Examples include late drug administration or omission when the patient is off the unit or when the prescribed drug is not available on the unit. When everyone is aware that actual practice differs from policy and procedure, it is not an error. Applying transdermal patch medications at 0600 instead of the prescribed time of 0800 is an example. Since 0800 is not a routine time for medication administration, and the patch would likely be applied later than the prescribed time because of busy schedules, the nurses change the time of patch application. The physicians know and approve of this practice.
More experienced nurses become innovative about making things right when an error has occurred.
This mind-set may also include documentation. When a discrepancy is noted, the nurse involved may be asked later to document a procedure that may or may not have been carried out. If, in the nurse's clinical judgment, other patient needs take priority, any irregularity in drug administration is not considered an error. Examples include dealing with emergencies, which often delay or otherwise alter drug administration. When a nurse on a previous shift fails to document drug administration or documents a dose in the wrong section of an MAR, often no one investigates because the nurse may already be at home sleeping or would not remember.