Fired for letting CNA give meds in pudding

[Nurse Beth, MSN]

Dear Nurse Beth,

I work through an agency, one of the nursing homes I work for just let me go for mixing medications in pudding and letting a nursing assistant give the medication. This was my error. I learned the CNA got fired also and they told her it was reported to the board. I'm assuming they reported me also. How soon will the board notify me and my license be revolved. I have no other prior offenses?

Dear Fired,

What you did was not necessarily wrong, it may have been wrong in your organization.

You do not say what state you are in, but many states allow RNs to delegate medication administration to unlicensed assistive personnel (UAP) in nursing homes. (CNAs are certified by their state agency, but not licensed). Some believe that delegating medication administration to competent UAPs frees the RN up to meet the complex needs of nursing home residents.

As an RN, when you delegate, you must follow the rules of delegation. You can delegate tasks within your scope of practice to a competent and trained UAP you supervise. You must also delegate within your facilities' policies, procedures, and protocols, which should align with your state's statues.

This last part is what caused you a problem, as clearly your organization does not allow delegation of medication administration.

While employers may say they reported you to the board, that doesn't necessarily mean they followed through and actually did report you. Sometimes it's an idle threat. Even if you were reported, each case is handled individually by the BON/BRN and there is a good chance nothing will come of it.

In the future, make sure you know your organization's policies because they protect your practice. I always say, you have to know the rules before you break them.

I'm not seriously advocating breaking the rules, but it's really important in your practice to know when you're practicing in your lane and when you're practicing outside of your lane.

Again, hopefully nothing will come of this.

Best wishes,

Nurse Beth

Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!