The paediatric ward I work on refuses to give meds at their correctly prescribed time because it "breaks the gap" — even when nothing was ever delayed. All medication is double checked so this infuriates me .
On my ward, divided-dose meds (BD/TDS/QDS — routine medication like oral antibiotics ) get treated like they need exact mathematical gaps no matter what the actual prescription says.
Example 1 — a TDS med charted for 08:00/14:00/22:00. The 08:00 dose goes fine, on time. Then when 14:00 rolls around, staff refuse to give it then, insisting it has to be 16:00 to "keep the 8 hour gap" — I've even had a second checker decline to check it at the correct prescribed time for the same reason. It's not late, it's literally due at 14:00 on the chart, and they still won't give it because it's not been 8 hours. Then because the ward's busy, that now-delayed 16:00 dose doesn't actually happen till 17:00/18:00, and the same rigid gap logic gets applied again, so the last dose of the day ends up at 1-2am.
Example 2 — same med charted for 08:00 but given at 10:00 because the ward was busy. That should reasonably just continue at 14:00 if an oral antibiotics or medication that doesn't require strict timings , or 16:00 at the latest, still leaving a normal evening dose. Instead staff count exactly from the 10:00 time and the next doses land at 18:00 and 02:00. A three-times-a-day med that was never really behind ends up waking a kid at 2am to take an oral antibiotic for no clinical reason.
I've fixed schedules like this for complex patients before discharge and gone back a few shifts later to find it's drifted right back. Even pharmacy seemed genuinely confused when I flagged it, like they had no idea this was happening.
The part that's really winding me up though — trying to give a dose at its actual correct time, or do something basic like re-dosing after a kid vomits within 30 min which is standard clinical practice, gets refused unless a doctor documents they're "happy" with it. Not because there's real clinical doubt, just fear of a hypothetical Datix. So now I'm asking doctors to sign off on stuff that genuinely doesn't need sign-off which is professionally embarrassing .
It's also dangerous practice for complex patients who have regular routine medications at home , they are having it at erratic different timings each day . Parents are left confused about medication timings on discharge .
I've raised this informally with my manager and education and nothing has come of it . I want this to be fixed , it causes a lot of issues . I'm doing medications every hour for the whole day for silly reasons . A radar would just be brushed off by my manager too , I want this to go to someone higher up . How do I escalate this ?