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.

[caliotter3]

Should you continue in this line of work, I would be very clear on when you need to have a nurse come and assess the patient, and to begin interventions. I would be very clear on what medications are in the lock box and what they are used for as to direct a family member accordingly, and be equally as clear of your need to have the nurse call and discuss the plan of care with a family member (like the son).

I quoted this paragraph from jadelpn's post to emphasize it as good advice for your future, to preclude such situations.

I am very happy to read that your supervisors have taken everything into account and have made things right for you. Hope this does not happen again!

[mzsuccess]

I quoted this paragraph from jadelpn's post to emphasize it as good advice for your future, to preclude such situations.

I am very happy to read that your supervisors have taken everything into account and have made things right for you. Hope this does not happen again!

Great post and advice! thing is they don't tell us what meds are for and share the clients health. They have his meds in a bubble pack and we put them in a cup and hand them to patient's wife and they have notes. I.E. Give to wife is patient become anxious or agitated, give wife to give if he's having problems breathing and etc.. I'm familiar with most meds but not all. But I will definitely take this advice to heart. Thanks again

[Gooselady, BSN, RN]

I wonder how common this kind of med delivery 'system' is used in LTC?

When I did CNA work prior to RN I didn't come within ten feet of a pill except the ones I found in the bed or rolling around on the floor.

Your overall attitude is an excellent indicator of the kind of nurse you will become :) I insist you become a nurse, OK? This is a rather specific-to-being-a-nurse kind of lesson, and you tackled it, did not blame everyone else including the BON , you took responsibility, followed through and came out the other side of a bunch of drama over 'nothing' (read: nothing you did wrong after all). :) Welcome to nursing :D

Anyway, this 'system' is a huge set up for CNAs to administer meds outside their scope of practice.

[Raviepoo]

Please don't take this the wrong way. I wish you only the best. If you want to go on and become a nurse I hope you are accepted into the school of your choice, get great grades without even trying, and pass your NCLEX with 75 questions the day after graduation.

With that said, this situation you found yourself in is exactly why med techs are a BAD idea. Your situation is exactly why LPN should be the absolute minimum professional qualification required to administer medications to a client. You didn't understand that Ativan and Haldol were not the same drug. There is no reason for you to know that. You were never taught that. You never learned the indications, actions, side effects, therapeutic effects or complications of either drug. You had not way in the world of making an educated guess about whether it was OK for the wife to give the client what she gave him. The triage nurse dropped the ball, and the result got ugly.

I'm glad this story has a happy ending. I'm glad they aren't holding you responsible for this. This is an opportunity for learning, for you AND your agency.

Good luck to you.

[MunoRN, RN]

I'm confused, what is it that the son thinks the medication did to his dad?

[jadelpn, LPN, EMT-B]

Why? Because I was so dumb?

This has nothing to do with your intelligence. It has to do with the fact that the nurse in this situation--who is ultimately responsible for the care received by the patient--dropped the ball at your expense.

Which is incorrect and wrong on a number of levels,

[ktwlpn, LPN]

I think many of you on the thread don't realize the OP is talking about assisted living. You can't compare that to acute or long term care. In my area it's common for the big assisted living chains to hire the cheapest labor they can cause it's all about the profits. Most around here don't hire certified nurses aides.AL is NOT regulated like LTC is, in this area an AL resident is supposed to be able to self administer meds, staff are only supposed to open packages after the resident chooses the ones they need. Every facility I know of stretches this rule as long as the resident has funds. As soon as they begin to run out of money out the go. Until then the staff(unlicensed staff) are expected to do whatever they need to do to maintain that resident as long as they can. This kind of scenario happens all of the time, in AL, in groups homes, etc. The OP was well within her "scope".

[mzsuccess]

Aww thanks Gooselady that meant so much to me. I got really worked because these are fragile people and the last thing I want to do is harm them in any way. Hospice or not.

[mzsuccess]

MunoRn, he says the med cause his Dad to have a change in personality, cognitive and just plain act differently and his Dad having it was a big no no.

[mzsuccess]

Ktwlpn..thanks for explaining so well. I've tried but couldn't quite get it across like you. I'm in assisted living and we're allowed to assist in opening and reminding that's all.

[thevez]

You need to realize that as a CNA YOU DON'T HAVE IN YOUR SCOPE OF PRACTICE TO GIVE MEDICATIONS. NEVER.

An error occurs if someone went out of line and this is an example of that.

Learn from it and move on. It's very hard to accept that we make mistakes but we do. Go shopping or work out to get your mind away from thinking too much about this error.

WE ARE NOT PERFECT, WE MAKE MISTAKES. LEARN FROM IT and DON'T DO IT AGAIN.

I too made mistakes and have blamed myself about it.

[kbrn2002, ADN, RN]

This situation is why I would never, no way work for an assisted living or any other setting that allowed a non licensed staff to administer meds, or even assist with administering meds by opening a blister pack for the patient to take or the family to give. There are just way too many opportunities for dangerous or even fatal med errors to occur. I'll be damned if I'll take the responsibility for administering a med I am not actually giving, and ultimately the responsibility for any med error would probably fall on the nurse.

OP, this is not your fault. I am very glad that everything worked out for all involved, but this was a bad situation to put you in. I am sure you were terrified.