Selena, an experienced critical care nurse, is new to rural practice. For the last three months she’s been working at a small community hospital. It’s early Saturday night and Selena’s covering Emergency while her RN colleague covers the inpatient unit.
While Selena is looking over lab results at the nursing station, she hears footsteps. She looks up to see an older man standing in the doorway, holding a piece of paper. After greeting him, Selena asks how she can help. He hands her the paper and says, “My doctor sent me to get this filled.” Selena realizes it’s an order sheet, with a medication order, from a local physician.
Selena asks him to take a seat and tells him she needs to do an assessment. He replies that he doesn’t have time for that, “I’ve already seen my doctor. Can’t you just give me the pills so I can go?”
Selena reads the order and considers her options. She knows the local pharmacy is closed and the hospital has the medication in stock. There isn’t a pharmacist on site but she knows RNs can dispense medications to clients with a physician’s order. She looks at the man, who appears a little uncomfortable. She wonders if the best option is to dispense the medication.
If Selena dispensed the medication, she would not be meeting the Dispensing Medications Practice Standard. While she does have an order for the medication, the man is not her client. Without knowing anything about him, she’s not able to determine if the order is appropriate for the man.
The Dispensing Medications Practice Standard provides nurses with the information to dispense medications safely.
Selena explains to the man that she cannot give him the medication without doing an assessment and consulting with his physician. She encourages him to stay, letting him know how long it’s likely to take.
She’ll also document this issue and discuss it with her manager to be sure everyone is aware of the agency policy and CRNBC practice standard on dispensing medications.
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