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

Nurses General Nursing

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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:

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

Don't presume "they did nothing about it" unless you are a fly on the wall privy to every conversation that goes on.

However, you should be concerned for your patient. This nurse needs an inserving on medicating they dying patient. The fact the patient has a history of drug abuse means perhaps the patient needs more pain medicine, not less.

What's she's doing is very unethical. She needs some serious counseling and if noncompliant should be fired. I'm being kind here, because I get angry when I hear about this kind of stuff, very angry.

Continue to be the patient's advocate and report each and every time this nurse does this. Unfortunately you can't be the judge and jury for the nurse, that's not your job.

I agree with Tweety, continue to report this each time it happens. Something may be being done, it would not appropriate for an ADON to discuss what actions she took, unless it is to their superior.

I agree with the above. Just because the patient has a previous hx of drug abuse, what the heck does it matter now? She's dying. She's in pain. That pain needs to be addressed.

Did you know that doctors and hospitals have been sued because they did not properly manage a person's pain? Maybe your DON needs to be made aware of that.

Specializes in Maternal - Child Health.

I agree that it is not possible for you to know what has been done by the DON to address this nurse's behavior.

However, you have continued to witness similar events where the patient's requests for pain meds have gone unfilled. THAT IS ABSOLUTELY UNACCEPTABLE. I don't usually wish ill on anyone, but how would that nurse like to be in agonizing pain, only to have someone deny her request for medication, or try to "trick" her into thinking that she is receiving it?

The next time the patient asks for pain medication, if it is not promptly provided, PLEASE call the charge nurse or DON (at home if needed). It should not be your responsibility to ensure that patients get their requested pain meds, but I don't se any other way to make sure it happens.

God bless you for caring for this patient.

Specializes in Utilization Management.

Fired? She, the DON, and the facility, could all lose their licenses!

You're saying that the nurse:

Is undermedicating a patient in pain.

Is misrepresenting a medication--in effect, giving a placebo instead of a narcotic. Unethical and illegal.

You're saying that the facility (through the DON):

Investigated and lied about the situation instead of correcting the problem and reporting the nurse to the State. Again, very illegal for all involved.

If you are sure that you saw a nurse giving cranberry juice instead of morphine and telling the patient that it's morphine, yes, that's wrong. Doesn't matter what state you're in, there's still a chain of command, and the next step is for you to call the State. They will investigate the allegations.

Did you know that doctors and hospitals have been sued because they did not properly manage a person's pain? Maybe your DON needs to be made aware of that.

That's true. In fact the amount of documentation now required at my facility in regards to pain is ludicrous. Essentially it is being done because to CYA in regards to adequate pain control for patients. Bear in mind I said that I consider the documentation we are required to do in regards to pain is ludicrous, not that adequate pain control for our patients is ludicrous.

so instead of giving the morphine, like she’s legally entitled to do - she gave the lady cranberry juice.. Passing it off as morphine.

Another point, one could consider this as administering a placebo, which as a nurse she cannot do this without a physician's order. I know in Canada a nurse cannot also administer a placebo without informing a patient that they are receiving a placebo, I don't know about the US.

Specializes in Urgent Care.

the next step is for you to call the State. They will investigate the allegations.

:yeahthat: ....................................and that nurse is a :troll:

kewl new smilies there, I havent been around much lately

Specializes in Urgent Care.
I know in Canada a nurse cannot also administer a placebo without informing a patient that they are receiving a placebo, I don't know about the US.

hmmmmm........I dont think it is a placebo if the PT KNOWS it is a placebo. I understand that in reply to th OP this nurse should not be doing this. But if you tell must someone when they receive a placebo, then how could you do a double-blind study to determine effectiveness of meds?

hmmmmm........I dont think it is a placebo if the PT KNOWS it is a placebo. I understand that in reply to th OP this nurse should not be doing this. But if you tell must someone when they receive a placebo, then how could you do a double-blind study to determine effectiveness of meds?

I agree that giving a placebo and informing the patient it is a placebo is pointless. What I was referring to was not double-blind studies for research. What was being referred to would be an instance involving a physican ordering a placebo in lieu of a medication, for instance ordering a placebo in place of an analgesic.

Specializes in NICU/Neonatal transport.

There was just an article on this in the AJN.

Basically how it is comepletely unethical for people to give out placebos, especially for pain. If there is pain, there is pain. Even if the pain is imagined or from psych issues, giving a placebo isn't going to fix that issue, it's just people trying to shove the patient under the carpet so they don't have to deal with them.

No one who is dying should be in pain.

Specializes in GERIATRICS, DEMENTIA CARE, MED-SURG.

Call the abuse hotline. One of every patients right is to be given pain meds.

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