/she is ready - if this is outside the one hour window, change the time and state that the pt requested to receive the meds late.