overstepping boundaries?

Nurses Medications

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I am an LPN student with one semester left of school.

I worked the cart as a TMA last night (NOC shift). I was helping the aide put a resident on the bed pan when she asked me if I was going to give the resident her medications. It was 0330 and her medications were not scheduled until 0600. I said no and she proceeded to tell me that's how all the nurses did it because they did not want to wake her up again. I asked a nurse on another lane (who frequently works the wing I was on) about it and she agreed that that's what they'd been doing. I told her I was uncomfortable doing that (and that, perhaps, I was being paranoid because I just finished a pharmacology class). She said she would call the RN manager to seek clarification. Fast forward to today, I was called by the RN and told to not overstep my boundaries and question a veteran LPN because they don't like it. Kind of took me by surprise...

There was no malice intended in asking the LPN about the med; if I wanted to get her in trouble, I would have gone straight to the RN.

Did I overstep my boundaries? The meds were sinemet and comtan and I feel that those are important to give on schedule

I probably would have done the same thing. Or just said I cannot give her meds at this time and left it at that. knowing that meds are to be given within one hour of their ordered time, if she wakes at that time every night to use the bedpan then one if the "regular" nurses should have had the medication times changed. Continue as you know you need to, not as the nurses think you need to. Don't find out the hard way when you get in trouble through your school for not giving the meds at the scheduled time (or within that timeframe)

You were being safe and thinking critically. You did a good job. The veteran LPN was not teaching you the right thing and you were right to question it.

Specializes in ortho, hospice volunteer, psych,.

Keep reminding yourself that you weren't questioning the LPN because she happened to be an LPN instead of an RN. You were questioning the

order itself and the way in which it was being carrieout, as any reasonably prudent nurse would have done.

I wouldn't have given it that early either. I'd have clarified it with her ND in the morning.

You did the right thing. You did not overstep your boundaries. Your manager is wrong. Ethically wrong too. Veteran status means nothing if you are not following proper procedure.

I think you did the right thing, but I word it in such a way that it seems your school is very strict with med admins, 6 rights etc

Specializes in LTC,Hospice/palliative care,acute care.

This is an example of what often happens in LTC, everyone is too busy just getting through the shift,they don't have time to really stop and consider the needs of each resident. The team of nurses I worked with last year on a dementia unit was awesome-each of us worked a bit of overtime, enough to really get a good idea of the resident's needs (and how they change at sundown) and worked very hard with the physicians to consolidate and reschedule the meds to facilitate both the resident's acceptance of them and streamline the med passes.We were an awesome team.

Specializes in LTC, Memory loss, PDN.

you certainly did the right thing by not intentionally making a med error

giving a med 3 hours early is a med error and you knew that

so you really didn't need confirmation for this

going on and involving another staff member is pot stirring

i know you'll say i didn't mean anything by it, but you are now aware

of multiple med errors and what have you done about it?

all you needed to say to the CNA is, "thank you, but now meds are due at this time"

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