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Can an RN lose his license for giving a patient an expired injectable medication if he was forced to administer that med?

Monday May 12, 2014
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Dear Nancy,

I was forced to give an expired injectable medication. Is this legal? Can I lose my license?

Ken



Dear Ken,

Your question raises many questions. For example, you did not indicate who was forcing you to give an expired injectable medication. You also did not share how long the medication has been expired. Was it months ago? A year ago? Two days ago?

Also it would be important to know would be what the circumstances were surrounding this incident? Was it during an emergency? Was this the only medication available to administer? What does the drug insert say about the expiration date? What type of medication was involved (e.g, narcotic, hormone, blood pressure medication)?

With so many unanswered issues, only some general comments can be made. The first is, as a licensed RN, you are the patient's last protection against a risk of harm. Whomever orders a medication, and regardless of what the medication is, it is you who takes accountability for the administration of that medication. Using critical thinking and judgment, it is you who must decide if the medication can be administered safely to the patient using the five rights of
medication administration.

If you believe, after a careful analysis, the medication should not be administered (e.g., wrong medication, wrong dose, expired medication), you must bring this to the attention of your nurse manager, the physician and any others your facility’s policy identifies you to notify, and you must document these details in the patient record.

Any results of "force" placed upon you to give the medication against your judgment can be handled in several ways. If you are terminated for not administering the medication, you can grieve it through the employer's grievance policy. You also may need to report the approach of using expired medications to the appropriate outside agency/authority (e.g., licensing agency for the facility, board of nursing if it was another nurse who forced you to give the medication).

And, if you would be reported to the board of nursing for failing to administer an expired medication, your actions would be clearly evaluated by the board using your ethical and legal mandates in the situation, including standards of practice. Likewise, if you gave the expired medication, your actions would be evaluated by the board utilizing the same mandates and standards.

Always remember you are accountable for your own actions. One cannot avoid this basic fact by saying that someone else forced me to do this or that. You must stand firm against any practice issue jeopardizing your professional judgment and your patient's safety.

Regards,
Nancy




Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.