It my opinion, it does not seem like elder abuse. I would definitely write down everything that happened while it is still fresh in your mind. If I do not have an order for a medication, I do not give it. And depending on your policy r/t med administration, you did what you were supposed to do. You assessed, did your intervention, and you reassessed the patient. This is what i would have done. Patients will complain and make statements, just make sure you documented what you did and what the patient said. Documenting that the patient is confused is appropriate, crazy inappropriate. If the pain was controlled until the cath, then it doesn't seem like an issue. Unfortunately, these types of facilities are way understaffed and high patient to nurse ratio. And sometimes CNA's will try to make judgement calls when it is out of their scope to do. Recently I had a family inform me that we needed to D/C patients colace (pt on BM protocol r/t constipation r/t opioids). So because the CNA has to change the patient, they made a comment about us (Hospice) d/c the med. I politely let the family know that the LVN/RN on duty has the authority to hold a med for loose stool. Just document for your own records.