Nurse told me to give Medication - page 2
So as I posted recently I just started as a CNA. Friday was my third and last day shadowing one of the CNA's that already worked there and Monday I will be on my own. Well yesterday, I was feeding a... Read More
Apr 7, '13 by ArrowRN, BSN, RNwhy not call up your nursing board and tell them you give meds for CNA to pass out see how long you will be an RN. Even though I'm just a student It ain't NCLEX hospital, this is the law, unless you from a state that allows that person to be trained in medication administration, she did the right thing to refuse and to leave it sitting on the table.
Apr 7, '13 by Jory, ADN, BSN, MSNQuote from man-nurse2b...no she didn't do the right thing by leaving it on the table. If she felt that strongly about not giving the meds she should have picked them up and handed them back to the nurse.why not call up your nursing board and tell them you give meds for CNA to pass out see how long you will be an RN. Even though I'm just a student It ain't NCLEX hospital, this is the law, unless you from a state that allows that person to be trained in medication administration, she did the right thing to refuse and to leave it sitting on the table.
If you want to get real technical about it, the nurse is supposed to witness the swallow.
There have been instances where LTC patients will not take meds when given to them only to stockpile them to overdose later.
You also don't know if the patient will fall asleep and another patient will walk into their room.
Again, passing meds and "handing over meds" are not the same thing. You are confusing the two. Some states allow for CNA's in LTC to pass meds and this is NOT EVEN CLOSE to the OP's situation.
Apr 7, '13 by yugot2h8I would not have given the medication because in my state, CNAs are not supposed to pass or even "hand over" (I'm sorry, I don't see a difference between the two) meds and a nurse is never supposed to ask a CNA to do so. I wouldn't put my license (or the nurse's) in jeopardy over "passing" vs. "handing over."
Apr 7, '13 by yugot2h8OP, you did the right thing by not giving the resident the medication, but you should have given it back to the nurse,
Apr 7, '13 by Mewsin, LPNI would give them but we can give meds as long as we don't pass meds. In my scope I can even pop the meds out of the bubble sheet and give them but not at my facility.
Apr 8, '13 by i_love_patient_careI had a nurse in the hall I worked on during day shift, and he tried to leave a medicine cup with crushed up meds/apple sauce on each breakfast tray for me to give to all the patients I had. I didn't even notice them the first (and last) time he tried to pull that on me, and started collecting the trays to put them back into the metal meal tray cart. He asked me about them as I was pushing the cart away, and I said what med cups? I didn't notice any.... (He had been reading magazines in a patient's room the whole time breakfast was being served). He said, "You're supposed to make sure they take those with breakfast." I politely told him that I cannot pass medications, and he never tried that crap with me again. He frantically had to go through each tray and read the name to match with the med cup so he could get them to the Residents on time.
Hey nurses, I know 99% of you are awesome. The good ones have my respect. To the minority of you that think this kind of behavior is ok, it's not..
Apr 8, '13 by hurty25I've seen a lot of these in LTC.If nurses are busy they just put the medicine cup on the tray and that's automatic that cna's have to give it to the patient.Well,maybe they have trust their cna's on that case esp when they know them already..It was happened at one time when the nurse put the medicine cup on the patient's tray but the patient went to sleep and forgot to take it.The next day all nurses were called up by the administrator because the dietary supervisor found the medicine on the tray.I understand that it's very busy in the morning esp when there is admission and its time to pass meds but relying on the patient or cna's is not safe thing to do.
Apr 8, '13 by JDZ344Can a nurse ask you to give the med with food IF they stay in the room? example: if I am feeding a patient, and the nurse brings the pills and asks me to give me them with their breakfast and then stays in the room to witness that the patient took them? Or would proper procedure be for the nurse to take over the feeding? Obviously, that's different from giving a cup of pills to the NA and saying "Mr X needs these" and walking off.Last edit by JDZ344 on May 14, '14
Apr 8, '13 by hodgieRNNot matter how much trust is given or how much easier it is to have the CNA pass meds during feeding, it is the nurses responsibility to administer the medication.
Nurses are not allowed to administer certain medication that are required by law to be given by a physician. If a doctor is standing in the same room and tells the nurse to push the medication for him/her, that is a violation. The medication must be pushed by the hand of the physician no matter how trusted the nurse is. The situation that OP faced also happens to nurses, and we also have to say "I can't do that. Sorry."
If a medication was left in the room for someone else to give, then the medication was not administered by the proper party. Any nurse who is called to court will not freely admit that they routinely leave medication for the CNA to give because they are busy (unless the CNA is allowed to pass PO meds per the facility policy). The buck stops with the nurse and it is the nurses job to watch the pt take the medication and ensure that it was properly ingested. Pts spit or pocket meds all the time. The nurse is responsible for the proper administration.
Even in the hospital, if a nurse walked up another nurse and said "Here, take this cup and give these opened, unmarked pills to my pt..I'm busy. Don't worry, it's the morning meds and it's all correct." Any nurse would pause and say, "I have no idea what these pills are...you pulled it and you are going to give it."
To the OP, I recommend never giving meds for the nurse (unless it is allowed by the facility). If the nurse accidentally gave you the wrong cup and it ever went to court, the nurse is not going to back you up. She will do everything in her power to save her own behind.
Apr 8, '13 by uRNmywayQuote from yugot2h8I would not have given the medication because in my state, CNAs are not supposed to pass or even "hand over" (I'm sorry, I don't see a difference between the two) meds and a nurse is never supposed to ask a CNA to do so. I wouldn't put my license (or the nurse's) in jeopardy over "passing" vs. "handing over."
I think the difference is something like this:
Where I work, in HH, a CNA can take prepared pills out of a pill box and put them in the patient's HAND (mind you, not directly in their mouth). We work with catastrophic patients, and they can assist the patient's hand to their mouth, so long as they don't physically place the pills in the patient's mouth for them. These are all lucid, oriented patients who can refuse the meds, keep their mouths shut, etc. A nurse or family member of the patient prepares a weekly pill box for these patients. So this would be more of a handover situation. Our CNA's are NOT allowed to take a medication out of a pill bottle, even if it is just Acetaminophen. I think that would constitute more of a med 'pass'.
Do I think OP did the right thing? Yes and no. In the hospital setting where a nurse is PRESENT, as the nurse, I would not leave a medication for someone else to administer it. If it was being given during the meal, I would stand and watch until completely ingested (If placed in a similar position to a PP, where patient refuses anything if not done by certain staff member).
However like others have said, if you didn't want to give it, knowing it was out of your scope, you should have handed them right back to her. NEVER leave medications at bedside. Ever. Even if the patient tells you they will take them in a second. In nursing school, this will be addressed.
Apr 9, '13 by KelRN215, BSN, RNQuote from KatieP86I would advise you to do neither. You, as an NA, do not know what meds are in this cup of pills, if they are the right pills, the right doses, etc. What if the nurse made a mistake and then you administered these meds? It is not within your scope of practice as an NA to administer meds and both of you would be liable if something happened to the patient. The nurse may have made the mistake and brought Mr. X's meds into Mr. Y's room.... and Mr. Y is really allergic or something to one of these meds. Saying "the nurse told me to administer these meds and stayed in the room" would not save you if something happened to the patient. And if the nurse is standing right there in the room, why can't he/she just administer the meds like he/she is supposed to?Can a nurse ask you to give the med with food IF they stay in the room? example: if I, as a NA, am feeding a patient, and the nurse brings the pills and asks me to give me them with their breakfast and then stays in the room to witness that the patient took them? Or would proper procedure be for the nurse to take over the feeding? Obviously, that's different from giving a cup of pills to a NA and saying "Mr X needs these" and walking off.
I myself have done the first one (feeding with a nurse right in the room). I would not be comfortable to give them with food if a nurse was not present. What if the patient asks what they are are or what they are for?
Apr 10, '13 by boogalinaIn Oregon, as I'm sure is the case everywhere else, the only settings in which CNAs may LEGALLY administer medications is when working for a home health agency, or in assisted living. A CNA who becomes a CMA may administer PO, TD or TF meds in LTC/rehab facilities (no IV push or IV infusion). Period. Anything else is outside the CNAs scope of work (not scope of practice, only nurses, NPs, PAs, MDs, etc. have that).
You have no knowledge of what's in that med cup! Don't get involved, no matter how much you like/trust the nurse.