Unethical?

[ahosoda]

There is a situation at work and I just don't know how to handle it. I work in LTC as a CNA, and I've found that the majority of nurses in my facility refuse to participate in a lot of care because it is for "CNAs", not nurses. Usually I can just laugh it off, because it is something silly like putting socks on a resident, but this situation is different.

I am nurse delegated, and my only job is to pass the medications to residents in assisted living. The evening med assist shift is only 4 hours (4-8pm). After the med assistant leaves, it is the nurses' job to give any PRN medications. Almost none of the residents want their PRN sleeping pills before 2000, so I let the nurse know that so-and-so wants their sleeping pills at ___ time. This nurse says that is completely unacceptable and that I am not doing my job. She got the sleeping pills and said, "Follow me". She then went to each resident and forced them to take the pills against their will. She said, "see? you can give them pills you just have to be forceful." I reported this situation to the head nurse.

The next night before I was done with my shift, I called this nurse to do count. I was surprised when TWO nurses came to count. It was an ambush. The eve nurse called the noc nurse to come in 2 hours early just so they could gang up on me. Both started lecturing me on how they shouldn't have to pass any medications because if there was a fall, they would be too busy. Everything I said to defend myself was shut down because it was 2 vs 1.

I am just wondering what you more experienced nurses would do in this situation. I have worked at this facility for a few years, but this nurse has worked there longer than I have been alive. I don't want to lose my job, I really depend on it for income, but I also don't want to be unethical and force people to take pills.

[jojo489]

How, exactly, did she force them to take their pills?

[ahosoda]

How, exactly, did she force them to take their pills?

She said "take your pill(s)". Then they would say "I want to take this at ___ time." She would say "you can't do that, you have to take them now". Then she would grab the residents hands, dump the pills in their hands, and guide their hands toward their lips. There were 3 this one night, and another on a separate night. One out of the four threw the pills on the ground, the other 3 complied after she guided their hands toward their mouth. All 4 refused verbally.

[IVRUS, BSN, RN]

She said "take your pill(s)". Then they would say "I want to take this at ___ time." She would say "you can't do that, you have to take them now". Then she would grab the residents hands, dump the pills in their hands, and guide their hands toward their lips. There were 3 this one night, and another on a separate night. One out of the four threw the pills on the ground, the other 3 complied after she guided their hands toward their mouth. All 4 refused verbally.

Wow... The nurse who is demanding that the resident take the pills, because that is when it is convenient for HER, should find herself being inconvenienced at the unemployment office... Smh...

[jojo489]

Get a notebook and document every word said between you and she, as accurately as you can remember. That way you have that to fall back on. Keep it updated.

I would revisit this with your supervisor and relay the incident with the second nurse. If nothing is done, and it happens again, start climbing the chain.

Stick to your guns, if it feels wrong, don't do it. If she tries to force you, tell her you're not comfortable doing that and you simply won't when they refuse. If she tries to write you up for insubordination, don't sign it, ask for a meeting with the supervisor to review the write up. It's not insubordination when what you're being told to do is obviously not right..you're being a patient advocate.

[Jensmom7, BSN, RN]

She said "take your pill(s)". Then they would say "I want to take this at ___ time." She would say "you can't do that, you have to take them now". Then she would grab the residents hands, dump the pills in their hands, and guide their hands toward their lips. There were 3 this one night, and another on a separate night. One out of the four threw the pills on the ground, the other 3 complied after she guided their hands toward their mouth. All 4 refused verbally.

This, pure and simple, is assault and battery, and your facility is skating on thin ice if it is swept under the carpet.

If these patients are alert and oriented, all they have to do is call the Ombudsman or the state hot line.

As PP said, keep a written record, with dates and times; it will come in handy when you give your deposition

[Adele_Michal7, ASN, RN]

Stand your ground, but prepared to lose your job

[benegesserit]

This, pure and simple, is assault and battery, and your facility is skating on thin ice if it is swept under the carpet.

If these patients are alert and oriented, all they have to do is call the Ombudsman or the state hot line.

As PP said, keep a written record, with dates and times; it will come in handy when you give your deposition

For that matter, being abuse (and it is - force-feeding psychotropic medication is assault & battery and chemical restraint), you're presumably a mandated reporter and required to report it according to your state and facility policy.

[BuckyBadgerRN, ASN, RN]

Is she though? If she's a CNA, is there a license that makes her a mandatory reporter? Not that anyone with any sort of heart would look the other way while this goes on. Ultimately, the administration of meds falls to a NURSE, not you OP, I hope that someone there will understand that and put a stop to this craziness!

For that matter, being abuse (and it is - force-feeding psychotropic medication is assault & battery and chemical restraint), you're presumably a mandated reporter and required to report it according to your state and facility policy.

[benegesserit]

Is she though? If she's a CNA, is there a license that makes her a mandatory reporter? Not that anyone with any sort of heart would look the other way while this goes on. Ultimately, the administration of meds falls to a NURSE, not you OP, I hope that someone there will understand that and put a stop to this craziness!

In my state, anyone who works with the elderly in a medical context, regardless of license, is a mandated reporter. Our kitchen and housekeeping staff are mandated reporters, even though they provide no direct patient care. May not work that way in all states, but it would definitely be a good idea for OP to be sure of her state's law!

[caliotter3]

Do everything stated in previous posts and start looking for a new job. You need to stand your ground on this and it will cost your job. Even if they were not to find a bogus reason to fire you, you will not want to continue working there once you start receiving more flak than those two attacking you.

[ahosoda]

Thank you all for your responses! I truly appreciate every single persons input.

I will definitely start writing down everything she says in a notebook. Luckily I still have all of the dates of when she said/did all of these things. She has said other things to me that I didn't mention, but I consider it bullying.

As for being a mandated reporter, yes I am in my state. I thought about reporting it but I already have everyone ganging up on me and making me believe I am the one in the wrong. One nurse has my back though, but I haven't had the chance to work with him much lately. I told him what happened and he called BS... All that nurse does is sit on her tushy and play games on the computer her whole shift. She's not too busy to give pills. My husband shares an office/nurses station with her and has confirmed! Also everyone here agreeing with me has given me strength. I will report it to the state.

These on call nurse delegated CNA jobs with good hours are hard to come by in my area. It is a very nice facility but this one nurse is killin me. I like the 16-2000 hours because I'm in school and this works well with my schedule sometimes, unlike a regular shift. It also pays higher than most CNA jobs, and is much less stressful in my opinion (until this incident).

Thank you again everyone!