Was I right to refuse to manage medication ahead of schedule?

Dear Nancy,

I worked the night shift as a nurse administering medications on my unit. When it was time to manage medications early within the morning, I used to be told to manage medications corresponding to Synthroid and Prilosec at 7:30 a.m., but I refused because they weren’t to be administered until 9 a.m. My charge nurse told me to manage these medications and return to report back to the upcoming shift that I’d not be administering them. Was I right to refuse to manage these medications earlier? Our policy, in addition to the state’s nurse practice act, states that we’ve got an hour after or an hour before administering medications. Some colleagues have told me that the charge nurse’s request was real world nursing.

Taylor

Dear Taylor,

Your refusal to manage the medication as requested by the nurse manager was the fitting decision. You were guided by two necessary guidelines on this matter: facility policy and, most significantly, the Nurse Practice Act in your state. Although your fellow nurses may perceive this as real-world nursing, if such a violation is reported to your state board of nursing, no matter whether or not the patient is injured, they’ll experience the actual world discipline of skilled licensing.

The query is why would the charge nurse want the medication administered earlier? For the convenience of the staff who’re coming in? For the convenience of the patients? The request is indeed odd, with out a reasonable basis. If the charge nurse wants the medication administered earlier, she should discuss her concerns with the physicians and advanced practice nurses who’re prescribing the medication. Or she could try to alter the policy.

Regardless of how your nursing director decides to handle this, you might be a licensed nurse in your state, and compliance with the Nurse Practice Act of your state takes precedence over such a request. You will probably be the one who must reply to a grievance about your nursing practice whether it is filed with the board.

Also do not forget that your practice must comply with ethical precepts. Code for Nurses with Interpretive Statement (2015). At least two provisions of the Code apply here: Provision 2 (The nurse’s primary obligation is to the patient, whether that’s a person, family, group, community, or population) and Provision 3 (The nurse shall promote, advocate, and protect the rights, health, and safety of the patient). Collaboration inside the nursing career and motion in cases of questionable practice is crucial. In your situation, you might consider discussing with the charge nurse the rationale for administering the medication sooner than required by facility policy and the Nurse Practice Act. Depending on the charge nurse’s response, you might must share your concerns with nursing administrators who may help resolve the problem for the advantage of each patients and nurses working in your facility.

You can read the entire thing Code. Click on “Ethics” after which “Code of Ethics” within the drop-down menu.

Best regards, Nancy