What to do

Atl-Murse · Jun 5, 2016

Ummm, I don't get it, what happen again ?

applesxoranges, BSN, RN · Jun 5, 2016

So she refused her other medications except narcs? I tell people all the time they have to take the medication in front of me.

Also, document when someone refuses medications. That way, she can't say you didn't offer them to her. I usually write a quick note like RN offered x med. Patient refused X med. If they say something like "toradol doesn't work" I'll quote them usually. Since I'm in an ER, I'll tell the provider.

It's more of a cya so when the patient says "I didn't get my pills till 11 pm!" I can point out that I offered them at the correct time but she refused them at that time.

Cmanursestudenta · Jun 5, 2016

She wanted me to leave narcotics with her and her not take them until she wanted but per facility policy I have to watch everyone take their pills and there are special rules regarding narcotics

stephalina6, BSN, RN · Jun 5, 2016

Just be firm with her that it is facility policy that all meds be taken in front of you. If she does not want the narcotics at that time, you will take them back and then she can ask for them when ready. If she was upset that when she asked for them and you were not available to run them in at that time, just explain to her that you were with another patient. Patients will complain all the time ... brush it off and move on to the next.

Cmanursestudenta · Jun 5, 2016

Just be firm with her that it is facility policy that all meds be taken in front of you. If she does not want the narcotics at that time, you will take them back and then she can ask for them when ready. If she was upset that when she asked for them and you were not available to run them in at that time, just explain to her that you were with another patient. Patients will complain all the time ... brush it off and move on to the next.

I am going to talk to the charge nurse about her and have him speak with her. Maybe that will help I went in 5 times and she will maybe be more reasonable if someone else talks to her. She told me I am not giving her the attention she deserves and she is an RN and I don't do anything right. I do however have other patients and I have to protect my license as a CMA and that means following the rules for dispensing narcotics and facility and state law

WheresMyPen · Jun 5, 2016

I am going to talk to the charge nurse about her and have him speak with her. Maybe that will help I went in 5 times and she will maybe be more reasonable if someone else talks to her. She told me I am not giving her the attention she deserves and she is an RN and I don't do anything right. I do however have other patients and I have to protect my license as a CMA and that means following the rules for dispensing narcotics and facility and state law

You don't have to worry so much about her complaining. Just protect yourself. Document everything very carefully and never leave any pills with a patient (narcotics AND non-narcotics). I always wait until they swallow the pills and if they refuse any, I document what they refused, the time they refused it, and the reason they refused (if they give you a reason). And make sure you know the policy on wasting narcotics properly. You do not want to be accused of taking them home with you or anything like that. In my state and facility, two nurses (Lpn or RN) have to waste narcotics together in a chemical drug buster. And we both sign. Where I used to work, the CMA could not waste narcotics, so she would put them in an envelope and write what they were and who they belonged to on the envelope, and leave them in the locked narc box for the other nurse and I to sign. If they come in labeled rappers, keep them in the rappers. Ours come in blister packs, so she'd label them herself. Make sure you know your policy, it may be different than mine. But please protect yourself!

Cmanursestudenta · Jun 5, 2016

I am going by the policy as that is just best. I generally wait until I see the patient swallow the whole thing was bizarre. When she did take the pills she wanted to do it in a very dark room and was angry I insisted on turning on the light but there was no way I could see anything otherwise. If she was a nurse she should know better than to act like that. In short she did everything to try to get the pills and keep them but not take them. I am not comfortable with that I had the feeling she wasn't actually going to take them and purposely made the room that dark to hide her pills. Her behavior was just suspicious

WheresMyPen · Jun 5, 2016

I am going by the policy as that is just best. I generally wait until I see the patient swallow the whole thing was bizarre. When she did take the pills she wanted to do it in a very dark room and was angry I insisted on turning on the light but there was no way I could see anything otherwise. If she was a nurse she should know better than to act like that. In short she did everything to try to get the pills and keep them but not take them. I am not comfortable with that I had the feeling she wasn't actually going to take them and purposely made the room that dark to hide her pills. Her behavior was just suspicious

that does sound very suspicious. I would be careful with her from now on and ask her to open her mouth to make sure she swallowed the pills. tell the supervisor about this. She may be trying to hoard them.

Cmanursestudenta · Jun 5, 2016

It also happened on the weekend. When family and friends tend to visit....

lavenderskies, BSN · Jun 5, 2016

I am going by the policy as that is just best. I generally wait until I see the patient swallow the whole thing was bizarre. When she did take the pills she wanted to do it in a very dark room and was angry I insisted on turning on the light but there was no way I could see anything otherwise. If she was a nurse she should know better than to act like that. In short she did everything to try to get the pills and keep them but not take them. I am not comfortable with that I had the feeling she wasn't actually going to take them and purposely made the room that dark to hide her pills. Her behavior was just suspicious

Don't focus on the fact that she should know better because she's a nurse. She's a patient and probably looking for control. Do your job, respectfully and document as previous posters have advised. :)

BuckyBadgerRN, ASN, RN · Jun 5, 2016

Is this an ltc facility or an alf? Is she " cleared" to self-administer? At my casual position if a resident can show that they understand their medications and can safely take them unassisted, we can leave them to take their meds on their own.

Currently I am a CMA and a nursing student well last night I was passing pills and I had this one patient that was difficult. She asked for pain meds and I gave her but then wanted it again too soon I told her I would be back at the time I could give her another one and then when I returned she wasn't there. When I returned 10 minutes later she said I don't want these two pills and out of the 12 pills she had spent 15 mins picking her pills and they were narcs so as it was 15 minutes til count I put refused. She was utterly enraged I would not leave the narcotics just sitting there with her but per facility policy I have to account for all the narcotics I pass. at 10 pm it was shift change and she pushed her call light and the CNA went in and I was helping someone else which took 17 minutes and then I had to give count and the other cart was counted first and give report. The CNA also told me someone had a question so I answers that and found out she wanted her pills she had refused and was angry she had to wait for them. She then told me I am an RN and you are doing a miserable job. I don't know what to say I can't leave narcotics unaccounted for I can be fired for that why doesn't she know that if she is an RN..