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What recourse does an RN on a rehab unit have if accused by the DON of not giving pain meds even when it’s tracked in the MAR?

Question:

Dear Nancy,

I am a nurse on a rehab unit. I work midnights. Lately my director of nursing has been approaching me stating I am not giving pain meds at night. Not only do I give them, I give them before they ask. She is talking about turning me in to state for abuse. I say it’s in the medicine administration record and you can ask my CNAs. I have never been in trouble as a nurse for 13 years. I also asked to be moved to another unit. She refused. It also was stated I said something rude to a resident, but I didn’t say it. The resident described me, but I wasn’t in the room by myself. What can I do?

Collette

Dear Nancy replies:

Colette,

It sounds as though your director of nursing has targeted you for some reason. First of all, it seems most disconcerting she would accuse you of not giving medications when the medicine administration record indicates otherwise. As for not speaking with your certified nursing assistants, she may already have done so and one or more of them may be staff who shared information about your medication administration, albeit not true. One also wonders what the patients are saying about the administration of their pain medications.

It would be best for you to consult with a nurse attorney or other attorney in your state who works with employees. He or she can provide you with some guidance about, as an example, filing a grievance pursuant to the employer’s grievance policy or perhaps the attorney will have other suggestions for you to handle this issue. If your DON would report you to the board of nursing for alleged abuse (which seems a stretch based on the information you included in your question), you will definitely need
legal representation.

Perhaps a hidden issue in this situation is the MAR has been altered, not necessarily by the certified nursing assistants, but by someone on one of the other shifts. Has there been any general concern about medication administration techniques, documentation of medications given or any other issue related to medications?

Because the medications in question are pain medications, it is assumed they are controlled substances. How are the controlled substances in your facility managed? Do you have an automated medication dispenser, like a Pxysis? Are they under lock and key instead? If under lock and key, for example, if another staff member is diverting the medications for his or her use (e.g., filling vials with water after removing the particular controlled substance), the patients may be complaining to the DON that they are in pain despite being administered their medication.

The DON’s whole approach to you not giving pain medications, if properly documented and you are in fact giving them as ordered, just doesn’t ring true. Something else is going on here. Be sure you discuss this issue with your attorney as well.

Cordially,
Nancy

By | 2014-12-12T00:00:00-05:00 December 12th, 2014|Categories: Blogs, Nursing careers and jobs|0 Comments

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