New CNA- Need advice on passing medication

[melijm]

Hello. I started my first job as a CNA in NJ last night. We are not allowed to pass meds in this state. I need advice before my shift this evening. Last night I was working under an LPN that seemed very overwhelmed as he had to pass meds to about 50 pt's in the LTC facility. I was warned about nurses who try to delegate to CNA's things we are not allowed to do and found myself smack in the middle of a situation last night and not wanting to make waves, I followed his direction. Heres what happened...the LPN was a black man. He was trying to pass evening med to an elderly white woman. She was pretty adamant about not liking black people and not wanting to take meds from him. He expressed his frustration to the 2 other CNA's I was working with...both black, I'm white. He pulls me aside and says something like this, I need help, you are not allowed by law to do this and if anything happens I have your back...yada yada...(all while crushing a pill) and proceeds to say "she will have a heart attack if she doesn't take this med" A scare tactic as it was Ativan. LOL, Then he says see if she'll take this from you. I stand there, my heart pounding, my teachers voice in my head (I just completed the course) talking of nurses who break law, knowing I shouldn't be doing this...and I did I walk into the room, she's full of smiles and happily eats the med-pudding of a spoon. I go back to cart and hand him empty cup. He then says "Lets see something" He puts 2 green pills in a cup and says "come with me" I accompany him into her room and he says "I have meds for you" She looked bewildered and then put hand out to take pills. He takes them away and says "Ahhh...now I see" and walks out. I just looked at her at a loss for words and said "Thank you, good night" and walked out. Now...tonight I have to work in same situation. Tonight I will say "I am not allowed to do this by law" and not be intimidated. Any advice? What can I say that will hit home that he can't do this to me and not cause issues. I keep thinking...my first night as a CNA and I broke the law, I could have harmed a patient:no:. HELP! Thank you!

[Meriwhen, ASN, BSN, MSN, RN]

1. Do NOT do it again.

2. If asked to do it again, put your foot down and refuse. Tell them that you both could get into trouble and that you don't want that for either of you.

3. If this continues or if you're feeling uncomfortable, start looking for a new place to work. This nurse will "have your back" until something bad happens, and then guess who gets thrown under the bus? Probably the nurse...but they're damn well going to take you with them, since you did act outside of your state's law.

If you have concern about legalities, talk to a lawyer as we can't give legal advice here.

Good luck.

[melijm]

OK, great advice. Thank you. I don't want to mess this up as it's a great place with exc pay and benefits, incl 42 paid days off per year. Tonight I put my foot down and Sunday the "white" nurse is on. He's filling in apparently.

[MrChicagoRN, RN]

I'm puzzled by the last part. It doesn't make sense to me.

The two of you returned to the same patient, and she was willing to take needs when you both were present?

Simple solution is that you may go into a problem patient room with him, but won't touch or administer the needs.

[melijm]

Yes..at first he tried to administer the med alone and she refused, that's when he came to get me. She took the original med he crushed from me and then he wanted to do a "test" to see if she would accept meds from him while I was present...and she did. I feel like I put a huge scar on my new career by doing that. I am non confrontational and didn't want to make anyone mad in the moment but after things settled and I thought about it, I was wrong as well and will not do it if requested in the future. I will help him but will not give it myself.

[jennycRN]

First, I'm glad that you are unwilling to perform tasks that are outside your scope and could jeopardize patient safety. On very rare occasions there have been patients who take an automatic dislike to me and I have asked CNAs to spoon feed them their meds (while I am directly supervising in the room).