PMR1027

In the LTC facility where I work on weekends, they are blatantly circumventing this law. They have a policy in effect that states that the nurse holding the narcotic keys has to stay for the next shift if they were short staffed on that unit (there are 2 nurses to all units on the evening shift, which is 3p to 11p). My shift is 7a to 7p every other Sat/Sun. On Saturday, they did not schedule a nurse from 7pm to 11pm at all- so I was mandadated to stay. On Sunday, they left a nurse that was terminated on the schedule, knowingly, and I was mandated to stay from 7pm to 11pm. I am filling out a department of labor complaint form. They are going around the nursing home like hotcakes. Several nurses are filling these forms out and handing them into the department of labor. They are making no effort at filling the staffing holes, either. We cannot be the only place this is happening at, either.

EmergRN: TY for the info that it can be given in the arm, if necessary. The facility I work in forbids it through policy, though. Have you heard anything of this affecting the PT/PTT and INR? It may be the nurse giving the injections that caused the bruising- with this particular drug I have heard from several patients that certian nurses give it so you do not feel it and it does not bruise, and other nurses give it and it hurts bad and bruises. I have had one woman who would only let me give her lovenox after her knee replacements. I could see in very thin patients where you could inadvertently give it IM.

In the LTC where I work, Orders must be given by a Physician, PA, or NP. You have to be allowed by NYS to prescribe medication in order to give telephone orders, to my knowledge.

Lovenox is a Low Molecular Weight Heparin. It should only be given in the abdomen, and only subcutaneously. I take care of alot of postop patients in my subacute rehab unit, and administer this drug daily.You cannot give it IV, but I do not know why.

I think you did the right thing. In our LTC/Rehab Facility, we had problems with a nurse abusing all kinds of opiates. Our suspicions started when entire supplies of non-narcotic meds were coming up missing, and patients were magically asking for all kinds of narcotics when she was working, when these patients were not taking them when any other nurse was working. This opened up a huge can of worms, but it is now going towards fixing several problems with medication administration in our facility.

I work on a subacute rehab unit in new york state- I work under my own license and do weekend and relief charge, on top of my patient load. RN's typically are charge/NM during the week, and are in supervision. The problem in NY is that LPN's are not allowed to assess because the state thinks we are no longer educated enough (And that is DESTROYING our health care delivery system, might I add!) and we do something called "Data Collection" where RN's have to make any and all critical decisions, based on the LPN's findings! (I'm sure everyone can see where that has the potential to go wrong, as well.)

Coumadin - Causes Increased Bleeding (This woman was also convinced that the Gastroenterologist found a peice of stool in her colon that was going to kill her- She only drank half of her colonoscopy prep the night before and refused the other half because of diarrhea) Morphine/Demerol- Confusion Narcotics - (Sister was a drug addict) Codeine- Nausea Also heard various antibiotics cause GI upset, especially Augmentin The list can go on and on..........