Hi everyone! I am having some severe anxiety about this so I just need to vent.
Last night I sent a pt to the hospital because he had elevated temp. Charge nurse said to send him.
So I did.
I later find out today, that the pt had several nitro patches on him. NOW. Here is why Im stressed, the daylight shift puts the patch on in the morning, and 311 takes it off at night (me). The pt is pretty 'with-it' and often takes the patch off himself. Each night I ask him if he took the patch off. If he says yes, I ask where he put it. He usually will stick it on his newspaper, or some other random place in his room. If he says no, he takes it off hands it to me and I throw it away. SO I am so confused as to how there was several patches on him. Im freaking out because I feel like this is completely my fault and I should have made him take his shirt off and let me strip him for the patch. I have worked the last few nights, and each night I ask him, he shows it to me, or he takes it off. The daylight shift never writes in the mar where they put it, nor they they right the date on the patch which would have been helpful to know that the patch i saw, or he gave me was the one from that day. I am just so upset over this whole situation. Im so scared Im going to get fired, but even more concerned about the pt. Any advice would be helpful =(
I'm not a lawyer, but it seems to be that you are performing duties that CAN NOT be delegated to UAP. What your doing is practicing nursing w/o a nursing license.What you are doing could have legal consequences for you. Be careful.
Many states do allow UAPs to administer meds. Since we don't know what state the OP works in, I would bet that she works in one of the states where this is allowed.
Ok, I do get why she is in this position. In AL, the patient is responsible for themselves. They are concidered competant and oriented, although maybe a bit forgetful. Technically, the poster is not administering meds. They SHOULD be doing the equivalant of checking up to make sure the resident took their meds 'this evening', not 'as ordered'. If he had 3 patches on and the EMS didn't slap them on there in route, I agree with pixie99, he needs to be assessed for a higher level of care(LTC perhapse instead of the autonomy that he has in AL) This means, technically, she's not responsible for the patches being on there. I am oriented and cohierant(as this resident has been deemed by his physician) and if I want to say I took my meds or didn't or removed a patch, without checking or doing so, this is irresponsible, but not illegal. It is no one's responsibility but mine. If someone is paid to remind me, they may do so, but they have no right or obligation to force me. In LTC(where he NEEDS to be) there would be more meticulous med observation by staff who was legally responsible to assure that he got the meds and that it was documented and signed behind by a license.
I'm not a lawyer, but it seems to be that you are performing duties that CAN NOT be delegated to UAP. What your doing is practicing nursing w/o a nursing license.What you are doing could have legal consequences for you. Be careful.
The OP is a med tech. It is legal for her/him to pass meds per the MAR.
I don't understand why a PCA is responsible for someones patch, especially nitro. Is this a US thing?
The nurse who does the meds is responsible. Also you should not be letting the pt take his own patch off. Tell him to cease this, the nurse must do this & document as such, ie: patch taken off/put on, time, place etc. This is a very dangerous drug: if he has too many patches, his BP could drop WAAAY low and all his vessels could dilate, as nitro is a powerful vasodilator.
I'm baffled at some of the practices that CNAs can do - no way this would be allowed down here!
This is an example of faulty med practices and slack care IMO.
On many discussions on AN, it has been said that an MA works 'under' the MDs license....so that if somthing happens in the doctor's office, the error committed by the MA will fall back on the doctor. In this case, is the UAP working under the RN's license? Would a med error reflect back on the RN even thought the RN did not play any role in passing the med? If so,I cannot imagine handing the duty of passing med off to a med tech without having any idea of what is going on, even if it is legal...just a thought.
I interviewed for a "assisted living" facility in another state once no they do not "have to" have a nurse on duty..ever really. UAP can give "remind" residents to take meds. Nurse aids do not have to be certified or "state tested". They were interviewing for a nurse because they thought it would make them look better and seem more appealing. They did not have a nurse staffed during the night. Totally legal.
I think that's the thing: is the OP talking about a LTC or an assisted living facility?! I posted earlier under the assumption that it was an LTC, based on the OP's screen name. Shouldn't assume, clearly!! For sure the rules/regulations/laws are going to vary wildly based on WHICH sort of facility she is employed by!
i will almost garantee that OP works for an assisted living facility. i do exactly what she does, full med pass with 18 resident, including crushing pills and putting them in apple sauce and spoon feeding them, and insulin admin... its def more that "reminding" them to take their meds, but its completely legal for some reason. i took a one day med admin class and a one day diabetes education class.
im in the process of switching jobs and becoming a pca at the hospital because i feel like its just unsafe. we are getting a 30 minute class next week on how to ASSESS a fistula, listen to the bruie (sp?). i dont see why this is allowed. im thankful for the experience but it scares me a little.
glencovediva
82 Posts
I'm not a lawyer, but it seems to be that you are performing duties that CAN NOT be delegated to UAP. What your doing is practicing nursing w/o a nursing license.What you are doing could have legal consequences for you. Be careful.