When a med runs out

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What do u do when u run across a med that ran out for instance Lasix 20mg to be given at 8am for ms.xyz u've called the pharmacy to make sure it's coming on the next run but what do u do?

I know borrowing is a big no no...but what do u do? Ms.xyz needs her lasix what would ur solution be?

I'm new to LTC I was just wondering what y'all do

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Specializes in New Critical care NP, Critical care, Med-surg, LTC.

We do borrow, no-no or not, it's better than missing a medication.

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Lasix should be in the e-kit...

I don't borrow. Other nurses at my work do but I don't.

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I never borrow. I call the pharmacy to see if it has been ordered and when. If they have had plenty of time to get it to us (ordered 3 days ago and still not here) I ask them to bring it right away. Notify DON whether its on the way or not. If the DON suggest there may be extra in the cart I tell her I was unable to find any. I've seen nurses get thrown under the bus for this one.

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Specializes in LTC, Hospice, Case Management.

1. Should be in the e-kit. This is a very basic medication for LTC. If not stocked in there someone needs to look in to getting stocked.

2. Pharmacies have a 24 hour contractual agreement to supply meds 24/7 (at least every place I've ever been). Ultimately if you don't have what you need they must get it to you.

3. If there is a delay in getting the medication for whatever reason, you need to notify the MD and get an order for an alternative that you do have on hand (always have the e-kit med list in front of you when you make the call) or you get the Dr. Ok to put medication on hold. Document, document, document all your attempts to get the medication. Cover your butt! You are accountable if you choose to do nothing (and remember: not documented = not done).

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Specializes in Aged Care, Midwifery, Palliative Care.

I'm also a new nurse and a new grad in aged care, I would look in the imprest cupboard for emergency stock, and then fax the pharmacy as an urgent order. Thanks for asking, I'm about to head into work for a shift so I'm going to be checking the emergency stock to see what is in there and I would hope that Lasix is one of them.

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I'ne vere heard of it referred to aged care. I like whole lot better than geriatrics.

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Special delivery. It's expensive, so it's best not to let med run out in the first place. I was told by my coworkers, that they were told, that 'if it's in the building give it!'. What exactly that implies I am not sure.

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Lasix should be in the e-kit...

I don't borrow. Other nurses at my work do but I don't.

Fair enough, but there's plenty of more obscure medications that might NOT be in the Pyxis/e-kit/whatever.

And never say never, one day that lasix might not be in the back-up, even though we all know it's supposed to be. And one day that 24/7 pharmacy might not deliver it, despite that contract they're supposed to fulfill. And one day the only way to give mrs jones her lasix is to borrow, even though you're really not supposed to.

With that said, I'm well aware the vast majority of med borrowing in LTC occurs because it's easier and faster than going through the proper channels to obtain that lasix the right way. There's no excuse for that. But to say it's never okay to borrow..... no, not true. I'm skeptical of any LTC nurse who says they've never had to borrow over the years. Either they work in the most magical, miraculous facility ever, or they're lying.

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Specializes in New Critical care NP, Critical care, Med-surg, LTC.

I'm surprised by the answers here, as a relatively new nurse myself, the only meds I heard it was a no-no to borrow was the narcs- they can be dispensed by the supervisor from the Pyxis if necessary. If I've got the same med and same dosage for a different resident, I've administered that. I do always make sure that the appropriate order has been placed, but to special delivery a Flomax when I've got six residents with the same thing, seems a waste of resources. I think I've had to do it only twice in the four months I've been there, so it's not a regular occurrence, but it was the least of my worries as I adjust to the whole new world of LTC, and nursing.

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Specializes in Correctional, QA, Geriatrics.

One reason to not borrow meds is that the borrowed meds never get replaced which leads to refills being requested too soon so the whole cycle just keeps snowballing. Also if the surveyors even get a whiff that meds are being borrowed the deficiencies start flying and sometimes heads start rolling.

Order refills in a timely manner; that is when 4-5 days worth of meds remain; not when the last dose has been given. Controlled drugs need to have refills remaining or new prescriptions written depending on the specifics of the prescription so ample time needs to be utilized to make sure the prescriber writes a new prescription if necessary and gets it to the pharmacy. Use the e kit AND make sure that a request for replacement for the ekit is sent to the pharmacy. Nothing is more irritating than going to the ekit to find multiple use slips inside and empty med slots because no one faxed a replacement request to the pharmacy.

If a refill has been ordered and no new med has been received by 2 days after the request was sent to the pharmacy pick up the phone and ask the pharmacy why. If there is a shortage of that med then inform the physician and either get a hold order or a new med to replace the nonavailable med. If there is a pre authorization required then pass that information along to the appropriate person for follow up (maybe unit manager or ADON or DON). Don't just ignore the issue and hope the refill just appears before the last dose is given.

Last thing if is there is an ongoing issue of med availability problems then inform the DON so the problem can be investigated. Lack of meds can cause serious repercussions for the facility and, obviously, can be very damaging to the resident. I have found quite often that there is an overwhelming lack of communication between shifts, nurses and nurse management whenever med availability is a problem. Borrowing someone else's med might seem to be the easiest solution and apparantely a harmless choice but the consequences can be quite nasty.

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"Use the e kit AND make sure that a request for replacement for the ekit is sent to the pharmacy. Nothing is more irritating than going to the ekit to find multiple use slips inside and empty med slots because no one faxed a replacement request to the pharmacy."

Pretty sure we do ekit exchange daily.

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