What to do

Nurses General Nursing

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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..

Specializes in HH, Peds, Rehab, Clinical.

Well, the good thing is that you don't have a license to protect, so no matter what happens your non-existent license can't be dinged!! Is it possible to let a nurse handle her med pass for a while so they can see firsthand what kind of demands this patient is trying to make of you?

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
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Well, the good thing is that you don't have a license to protect, so no matter what happens your non-existent license can't be dinged!! Is it possible to let a nurse handle her med pass for a while so they can see firsthand what kind of demands this patient is trying to make of you?

she has a certification to protect. And if she gets reported it could jeapordize getting her nursing license in the future. I definitely would get the nurse to pass meds to this patient though, so he/she can see it first hand

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In my state the CMA has to be licensed. She is absolutely not allowed to do her own meds but I did discuss this with my supervisor and she told me what to do

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Specializes in HH, Peds, Rehab, Clinical.

Then you'd be a licensed medical assistant, not a certified medical assistant, no? What was your supervisors advice? As I reread your post, it really seems like it's a control issue for this patient

In my state the CMA has to be licensed. She is absolutely not allowed to do her own meds but I did discuss this with my supervisor and she told me what to do
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Well to put her meds out and watch from the other room and do her first before her previous dose wears off.

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Specializes in HH, Peds, Rehab, Clinical.

Interesting. Crossing fingers that it works!!

Well to put her meds out and watch from the other room and do her first before her previous dose wears off.
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Specializes in Med Surg, Ortho/Neuro, Hospice..

Document, document, document. I doubt that she's a RN, if she was she'd be much more pleasant and less abusive and also more understanding. My guess is that she's a junkie or selling the narcs, but by telling you she's a nurse she can outrank you and bully you into breaking policy, don't fall for it. (it should be pretty easy to go to your board of nursing website and confirm her claims) You did the right thing.

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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 do not hold a license, you hold a certificate. The licensed nurse in charge of the floor holds the license. Therefore, you need to be sure that the first time the patient begins fooling around with medications, especially narcotics, the licensed nurse is made aware of the situation, and then can decide how to proceed. Which could mean the nurse then goes in, discusses this with the patient, then medicates the resident herself/himself, but at the least documents accordingly.

At the end of the day, the nurse is responsible for all unlicensed assistive personnel and what they do or don't do. And the resident/family/friends whomever who may complain, believe that you are not doing something correctly, whatever....it can legally fall on the licensed nurse, not you.

You did the right thing in not leaving meds unattended at bedside. What you then needed to do is to get the charge nurse, explain the situation, and have the nurse take it from there...by assessing for pain, documenting everything, and documenting refusal.

I am sure that people who pass meds in a facility are certified to do so. But they are not licensed. In other words, it may jeopardize your certification with the state, but the ultimate responsibility is on the nurse who is legally bound by a license.

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