On a pediatric unit, the policy requires that all medication doses be double-checked by another registered staff. The experienced RPN cannot find anyone to check the medication because staff are dealing with an emergency; she is only giving a laxative and has given it to this child before. What is the best course of action?

• A. Wait to give the medication to be checked
• B. Administer now and document check later
• C. Have the nurse manager confirm
• D. Cancel dose and monitor

Answer: (A)

Safety relies on independent verification: every medication dose must be checked by another registered staff member before it is given, to catch dosing or administration errors. In pediatrics, where dosing is often weight-based and mistakes can cause serious harm, this extra check is essential.

Even though an emergency is underway and the nurse is experienced, bypassing the double-check increases the risk of a preventable error. Waiting to administer the laxative until a second registered staff member can verify the dose aligns with the policy and protects the child. Administering now and documenting a check later would defeat the verification step, and canceling the dose or seeking only a manager's confirmation would delay care or fail to meet the safety requirement. If no one is available to double-check, the appropriate action is to delay the dose until the check can be completed or escalate according to unit protocol to obtain a second verifier.