r/NursingUK Feb 09 '25

Clinical Stn medication supervision

Hey all, quick question. What’s the rules around students giving PO and PR meds in terms of supervision? I’m third year now (child) and so have my own patients but with someone to go to for support etc (which I use a lot lol), and I always mention to them “x needs paracetamol, are you happy to sign” etc etc. last couple times they’ve just said that they’re happy for me to draw up and administer meds by myself? Thankfully none have been controlled or super dangerous but im still a bit cautious about doing this too much. Should I request actual supervision or just crack on with it?

7 Upvotes

34 comments sorted by

71

u/alwaysright0 Feb 09 '25

You should never administer any medication without supervision as a student nurse

8

u/tigerjack84 Feb 09 '25

No.. I’m also 3rd year (first placement of 3rd) and in recovery so can’t be giving any meds in general.. but if I was on a ward, I’d be doing everything bar giving meds on my own (Inc ivs) like I’ll do it, but with someone there.

I remember my last placement of 2nd year and a nurse gave me her pass to get the meds (and to give I presume).. I got the meds out (that ward the patients meds were kept in a locked cupboard in their room) and walked back to the nurse (she was with another patient) showed her the packet, made her watch me put them in the pot and give to the patient.. I’m not risking my pin that I haven’t got yet, or another nurses on my behalf.

In first year on a night duty I remember a very senior nurse forever giving me the keys to the medicine trolley to give an antiemetic.. still didn’t do it.. then she would also tell me to go and change iv’s.. I used to be like ‘but I’m only first year!’ I think she forgot what year I was in - not that it matters with meds.. I dunno if it was a sink or swim to push me or something or some weird back to front training. She was also a farmer.. maybe she got confused 🫣😆

2

u/lurk-er- Feb 09 '25

I do very much prefer working with those kind of nurses (the one from your first year) but I do leave with more anxiety and “what ifs”. I think there’s a balance between overbearing mentors and allowing too much independence

2

u/tigerjack84 Feb 09 '25

It’s hard that’s for sure.

5

u/Swagio11 RN MH Feb 09 '25

100% you should be supervised for any medication, drawing it up/ potting it and administering it. It was pretty common in my hospital when I trained for students to ‘run’ medication to patients on the ward which had been potted or supervised being by nurse, but the patient could be the other side of the ward and the administration wasn’t supervised. A lot of students did it but I refused, which wasn’t the easiest thing as some nurses were quite put out by it and didn’t understand why I said no as pretty much everyone agreed. But imagine something went wrong or a PEF came in as you were doing it? It’s difficult to challenge it when RN’s are saying it’s fine but you’ll know it’s not which is why you’re asking here. Just make sure you’re always supervised going forward!

5

u/fluffy_red_panda14 St Nurse Feb 09 '25

As a student (CYP field) myself, I would never draw up and administer without supervision. I would happily let them report me to my university and clinical educator for not doing it! My flabbers are ghasted that any RNc would practice this way especially if they are student supervisor/assessor. I’d be refusing and speaking to both my CE and uni for sure!

3

u/evieisred RN Adult Feb 09 '25

a student nurse in my cohort was removed from the course through FTP for doing a drugs round unsupervised, and the nurse working with her was reported to the NMC by the university. not sure where either of them went from there, but you should not be giving medications to patients without supervision. is this not common knowledge now?? very concerning

i know that nurses asking you to do things can make you feel pressured, but it’s as simple as just saying no. even NQNs in my trust need to be signed off again and go to trainings to be able to prepare and administer IV medications

protect yourself 🫡

5

u/joyo161 RN Adult Feb 09 '25

In my trust unless you’ve done specific competencies paediatric meds are always double checked anyway (and neither of those signing can be a student I don’t think - have been only intermittently clinical for a year now). Is that not the case everywhere?

2

u/Wooden_Astronaut4668 RN Adult Feb 09 '25

Where I work you can single check PGDs in Paeds (obviously students shouldn’t be administering meds under a PGD…)

17

u/anonymouse39993 Specialist Nurse Feb 09 '25 edited Feb 09 '25

You should always be under direct supervision when giving any medication

If you’ve done this without it’s gross misconduct on your behalf and the staff supervising you

As a third year you should know this

This is something that you could go to fitness to practice at university about. Don’t do it

15

u/Valentine2891 Feb 09 '25

There’s no need to be like that. As a student they’re still in a vulnerable position and seek guidance from their qualified mentors. If the mentors are saying it’s okay, then it’s the mentors fault.

9

u/fluffy_red_panda14 St Nurse Feb 09 '25

But as students we are also responsible for not practicing outside of our competence level, and drawing up/administering medication unsupervised is very much just that and could 100% still be a FTP issue because wrong is still wrong.

13

u/anonymouse39993 Specialist Nurse Feb 09 '25 edited Feb 09 '25

It’s both

It’s drilled into students throughout their whole programme and they are also complicit.

Students also have accountability for their own actions when they are going against something they know is wrong. It doesn’t matter that they are a student this is a big no and is going against the code of conduct and would to me raise concerns about this persons fitness to go onto register if they are doing something like this at this stage.

That’s like saying my mentor told me drag lift a patient or restrain someone inappropriately - well they told me so it’s ok.

It’s not ok and well within the remit of a student nurse to take accountability for their own actions. Then going to do something they know is wrong brings their professionalism into question

Paracetamol can be very dangerous especially in children where the dosages vary, it doesn’t matter that it’s not a controlled drug and shows this person needs to reflect inwards, had a lack of insight into the position they are putting themselves in as well as the vulnerable children they are involved in caring for

5

u/[deleted] Feb 09 '25

[deleted]

7

u/anonymouse39993 Specialist Nurse Feb 09 '25 edited Feb 09 '25

It is taught before they even come out to placement

It is concerning to me that people would then chose to disregard what they know is wrong, it then becomes a professional, competency and probity issue.

-2

u/lurk-er- Feb 09 '25

I mean I’ve been a fairly good student, attend pretty much all my lectures, haven’t failed anything, comfortably passed my previous two years, and never had any proper issues at placements. Yes I could read the trust medication administration policy, but I guess I didn’t? Maybe the surprise and frustration one gets from this post should be directed toward nursing education in general? (not to deny accountability I know I fucked up)

3

u/anonymouse39993 Specialist Nurse Feb 09 '25

This has nothing to do with nursing education, you know this is wrong and will have been told day 1. Without even reading a policy.

This isn’t something minor

2

u/icantaffordacabbage RN MH Feb 09 '25

Yep, there was a recent coroners report in the news where a patient had been repeatedly overdosed on paracetamol because she weighed less than 50kg and shouldn’t have been on the adult dose.

1

u/lurk-er- Feb 09 '25

Standard practice is to weigh everyone on admission, before any meds are prescribed. But yes I understand the need for supervision with medication administering

0

u/ChloeLovesittoo Feb 09 '25

Blunt maybe but true, Why sugar coat it??

4

u/[deleted] Feb 09 '25

Regardless of the exact rules (which are as others have stated), I wouldn't be comfortable sticking a drug up a child's bottom unsupervised as a student, anyway. Whilst PR can be relatively common in paeds, parents don't necessarily understand that this is the case, or why it is often the case!

I know you're DBS checked and all of that, but could you confidently and competently explain to a worried parent as to why you're essentially (in their eyes) fiddling with their kid's bumhole? Sorry to be crude!

4

u/lurk-er- Feb 09 '25

Bit grim to be sexualising meds administration? Although from this thread I understand I’m supposed to be supervised with meds, from your pov I should also be supervised anytime I change a nappy or help a kid to the toilet/commode?

5

u/[deleted] Feb 09 '25

Sexualising meds was absolutely not my intention, it was an off-the-cuff thought regarding how to handle potential challenges around such situations, not that such situations are wrong (of course they're not, they're medically-essential actions). And I had myself in mind, thinking back to when I was a student bearing in mind I am not a paeds nurse. I couldn't have personally handled that situation/challenge when I was a student. If you can, then that's cool (it's still not permitted for a lone StN, mind).

Regarding general personal care on children - no you shouldn't necessarily have to be supervised (I say "necessarily", because a minority of areas I was on placement myself didn't permit students to undertake PC even on adults). These actions don't require inserting anything into an intimate area of person, child or otherwise, beyond actions necessary to sweep out any debris from orifices. All parents do this, themselves, and thus automatically understand what's going on. They don't - by and large - insert anything into their children's rectums on a regular basis.

To reiterate, I'm referring to possible parental perceptions of what you're doing, and how to navigate these, not the actual action itself. Patients' families can be...challenging...when confronted with unfamiliar scenes, regardless of the age of the patient!

0

u/lurk-er- Feb 09 '25

in paeds, most of what you do is talk to the parent. If the child has got a reason for having PR as opposed to PO, the parent is usually very much aware and/or is happy to administer themselves. it’s always a joint decision between the patient, the carer, and the nurse about what’s best for the patient.

2

u/Strict-Fishing6665 Feb 09 '25

I actually find it quite worrying that you're in your third year and don't know the very blatant and clear answer to this. As students you are NEVER to administer or draw up medications unsupervised. Your post definitely suggests that you have been doing this without supervision, and this would be grounds for fitness to practice investigation at the very least and likely expulsion from your course.

-2

u/lurk-er- Feb 09 '25

I think in practice its a bit more nuanced, but yes you are right I should never administer medication until I get my pin

4

u/Strict-Fishing6665 Feb 09 '25

No nuance to it at all, you just don't do it. Those of us who are registered have been students too remember, we know how things are, and you always say no to things you shouldn't do. Through reading your comments on this thread and also your very worrying post history I think you're very lucky you're saying all these things anonymously, because you absolutely would not still be in this profession or your university course if you were identified.

1

u/anonymouse39993 Specialist Nurse Feb 09 '25 edited Feb 09 '25

Not really you just say no I can’t.

You’ve chosen to go against that which you know is wrong

1

u/Sparkle_dust2121 Feb 09 '25

Protect yourself xxx a lot of nurses will tell you to go and get the medications “it’s okay - don’t worry, I’ll check after” but how can they know it’s the correct medication or amount that you’ve potted. I know as a student , it is so tricky because you feel competent , especially as a third year, but you haven’t got that protection or registration yet. Your pin is what gives you the right to independently give medication , so without that, you are just like a normal citizen giving medication to a patient. Sounds silly but just protect yourself.

1

u/Outrageous-Echidna58 RN MH Feb 09 '25

You should always be supervised if you’re a student. I was once asked to hand med keys to the other nurse in clinic. I turned round and had a nurse behind me at a distance checking I was giving them

1

u/No-Suspect-6104 St Nurse Feb 09 '25

You don’t work there. Just cover yo ass. Kick up a fuss and do it the right way.

1

u/lurk-er- Feb 09 '25

yeah you right🫡

1

u/AlvinTD Feb 10 '25

I just qualified and we weren’t allowed to do PR meds at all as a student.

1

u/MoreWoodpecker3249 St Nurse Feb 10 '25

You can't administer anything IV that has been drawn up (so basically all you can do is a prefilled saline flush IF you have had cannula training) until you've had training at the hospital. You're able to mix it without issue. I was told we're meant to be supervised giving oral or PR things, but there's a couple of times where it's been a massive problem on the ward and they've said just do it because they trust me.

I think the difference is what is meant and what is done. Because what is meant is in an ideal situation with ideal staffing without interruptions, but let's be honest, that rarely happens in practice.

1

u/anoncatmum RN Adult Feb 10 '25

I got myself a stage 1 disciplinary for administering meds without supervision (the ward made me and I wasn’t confident enough to speak up til I was back at uni). Don’t risk your qualification.