What did I do wrong?

[mzsuccess]

OK. So I'm a Cna while in nursing school. I work at a retirement center. And I was assigned to sit with this gentlement who had a stroke. One evening while sitting with him he gets really agitated and starts yelling, screaming at his wife. Kept getting up saying things were out the window that wasn't there, asking was he going to doe and couldn't sit still. I thought he was honestly going to hit his wife..I never seen him so upset. Now I'm not suppose to give meds we give them to his wife and she gives them to him. Every other day, the mangers are changing the "what to do" forums and who to call and his son also. He's on hospice. I called the triage nurse because it was late. I explained to her what was going on and I told her he had ativan and she told me to give it to him. ThT was two days ago and now. I get to work and I hear I'm in big trouble and the son is so upset yelling. Saying it was the wrong medicine, but it had his name on it and he's now messed up. Anyway I'm suppose to have a meeting tomorrow and don't know what to expect. I feel bad and everyone is looking at me crazy like its my fault and I don't know what to tell my boss. I feel embarrassed and it makes me not want to be a nurse anymore. Plus the wife is fabricating the story and she isn't all the way in her right mind. How can I handle this or should've handle this? I charted everything, like I was suppose to and other girls gave it to him and didn't chart anything.

[Omaapecm, ASN, RN]

I'm sorry this happened to you but consider it a good lesson. Even as a nurse we will be put in situations and told to do things that are outside our scope of practice. We must have the courage and the smarts to put our foot down and say no. Don't let this situation discourage you or defer you from being a nurse . It is such a rewarding occupation. You will definitely be written up and may even lose you job. The nurse that advised you to give the medication should be in trouble as well.

[kbrn2002, ADN, RN]

Perhaps I should have tempered my question with more information. The LTC where I have worked and my now current employment at a hospital are small, rural locations. The atmospheres are very laid back; nurses share information about medications, their general use, and what we need to look for in administration to a patient freely; all the CNAs coming on shift, unless they are in surgeries, sit in on the report from the off-going RNs, so we hear about patients first hand, meds, condition, all. There are times we probably function more like a PCA than a CNA because of our staffing numbers. We get asked to assist with catheter insertions (not the actual act, but by keeping the patient in position), IV insertions (again, positioning), telemetry set up, and sometimes we have to assist in the ER.

Our function at my hospital is obviously an outlier, and not the norm. There are times when there isn't an extra RN around to help and we are asked to step in and help. When that happens, I listen and pay attention to what is happening and ask questions later in an effort to expand my knowledge base. The nurses at my hospital put quite a bit of trust in the CNAs, and I would say the providers do, too. I had a provider ask to relay a request for an one-time dose of an IV medication, medication name and dosage, to the nurse assigned to a patient because he couldn't leave the patient in the middle of his assessment. I never touched the med; I only passed on the request. Things are probably much more casual where I work than most.

Your first paragraph includes things that are very much within the CNA scope of practice. The second paragraph not so much. No matter how laid back an atmosphere there is, I would never take a second hand verbal order for anything, much less an IV med. Any order I receive is coming direct from the MD, not filtered through somebody he [or she] told to pass it on.

[ktwlpn, LPN]

I have seen cna's duties expanded in acute care ,it was a cost savings at out small community hospital.It can be an issue.The scenario you speak of for instance could have resulted in a poor outcome.You actually relayed a verbal order,many meds sound similar.A patient could be killed.Another nurse should have been assisting.

[RescueNinjaKy]

I have seen cna's duties expanded in acute care ,it was a cost savings at out small community hospital.It can be an issue.The scenario you speak of for instance could have resulted in a poor outcome.You actually relayed a verbal order,many meds sound similar.A patient could be killed.Another nurse should have been assisting.

My thoughts exactly, with a verbal order that comes from a doctor there is already the need to double check as sometimes they don't speak clearly or even say the wrong thing. And that's from hearing from the doctor first hand. I would not trust a second hand relay.