I work in a skilled nursing facility. Last night, the other RN on shift had to deal with an emergency just before we were starting our medication pass. I said I'd handle them all. After she left, I found that she'd already poured medication for each of her patients (which we aren't supposed to do) and had even signed off on all their medication administration records. Did I risk my license by going ahead and giving those meds?-N.L., PA.

You've both taken a big risk-and put your patients at risk as well. Your colleague intentionally violated the facility's standards for patient safety, which could be grounds for dismissal. Report the situation in an event report and discuss with your nurse manager how to correct the record according to facility policy. If you don't, then you'd be violating the facility's standards for patient safety too. Most state nurse practice acts address peer review and the nurse's duty to report illegal or unethical behavior. Your colleague may have also violated the law if she signed off on giving controlled substances without administering them.

You created potential liability for yourself by administering medications you hadn't prepared. Never administer medications you haven't prepared yourself, and never document giving medications you didn't administer.