nurse not giving her meds.. should she be fired?

[cant_not]

Hello,

I've visited this site for quiet awhile but recently decided to join. Anyway, I'm an aide (hope to start nursing school really soon..) I work in a long-term care facility in Kentucky. We're a rather small facility, housing only 57-60 residents (60 = max). One of our patients there is hospice, and has been for some time (from my understanding, I've recently moved here from WV, and started working there in Feb). A popular thing there is that if you have a resp. over 24 there's like a standing order for morphine? Or something to that effect. Anyway - To get to my point, I'm basically new there - This poor, dying resident, whom is obviously in pain and has a resp of 28 ask for her morphine. I told the nurse promptly, like I'm supposed to do- she said that the lady has a history of drug abuse - she "knew" because she was friends with her daughter, so instead of giving the morphine, like she's legally entitled to do - she gave the lady cranberry juice.. Passing it off as morphine. I reported this to the ADON - and she said she'd take care of it. Well, 4 days later - the same nurse did the same thing. I brought it to the ADON's attention once more - and still, they haven't done anything about it. Several of the other aides have reported this as well. Should she be fired? I think so...

This is still going on, on her shift anyway. From my understanding she's not signing the morephine out of the book - so I've heard there's nothing anyone can do. I plan on finding employment elsewhere very soon.. I just think that this is so...disturbing. I've been an aide for 3 years now, since I finished HS and I've never seen anything like this :chair:

[steelcityrn, RN]

Call and report your story a.s.a.p. to the state and let them handle it from there. Those who are in charge and know this is happening will be found just as guilty. This story is actually disgusting!

[NurseyTee]

There are too many nurses who have a God complex. Most of us do not but I've ran across a few that think they have the right to deny a patient pain meds just on their own assumption that they "think" the person isn't actually in as much pain as they state they are in. That is for the Doctor to decide and for the nurse to administer his orders, period. We are given parameters in which the analgesics are to be given and if the pt. requests them within those parameters it is not for the nurse to deny the pt. those medications. Nurses like this make me want to pull my hair out!! How would they like to be the dying hospice patient denied medication for comfort while passing on. She should lose her license for this.

OP, PLEASE, PLEASE contact the state about this. You may be the only advocate for this human being. Bravo to you for standing up for the patient.

[Tweety, BSN, RN]

I know in Canada a nurse cannot also administer a placebo without informing a patient that they are receiving a placebo

I believe that a person must consent before having a placebo, which means that they could sign a general consent for a treatment that says that may, or may not receive a placebo instead of the actual drug or treatment. They don't necessarily have to be told that they are getting the placebo, but they do need to consent to the possibility of that happening.

JS

At the very least there must be a doctor's order to administer a placebo. For a nurse to decide a patient is a drug addict and needs cranberry juice instead of Roxinol is practicing medicine without a license. Very unethical.

[Daytonite, BSN, RN]

I've worked in nursing homes a lot and seen some similar stuff as an RN. Most recently another RN who just wasn't giving patients their medications. I was chomping at the bit to get her out of the place, but like you, had no authority to do anything other than keep reporting her. And, that's what I did. I kept reporting all the incidences I found of her not giving medications. I put it all in writing. What I can tell you is that the DON's hands are tied if nothing is put in writing or witnessed. Even then, things sometimes move very slowly. In the circumstances you've described the nurse could be in trouble with the state board of nursing and the facility with your state department of health. They have to have impeccable documentation to back up any claims against the nurse. Worse still, and I hope this is not the case, the DON could be conspiring with the RN and approving her actions.

You're in a difficult situation because you really have no authority except to report what you've seen. I found after my situation I mentioned above was resolved that several of the CNAs were aware of what this RN wasn't doing but were afraid to speak up. You always have the option of reporting this to your state department of health or the state board of nursing as a concerned consumer yourself, especially having witnessed these events. You will not be a popular person with the bosses at the nursing home, however, and it is quite likely that your complaint will not go anywhere because there won't be enough documentation for the state to take any action. However, the state may have to inform the patient and her family that a complaint has been filed and that the patient is at the center of it.