Team Mate working out of scope or practice?

What do you interpret dominant to mean? I don't think it's necessarily a bad thing.

The SW should not have drawn up the morphine. What if she made a mistake and drew up the incorrect drug? It would be on your head because you're the nurse, and were there when it happened and didn't do anything (and gave it? never give something someone else draws up!). I know family members of hospice patients give meds, but that's in their role. It's not the SW's role.

I wouldn't have a problem with her telling the family about the drugs, to a point. She probably knows about them from being in her job awhile. I doubt she thought you didn't know things. I think she's just more likely used to giving information when people ask. She's probably had to learn the basics for when she visits patients on her own. I bet questions come up that she's had to find answers for, rather than telling the family to call the nurse. If it's an easy answer, what's the harm? Do you think she would give more than basic information, that she couldn't know the details of? You can always talk to her about your concerns, when no one else is around. There's no need to go to the boss if you haven't talked with the social worker first.

As for the CP. She's probably used to it being a separate bag or box. When she didn't see it, she assumed. The important thing for her to do if she's being helpful when the nurse isn't there, is to help the family find the medication, not a specific container.

If I were in your shoes I would have lunch with the MSW and discuss how we would work together as a team. As the case nurse you are responsible for the implementation of the plan of care so it is natural for you to pursue this type of conversation.

In my practice the MSWs may share the factual information they have regarding hospice care. Many times they have important and correct information about medications common to our work. They must always defer to the physician or nurse on those topics but can certainly correctly answer some questions from patients or families. MSWs or Pastoral care staff should NEVER prepare or administer medications! You will want to address the prep of the morphine with the MSW in question...it is important to NOT be a partner to bad professional practice in this field.

Dominant vs. assertive vs. straightforward vs. bossy...whatever...as long as you have effective communication skills and good practice habits you will do fine!

Let's see, a SW administering and educating about drugs. Not a good idea. Definitely out of her "scope of practice". If this happened with my SW I would arrange a sit-down, inform her that she should not be administering any meds, and that although she may have some basic med knowledge, education re: meds is your job. If someone said I was "dominant" I would simply smile and say "thank you".

Hello:

I usually just read this forum vs post since my hospice experience is very outdated. I have to say , the very first thing that jumped out a me reading this thread was diversion. It sure seems like she is creating a lot of different reasons and opportunities to be nosing around the meds. I'd almost be willing to bet money on it.

Hey, Old.Timer...nice to see someone with the same dirty, suspicious mind I have. It's what happens when you've been around the block a time or two, right?

Also, to OP: If one is going to thrive in nursing, it behooves one to be somewhat assertive. Learn the Southern art of smiling beautifully while telling the SW to keep her hands to herself.

I have taken care of this. The SW understands I know my role.... and that I "appreciate" her

"input" on the issue. "I have taken care of it".

The family has been educated to call upon the RN (not the SW ) for all and ANY medical issues.. After all, that's my role.