Withheld meds

[demo24]

Hi all,

I was just curious about the legality of a particular situation. One morning I come into work and the night shift nurse leaves a note stating that the pts peg tube was clogged and to call for a GI consult which I did. The problem being is that i was unable to pass meds that were to be administered via peg due to the clogging of the peg tube. I called the GI dr twice to come and hopefully look at it in hopes of fixing it, but no response all day. I at some point had to state that meds and feeding were held due to no access pretty much all day. The pt still remained stable and i was able to give iv meds, but in the mar i had no choice but to put med not given via peg due to no access. I also wrote in my notes that the dr was notified twice, and no response. Is this a red flag and considered a med error and will and can there be legality issues because of this? I guess what im asking is did i chart properly? Thank you

[Everline]

Did you tell the charge nurse about this situation?

[calivianya, BSN, RN]

I'd say you did almost everything you could do to get the meds passed. It's not your fault the physicians wouldn't respond to you.

That being said... you didn't mention what you did to try to unclog the tube so you could give meds. I would say you were only in the wrong if you didn't try anything and just took it at night shift's word that the tube was clogged.

[JustBeachyNurse, LPN]

I'd say you did almost everything you could do to get the meds passed. It's not your fault the physicians wouldn't respond to you.

That being said... you didn't mention what you did to try to unclog the tube so you could give meds. I would say you were only in the wrong if you didn't try anything and just took it at night shift's word that the tube was clogged.

^^^this!! did you try facility protocol or manufacturers recommendation to unclog tube? Did you check that it was clogged? I followed someone once that said a GT was clogged it wasn't--a kink in the tube by the clamp that made it difficult to flush

[demo24]

Hi all. Thank you so much for responding. I did tell my manager about the peg and the response was to check the patency and call back the GI doctor which i did. The peg was in fact clogged. I felt I had no other choice, I even contacted the house dr which told me to call the GI. I am a little nervous as to the legality of having to omit the meds due to the clogged peg. I did put on the mar the meds could not be adm due to the clogging of the peg though, so i was unsure of how to go about the situation, and I thank you all for your responses again. Is this is a good enough reason to hold meds without being held liable at some point giving that I did everything I could have?

[demo24]

I did try the warm water and milking the peg a bit.

[JustBeachyNurse, LPN]

Why would there be legal implications of you couldn't physically administer the drugs? You followed up, alerted management, documented. Did you alert the providers that mess were held and why? Were any critical/crucial to not miss meds that you should have gotten an order for an alternate route? Or basic routine meds like vitamins?

[Adele_Michal7, ASN, RN]

Where I work we have GT decloggers in the med room. All we need to do is obtain a doctor's order before using it. A place I worked in the past had patients who were known for getting clogged constantly. Those patients had a standing MD order to just use the Declogger.

[Horseshoe, BSN, RN]

Where I work we have GT decloggers in the med room. All we need to do is obtain a doctor's order before using it. A place I worked in the past had patients who were known for getting clogged constantly. Those patients had a standing MD order to just use the Declogger.

Haven't done this in a long time. How does the "declogger" work?

[~PedsRN~, BSN, RN]

Document document document. You notified the physician about the problem, that's all you have to do. It would be one thing if the tube was clogged and you just decided it was no big deal, didn't notify docs, nada. You did everything right.

[demo24]

Hi,

They were pretty much all basic meds.

[Adele_Michal7, ASN, RN]

Haven't done this in a long time. How does the "declogger" work?

It looks almost like a pipe cleaner but made out of plastic. You insert it in and out of the tube in hopes of loosening any thick sediment that had formed.