medicarelpn

I wasn't going to reply but after reading several of these posts I just have to. Having medication aides can be bittersweet. I started as a CNA then got my OMT which in Iowa stands for oral medication technician and am now an LPN. I have worked in several different facilties as an OMT and my duties have varied slightly in each one. Basically in Iowa med techs can give oral meds but must have PRN medications and narcotics co-signed by a nurse. We could apply topical ointments and do treatments if there is no open wound. We could do nebulizer treatments and give supps. and enemas. We could not do injections but we could do blood sugar checks if we had been trained and had that training on file. We could not do G-tube meds. Any charting we did had to be co-signed by a nurse. We could not take doctor orders or write telephone orders and we could not do anytype of assessments. The most recent place I worked as an LPN on 2nd shift I would charge the back half of the facitlity and the OMT would charge the front. Although in actuality I was really charge of the building. I would come up to the front and do the insulins the tube feeders the assessments and not the orders. The OMT's I worked with her were very good, but I have also worked with some who were not that good . I stand up for med techs because I was one and I know I was very good at my job, but at the same time I do worry at times because me liscense is on the line if they make a mistake.

What would you have done, we have a resident in my facility who had a major MI a week and a half ago. They did a cardiac cath and put in a stint. She came back to the facility about a week ago. Last Friday when I came into work at 6am the night nurse told me the res. had c/o chest pain, but the nurse thought it was just anxiety so she gave her an ativan and maalox for indegestion. Well I called the cardiologist to give him an update and possibly get an order for nitro. since she had not come back with an order for any nitro. Well the cardiologist said due to the size of the stint he really did not want to give any nitro at this time but if the chest pain continued he may. He said for now just to monitor her. Well she was fine the rest of the day. I was off this weekend and when I came in on Monday, I guess she had continued to c/o chest pain so they had gotten a nitro order, but they had not given her any over the weekend, they had only given her ativan. As soon as I got there Monday morning she said she couldn't catch her breath and had chest pain she rated as an eight. I checked her vitals asked her if it was radiating anywhere, it wasn't and gave her a nitro. The order read give 1 every 15 min up to 4 times if no relief send to ER. Well she had 4 over an hour and her chest pain had not allieviated. I called the doctor and told him I was sending her to the ER. When the paramedics came she was in and out of A-fib and was admitted to the hospital. The nurse that had given her the ativan was there when I gave her the first dose of nitro and she said I would just give her and ativan. When I gave her the nitro anyway she went to the other nurse and said "Well if she doesn't want to benefit from 26 years of nursing experience, that's just ridiculous." But I don't feel you should disguise potential heart problems with ativan. What do you all think/

This did not happen at my facility it was a facility my friend works at. At the facililty I work at we have double and triple check systems to keep this kind of thing from happening. I do not know if an incident report was filed or not as I do not work at the facility I do not have all the specific details. Myself though if I'm am giving meds, when I look at the med sheets If we do not have a med or I feel there is a question about the med I immediately get into the person's chart to try and find the original order, then check with the pharmacy If I still have questions I call the MD.

I will try to make this as brief as possible but I would like to know what you all think. A friend of mine who works at a different long term care facility than I do called me at work yesterday and asked me to come over to her house when I got off of work, because she needed to talk to me. When I got to her house she was on the phone with her DON. When she got off the phone she told me a couple of weeks ago they had a resident that was admitted to her facility on Saturday evening, the nurse that did the admit (not my friend) wrote up her medication orders. This lady was 57 and had been in the hosp for MI, she had an order for coumadin but the order was not clear so she wrote pending on the order and it was supposed to be followed up on the next morning by calling the docter. This nurse also wrote on the med sheets Coumadin (pending). Well 4 days went by and no one followed up on the order. On the fourth day she was admitted to the hospital with a blood clot and died. Her DON wanted her and all the other nurses to write statements that pretty much stated that they were negligent, she told my friend that this would go no further than her and the administrator. The family is irate understandibly so, my friend was so upset that she may lose her liscense I didn't want to tell her that she was partially at fault as she along with the other nurses did not followup on this order. But I did suggest to her she not put anything in writing until she talks to a lawyer. What are your thoughts on this? What advice should I give her? :uhoh21: