Accused of not giving dilaudid

Nurses General Nursing

Published

I had the misfortune of taking care of a patient last weekend. This patient was a friend of mine that I have not associated with in years. This acquaintance is the type of person who called the cops on a restaurant due to they added the tip into her bill and she didn't want to pay. One of the reasons I stopped hanging out with her was due to she would ALWAYS complain about poor service when we went out to eat; the most memorable experience my birthday was ruined due to her complaining about the service at a restaurant that was fabulous. I met her at a salon and she had started doing my hair and we became acquaintances/friends. She brought me Thanksgiving dinner when I had to work a few years ago. So, she's my patient last weekend. She had her arm bent showing me pictures of the gas station where she fell and broke her arm meanwhile telling me she has a lawyer. I asked her to straighten her arm because the IV was in her AC so she did and I administered 1mg dilaudid. The MD that same day increased the dilaudid dosage from 1mg to 1.5mg but the day shift rn told me in bedside handover report that the patient did not want 1.5 md she only used/wanted 1mg. I asked her if she wanted 1mg or 1.5mg and she said she only wanted 1mg. I gave 1mg dilaudid and then flushed her. She continued telling me her story and the flush syringe fell off bed; patient's husband pointed that out. I found out after the fact that this patient put up a big stink the last time she was admitted for hip surgery posting two nurses names on Facebook saying they were not compassionate etc one of the nurses I was working with that night is one that the patient posted about on FB; she told me she would not ever take care of said patient and because of said patient she switched from full to part time she also told me that another nurse who is a day shift charge quit over that same patient but later came back. I said to myself I wish I had known this before I took this patient. Well back to my point, this patient stated after I gave her the 1mg dilaudid that she didn't feel it. I offered the extra 0.5 mg (which would be 1/2 of the 1mg syringe) and she agreed to take it; I gave it to her. After all this the patient calls my charge nurse to tell her she can't believe I did this to her accusing me of not giving it to her I guess. After I left the room I wasted the 0.5 mg left in the syringe. My question is, how do I prevent someone from accusing me of not giving them their medicine. My thought is that I tell them when I give it to them that I am giving them the 1mg of dilaudid right now. Do I always bring a witness? I wish we could wear cameras. Make a point of verbalizing what I'm doing. Any suggestions? This has bothered me. the patient posted on FB negative things about the hospital and my cohorts about her last stay and the hospital apologized to her. This experience is making me question my career choice. To this day I have thoroughly enjoyed nursing. I LOVE nursing. I love teaching nursing. I love my coworkers and the clients I serve. How do I not allow this experience to taint my satisfaction and love of the field? Can someone's claim be substantiated even if it's false and I lose my license?

Thank you.

P.s. It is my goal to further my education (current BSN want MSN in clinical nurse education) because I love nursing and education so much. I intend on always having hands on nursing care but want to teach too. Just and FYI.

They can drug test the patient for levels. I have seen physicians order it before and tell the patient why they need to draw them.

The patients that lie back off VERY quickly.

From a legal standpoint, it is inappropriate to deliver partial doses of medication without obtaining a new order. (I realize that doesn't apply in this situation because OP ended up administering the ordered dose, but there seems to be some confusion on the matter.)

Yes, patients absolutely have the right to refuse ordered medications. No, that doesn't give them the right to prescribe their own dosing preferences.

If you had an order for 1,000 mg PO acetaminophen, you wouldn't allow your patient to say "No, thank you. I'd like to refuse oral administration but still want this medication. I'll take 1,000 mg IV acetaminophen instead." Same concept!

It goes back to the 5 rights and prescriptive authority.

By all means, advocate for patients to get smaller narcotic doses if they prefer. Just make sure you're going through the proper channels to do so!

Edited to add: I just noticed that some replies indicate facility policies allowing for partial dose administration, which is great. There'd still need to be a standing order supporting the policy for this to be a legally sound medication adjustment though.

+ Add a Comment