Help lpn pediatric homehealth

caliotter3 · Mar 15, 2009

You are within your rights to refuse to administer meds that you have not drawn up. I have explained this to parents in the past and they have always relinquished that chore. Offer to have the parent watch you do it to allay their fears. Once they see that you know what you are doing, they should be ok with it. I would not back off on this. As for the other, I had a family that did all care with one parent for the first half of night shift and the other taking over. They had me assist and said that I was basically there for backup. This was in line with their particular case and there really is nothing wrong with it as long as you appropriately chart and make it be known to them that if the occasion arises, you will call 911 first then get them. And you must take other steps to help the child while awaiting the paramedics. If they do not agree to this, then drop the case. Being unemployed is better than working with your license in continuous jeopardy.

Added thought: You need to discuss this with your supervisor and stand your ground. This is an example of the trouble caused by nurses who take the easy way out. It is almost impossible for you to do what is correct when the client can say that "the other nurses do it" in a confrontation. If your supervisor is good at their job, they will call the other nurses in and correct their bad practice. Likewise, the supervisor will have a talk with the parents and lay down the law. Don't work on this case if the opposite occurs. Your supervisor can't force you to jeopardize your license.

treeBranch · Mar 15, 2009

I do agree with Poster #1 :yeah:and add the following:

I sense in your thread that you also concerned that because the other nurses are allowing this mom-med behavior to continue that it will make it more difficult for you do the appropriate intervention. I suggest you sit down with your DON and request a team meeting on the case and everyone get on the same page immediately. If this is not possible, consider another case. If it is possible, whomever has the best rapport with the mom should be the band leader to educate her why there is a change -- but most importantly have the skills to not offend her as a parent. The dynamics of her doing this involve more than control --- she is the parent. Personally, I never had any trouble with parents, because I knew the balance of parent versus nurse. However, if all of the health care providers are not on the same page it will breed problems for both the parent and them. Why? Because triangulation and confusion will ensue.

dreamjob25 · Mar 15, 2009

Just as a nurse could mistakenly draw up the wrong med or wrong dosage, so could this parent and if you give it, its your med error.

SunnyAndrsn · Mar 15, 2009

Ditto what the other two responses have already said regarding the meds. Someone from the homecare agency office should explain this to the family as well, and make sure that your supervisor knows that mom is stating the other nurses are doing this. Do you have a communication book for the nurses to use? Bring it up to the other nurses there as well.

As for mom not wanting you to disrupt the child's sleep, what concerns do you have? Unless the child is at risk for skin breakdown (easy enough to assess for) then I would agree with mom, leave the kiddo undistrubed, as much as you can and still provide good nursing care for him/her. Document mom's refusal of cares "Mother declined to have child repositioned, CMS intact, no pressure/skin concerns noted."

Always CYA...