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Nurses Medications

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Hello all,

I need some advice from nurses who have been in my shoes in the past or any constructive advice that can help me move forward from this ordeal. I was terminated from my job after according to my employer's statement, I falsified documentation by scanning medications but physically I did not witness or give PO medications to a patient with expressive aphasia, instead I left medications to his wife to administer.

So this is my side of story.

After scanning all the medications, as I attempted to administer them, however, he (he is a MD) was not cooperative which it could be due to his medical condition or just he didn't want to. I am not sure exactly why he was not cooperative. So I asked his wife (according to a day RN during shift report, she administers medications for the patient) if she wouldn't mind giving them to him. She agreed to it and I left the room. He was not on aspiration precautions so I was not worried about him aspirating, it just takes time for him to swallow PO meds.

I didn't clarify with my employer whether that day RN did the same thing or not but I knew my employer would not have disclosed that info anyway.

I have been working on that floor close to 2 years and sometimes patients are not ready to take their medications right away for whatever reasons, then I would leave them at bedside until they are ready to take. Was this wrong? Was I supposed to chart as "refused" if they didn't want to take them at the time medications were due?

Please help, I think my head is going to explode and thank you for reading my post.

Specializes in hospice.
FYI, LPNs learn NOT to leave meds at the beside of ANY pts; that is a part of Nursing Fundamentals, whether it be a PN, ADN, or BSN program.

Thank you! I was hoping someone was going to say this.

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Absolutely, I can't agree more. I am glad, in a way, this happened sooner than later. I understand that sometimes in nursing practice, there are some situations that are strictly black and white but some situations requires to be flexibl( no matter what policy says) to better care our patients and their family members. Hopefully as I gain more experience in nursing, I will figure out when to, and when not to. AND administering medications were definitely when it had to be black and white.

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Specializes in hospice.

Slightly tweaked, that last post would make a great answer to that dreaded interview question, "Tell me about a time you made a mistake and what you learned from it."

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Red Kryptonite, how would you say it during an interview? I am hopeful that there got to be a job that I would enjoy more but I am very worried that I would end up being at a job that I am unhappy again.

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Yikes, I am sorry that this happened to you, OP.

Going forward, the only thing that you can do is to learn from this and don't repeat.

As an LPN, this was drilled into our heads as well....medication administration is a verb.

"I don't want to take them now, leave them here" "I will have to come back, as the natives get restless if I don't give you these babies myself. I will be back in 45 minutes, OK?" Then go back.

The family member that administers? "I know that I am lurking, but I have to observe you giving the meds. To be able to document medication education, do you have any issues/problems/questions about the administration? You take such good care of your husband, but I have to ask"

You can only learn and go forward. Best wishes.

Oh, and in a future interview? I took 2 years to refine my practice to be safe and effective. I learned a great deal on what it takes to practice safely. I want to take what I have learned and apply it going forward with your facility".

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Specializes in Med/Surg, Ortho, ASC.
FYI, LPNs learn NOT to leave meds at the beside of ANY pts; that is a part of Nursing Fundamentals, whether it be a PN, ADN, or BSN program.

Now, OP, the lesson of being terminated, is to move on and improve your practice; hope to heck that they don't report you to the BON either; and ensure YOUR (not another nurse's) actions are within your BON practice; you can never go wrong with it. IF, a pt rather have a family member give the meds, then staying at the bedside is a MUST; otherwise, mark it as a refusal and notify the MD, as others have expressed.

Best wishes.

I really did not mean to offend anyone. OP referenced "the RN" and somehow that led me to believe that he/she was not an RN. That left 2 possibilities for med-giving - LPN or QMA. ALL OF WHOM who should without a doubt have received the appropriate training about this very basic issue.

Again, was not trying to single out anyone or be offensive, just trying to figure out the scenario.

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Specializes in Peds, School Nurse, clinical instructor.

That definitely was poor practice but I am sorry you were fired. I am all for re-education.

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Specializes in Psych ICU, addictions.
Hello all,

I need some advice from nurses who have been in my shoes in the past or any constructive advice that can help me move forward from this ordeal. I was terminated from my job after according to my employer's statement, I falsified documentation by scanning medications but physically I did not witness or give PO medications to a patient with expressive aphasia, instead I left medications to his wife to administer.

So this is my side of story.

After scanning all the medications, as I attempted to administer them, however, he (he is a MD) was not cooperative which it could be due to his medical condition or just he didn't want to. I am not sure exactly why he was not cooperative. So I asked his wife (according to a day RN during shift report, she administers medications for the patient) if she wouldn't mind giving them to him. She agreed to it and I left the room. He was not on aspiration precautions so I was not worried about him aspirating, it just takes time for him to swallow PO meds.

I didn't clarify with my employer whether that day RN did the same thing or not but I knew my employer would not have disclosed that info anyway.

I have been working on that floor close to 2 years and sometimes patients are not ready to take their medications right away for whatever reasons, then I would leave them at bedside until they are ready to take. Was this wrong? Was I supposed to chart as "refused" if they didn't want to take them at the time medications were due?

Please help, I think my head is going to explode and thank you for reading my post.

Mistake #1: giving the wife the medications to administer and then leaving the room. It would have been something else had you stayed while she gave the meds. Sometimes with seniors/children/patients not fully AOx4, I have better luck with a family member helping me with administration...but I would never leave the family member alone with the medication. I would be there the entire time until the medication went in/down.

Mistake #2: leaving medications at the bedside. BAD habit because you have no way to prove that the patient did take the medication. Neverminding that the medication may not even make it to the patient, instead disappearing in the pockets of another patient/employee/visitor.

If a patient refuses the medication because they're not ready for it yet, then you need to chart that they refused the medication and let the MD know why. If it's a matter of the patient being ready at a certain time to take them, then the MD can adjust the dosing schedule, or set a parameter that allows you to administer the medication a little late. For example, in my facility, sleep meds are usually given at 2100 but if a patient isn't ready for sleep at 2100, we have our MDs' blessing to hold them until the patient is ready for bed. However, there is a limit set: if the sleep med isn't claimed by 2300, it's considered refused.

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Great replies so far, I won't bother repeating any of it! I am curious however, if this seemed to be standard procedure with this patient, why was it YOU that caught heck for doing it? Who turned you in and decided that you would be the almighty example of what not to do?

I am uncertain if others did the same thing and i was the only one got told on by the patient's wife. Even if they did, i am not surprised that i got fired. Because, that is the kind of the floor i worked on.

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I would be very, very careful mentioning this incident during a job interview. As a matter of fact, I would avoid it, based upon my experience with interviews and consequences of saying the wrong thing the wrong way.

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Specializes in Behavioral Health/Substance Abuse.
I am hopeful that there got to be a job that I would enjoy more but I am very worried that I would end up being at a job that I am unhappy again.

First thing, I just want to tell you to not beat yourself up over this. You made a mistake, and you suffered the consequences. No one was hurt, and you can move on. Perhaps (considering what I quoted you saying above) this is a blessing in disguise, if you weren't happy there. I'm sure you've learned a huge lesson in all this, and won't make the same mistake twice. Good luck in finding a new job you enjoy, and don't let this get your self esteem down (which is very easy to let happen). Best wishes! :up:

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Specializes in Hospice / Psych / RNAC.

Well I don't think you need anymore "never leave medication at the bedside;" seriously? :angrybird10: She's asking for help.

Listen girl; you fall down, you get back up. If you feel that it was wrong, than get an attorney and fight it. I hired an attorney after I was fired from a BS charge and it took over a year but I won. I see BS all over this incident. Obviously you aren't protected by a union so get a lawyer but first go file for unemployment. Unemployment will refuse you at first until the unemployment office investigates the incident and I bet there's a good chance they will clear you for unemployment...than go after your workplace!

Call the EEOC and if they can't help you call legal aid if you can't afford an attorney. You could also do this pro se (sue them yourself). Ignore the naysayers and do what you think is best for you and your career.

Good luck to you...

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