Hi all nurses out there,
This is my first post here. I am currently a Student Practical Nurse, but I have worked for a year as a Medication Aide in Long-Term Care. I was wondering if anybody else has come across situations where they felt that Narcotics were given for the wrong reasons. I have had two confrontations with other staff members about the use of narcotics.
The latest confrontation I have had was with a CNA on one of the halls where I was passing meds. We have a resident on that hall who has a habit of wandering, calling for nurses, she is confused and will call for you if she sees you walking by her room. Most of the time she will quiet down if you find out what her need is and take care of it. That evening the CNA came down the hall and told me that "She is getting on my nerves, she won't shut up. Give her an Ativan." I told her that she will calm down by herself if she finds out what she needed, but she got mad at me and run off. After that I walked down to the residents room to see if she really was as bad and restless as the CNA said and found her covered up in bed yelling "I want to be warm!!!". Her thermostat was set on 55! (for the CNA confort, not the residents) I turned up the thermostat, covered her up with an extra blanket. For the next 2 hours the resident was quiet without the use of Narcs.
My first confrontation was in a different Nursing home with an RN. We had a resident who after she was put to bed after supper would yell for help for about 30-45 minutes. If you asked her what she needed she doesn't even remember yelling
we all had those kind before. One night the RN on duty was in a bad mood, has had a bad night, and was tired of listening to her yell. She told me to give her a Lortab 7.5/500 to get her to "shut up and go to sleep". I told the RN that the resident will go to sleep by herself in about 30 minutes, she doesn't need a Lortab. (the resident was also on Duragesic Patches, and her pain was being controlled, she would specifically ask for pain pills when she did hurt) The RN told be that she wanted her to have the Lortab and I better do as I was told. Pretty ticked of at the RN now, I opened up my MAR to the residents page, looked for the doctor's orders and told my RN that her doctor has prescriped "1 Lortap 7.5/500 q6hr prn Pain" not "1 Lortap 7.5/500 q6hr prn for staff convienience and chemical restraint" (yes I know, I was a mere CMA arguing with the BSN RN about her decision) and I told her if she wanted the resident to have it she will have to sign it out herself and give it to her, because I did not feel comfotable dispensing that narcotic under this situation. She ended up signing it out herself and giving it.
I wonder if any of you out there have had similar experiences and what you think about the use of narcotics for staff convinience.
Let me know what you think.