Hello fellow nurses. I have something to get off my chest, and I cannot discuss this with coworkers so I sought out all of your opinions. FYI: I am a new grad RN, currently working in LTC for about 7 months.
A few months ago, during a med pass at 5 pm (supper), I left a pill in the pill cup next to a resident who normally will take the pill, if not, the aide will help her take it (it was senokot). When I left it there, I acknowledged to the resident that I am leaving a pill beside her and would like her to take it. A family member of another resident sitting at the same table, saw this and commented "She won't remember to take that," in a very rude manner. In response to her hostile personality, I was firm and told her "She usually does take the pill, if she does not, I will follow up and be back to make sure she does". I left saying this and administered pills to the other residents at this time. I came back to the same table while giving a pill to another resident sitting on the same table as this family member and the original person I left the pill beside, I asked the aide "did A.I. take the pill?". The aide responded and said yes. I then proceeded to administer the crushed pills to another resident while waiting for her to finish IN FRONT OF this family member.
This family member then went to my director and reported me for inappropriate medication administration. I was written up for something that did not even result in harm or distress for a resident. I was disciplined for "leaving a medication beside a resident that has dementia," instead of waiting 5 minutes to help her take it, I proceeded to admin meds to the other 30 residents before time runs out.
I honestly feel like this is unfair. Also, my director was very strict and had a look of no mercy when telling me that this is just "unacceptable practice". Also, the family member who reported me has a history of issues with many co-workers, and the management team knows that.
So, tell me, give me your honest feedback. Would you write me up for this? I feel a sense of indignation towards my director.
It's one thing to leave a senna next to a patient/resident in their own private room, quite another to leave it next to a patient/resident in a group setting. Both are technically wrong, but what it someone other than the intended swallowed that pill? True, the "worst" that could happen in an unexpected code brown, but that's not the point.
It's also incredibly unfair for you to expect an aide to follow up on what is technically YOUR duty. Just don't do what you did. Ever.
Even in a private room, for a "with it" pt, no pill should ever, ever, ever be left at the bedside.
The OP left it in the dining room, not a private room, though. Wrong, wrong, wrong.
I would not report her, but I would advise her that it is against policy and is dangerous to leave pills unattended. Ever. If I were going to be able to watch the pt to make sure she'd take it when she finished her current bite of dinner, I might go on and leave it. But I would be right there - maybe giving pills to the pt next to her.
It is not the aide's job to give pills. It is not the aide's responsibility. This is not a task a nurse can delegate, unless to a med tech.
And with the family member - OMG. The family member has entrusted her loved one to the facility and has a perfect right to believe that her loved one, and the loved one whose pill you left sitting around, will get legal and good and proper nursing care.
I know this sounds like a mountain out of a molehill type thing, but it isn't. Rules and policies are there for everyone's protection - including yours. If you always give all of your own meds, you will always know whether they were properly given or refused or whatever. Your experience does not qualify you to buck decades of nursing care.
OP - don't do this ever again if you want to stay employed. You haven't really had a change of heart or learned anything, have you? I wish you well. Please smarten up, for your own survival.
Specializes in cardiovaslular PCU, inpt rehab, HHC, ICU, PP.
Medication administration is a very important thing. It is one of the first things nursing students are taught. It is definitely true that a medication should never be left like that because you DO have to be certain the patient took it, and that it was indeed THAT patient who took it, no matter what it is. At our facility, we can't even give a cough drop without and order for it. If I were the director, I would definitely do something about it. If this was your first offense, then yes, I would give counseling, and I would document it as such. I have my license to protect too. One thing to keep in mind with nursing, is that we do make mistakes, but everything we do will affect someone else. If I make a mistake, depending on the seriousness of that mistake, my superiors could get in trouble too. Be very prudent with medications.
I've been thinking about this ever since I read this thread a couple of days ago. Today I remembered something. My very first semester of nursing school I had a teacher who told us something before our very first clinical. She said that any time we have meds they have to be within our reach or in a locked medroom. If we left a med at the computer station and walked four feet away from it so that we could not reach the med, and were seen by clinical instructor, we would get a clinical failure for that day.
Understand, two clinical failures and you failed that class AND were dismissed from the nursing program.
Now this is not an instructor I liked. In fact, it was one of the instructors I really disliked. But I guarantee you if she had a rule she had a darn good reason for having that rule.
Unless you have an order for the patient to self administer, yes I would write you up. Not just for that if you know a family is crazy why chance it? Over nurse so they can leave you alone. Many family members feel guilty in the first place or may be looking for a law suit or may just be trying to be a bully staff so their family member gets better care who knows. Nurse the nursing you know if there is no order don't do it. You wouldn't tell a state examiner that cuz you know they would look for an order. Plus you told the family member you would recheck but then asked a CNA did she take the pill. Don't let the nursing home make your skills lack many new nurse go to LTC for the pay and lose out on experience. Find out the facility policies on self administration.
It's one thing to leave a senna next to a patient/resident in their own private room, quite another to leave it next to a patient/resident in a group setting. Both are technically wrong, but what it someone other than the intended swallowed that pill? True, the "worst" that could happen in an unexpected code brown, but that's not the point.
It's also incredibly unfair for you to expect an aide to follow up on what is technically YOUR duty. Just don't do what you did. Ever.
Actually, the worst that could happen would be an allergic reaction if the person accidentally taking the wrong med had an allergy to Sennakot. Even something as innocuous as Senna could cause anaphylaxis. And yes, it is very unfair to the CNA to put the responsibility of med administration on her--very much outside of her scope of practice.
Kooky Korky, BSN, RN
5,216 Posts
Even in a private room, for a "with it" pt, no pill should ever, ever, ever be left at the bedside.
The OP left it in the dining room, not a private room, though. Wrong, wrong, wrong.
I would not report her, but I would advise her that it is against policy and is dangerous to leave pills unattended. Ever. If I were going to be able to watch the pt to make sure she'd take it when she finished her current bite of dinner, I might go on and leave it. But I would be right there - maybe giving pills to the pt next to her.
It is not the aide's job to give pills. It is not the aide's responsibility. This is not a task a nurse can delegate, unless to a med tech.
And with the family member - OMG. The family member has entrusted her loved one to the facility and has a perfect right to believe that her loved one, and the loved one whose pill you left sitting around, will get legal and good and proper nursing care.
I know this sounds like a mountain out of a molehill type thing, but it isn't. Rules and policies are there for everyone's protection - including yours. If you always give all of your own meds, you will always know whether they were properly given or refused or whatever. Your experience does not qualify you to buck decades of nursing care.
OP - don't do this ever again if you want to stay employed. You haven't really had a change of heart or learned anything, have you? I wish you well. Please smarten up, for your own survival.