I am a recent LPN grad on my first job at a LTC facilty with a few dementia patients. One in particular has a prn order for Ativan when she is agitated, although there aren't totally clear guidelines on when to give it to her and I have had problems getting a clear picture from the other nurses. A couple of times CNAs have just come up to me to tell me to medicate patients right when I come on shift, before I have even had time to see the patient myself. This happened last night so I went to see the patient and she wasn't that bad, saying "mama" over and over, but she does that, and she wasn't screaming it or trying to undress. So, I sat with her a bit, held her hand, gave her some pudding and she seemed okay. I asked the CNA to please try sitting with the patient one on one and she told me she didn't have time and it wasn't her job. I explained that prn meds, such as Ativan, are only to be given after trying other measures first, not as a preventative, or convenience to the healthcare workers. Later that night I saw the same CNA ask a patient if her knees hurt and did she want Tylenol? This is totally out of her scope of practice! Most of us got into nursing to help patients be the most independent as possible and live the fullest lives they can, not to be managers. At least I didn't get into this to be a manager. I deeply value the input and work the CNAs do, and could not do my job without them. Any advice for working better witih CNAs or to facilitate team work? Or even advice on working with dementia patients?
