Without divulging too much information that might identify individuals, I wanted to share an event that happened recently.
We had a provider who was feeling ill and went to a nurse and asked for a medication. The nurse wanted to help, went to the Pyxis, did a quick override, and then gave the medication. Nothing bad happened. The provider was fine. It all worked out fine.
But here’s the thing. The nurse should not have done this. You might ask why not?
When a nurse gives a medication it is supposed to be under the order of a physician. When a physician asks a nurse to do them a favor, it’s not exactly an order. You might quibble that this semantics. But when a nurse gives a medication they are supposed to check several things including the right patient, the right dose, the right time. Ok you say – the physician is the only one there and specifically asked for the medication. But the nurse is also supposed to check allergies, other medications, and the big one…do an assessment that the person had no problems with the medication that was given. When we “curbside” a nurse and ask them to help us out, it takes them out of their norma rhythm and they don’t do those things. Plus, there is no chart, so the nurses cannot document that they did any of those things. This end up falling into a scope of practice area, and these simple “favors” can put the license of the nurse at risk.
The problem as I see it, is that in the past we often would take care of each other when we were sick at work. Plenty of physicians and nurses have received IV fluids or an antiemetic to help get through a shift. Once we started using electronic medical records and orders, it became harder to do this sort of thing. But maybe it was never really the right thing for us to do.
Whatever your feelings on this issue, please be careful and consider the risks that we might be imposing on our nursing colleagues.