*Long Rant Alert*
I know I haven't posted in a while- there's just been so much that's been going on lately with work. I feel betrayed, invaluable and very angry due to a recent situation and how it was handled by my DON and ADON.
Long Story Short: I had a hospice resident who was in the transition phase of dying (the phase before actively dying). The medications that I had ordered for that resident was Haldol and Ativan q4h prn s/s of agitation and morphine q2h prn s/s of pain.
The family would not allow for us to administer the morphine as they believed that it was causing the resident to experience adverse reactions. Which was fine, hospice knew about this and were okay with us not administering it as the resident was not yet actively dying. The problem laid in the fact that the family was under the impression that I should be administering the Haldol and the Ativan scheduled every four hours on the dot despite the fact that the resident was resting peacefully. I explained to them that the order states that I can't administer the medication prophylactically, the resident had to show s/s of agitation. So what do they do? They go in there, agitate the resident, then say "There, now you have to give it to her." So my medication aide and I went in to the room and attempted to administer it via syringe sublingually. The resident spit it out and the family would then expect us to re draw these narcotics and attempt to re administer. I explained to them that this was not appropriate as I was not sure how much was actually ingested. It was just the same thing over and over with them the whole 32 hours I was there that weekend.
I got called in on Monday and already knew that it was most likely because of that situation. I got written up because the family claimed that I allowed for the resident to be in pain. Really? They weren't even ON pain medication, just medication for anxiety and agitation. It just really frustrates and bothers me that my director actually believes that I would just allow someone to be in pain. It really does.
That was the last straw for me. I am now applying for other jobs that do not involve nursing homes or long term care of any sort. I have an interview tomorrow at a doctor's office and I'm extremely excited about the possibility of having that type of opportunity considering my goal is to get my NP and open up practice. I would really appreciate good thoughts tomorrow. I just really need this.
