I am a CNA at nursing home in the US. What do I do if I suspect or know of overmedication and it needs immediate attention?

Let go of the matter, that's my suggestion. You've spoken your peace, you've been told there's no problem by people who have more training and medical background than you, so there's nothing further for you to do. There are going to be many situations that you find yourself in that you may disagree with, but you have to abide by the chain of command in the facility you work at.

Good luck! Give yourself a chance to acclimate to the SNF and to the staff and I'm sure everything will work out fine.

My Mom received one iron pill a day. As said her stool was black which is normal and like said, they suffer from constipation. So stool softeners are prescribed.

You have reported it to a nurse. Your sister has confirmed the Nurse. Going over the Nurses head could find u with no job or ur life made hell at work. I would hope that labs were being done every so often to check the patients levels.

Folks taking iron supplements often have dark stools. You’ve reported this to your licensed personnel supervisor. They have provided sound clinical rationale for the patients symptoms.
On a related note, please suggest or confirm the patient is on a stool softener as a side effect is constipation.
Thank you for noticing your patients deviation from normal stool color and reporting it to the nurse. Your opinions do count. Your actions prove you are indeed a caring caregiver.

Iron supplements do turn stool black. That is normal.

You say this lady is showing 'many signs' of iron overdose. Such as?

Your responsibilities as a CNA are to document your interactions with this lady and to report any concerns. You have reported your concerns. Have you also documented your observations? And documented your reports? For example, in your client's daily records it will say something like "stool loose and black, reported to Nurse Smith."

Do you hand this lady her medications? If so, you also see what she has been prescribed. If you think there is a prescribing or a dispensing error, it is your responsibility to report that *before* you hand the medication to the lady and then to take instructions from your line manager. You MUST then follow the instructions. You do NOT second-guess them.

It is absolutely not your responsibility to diagnose her or to alter ("correct") her medications routine.

Suppose you had been looking after this lady five days running, and she always opens her bowels in the morning, and four days running her stool was that sort of slightly grainy at the edges black, and then on the fifth it was blacker, a different sort of black, kind of tarry-looking. You would then report that *change* in stool, describing as much detail as you can. But it is not for you to give your opinion about the possible cause of the change.

I sympathise with the frustration - because getting people to pay attention to a detail you've spotted can be like pulling teeth, I know - but I would have absolutely no sympathy with any tinkering with this lady's routine.

Plus, based only on what you've said so far, this is not a case for whistle-blowing. You would probably make a fool of yourself.

Is she having headaches? That would be the indication that she is over dosed on iron, it gives major headaches.

Black stool is also an indication of internal bleeding.

I would let the DON know that you have a concern about what you are seeing and ask how you deal with situations like this.

The 2 that have said it is normal could very well mean for that patient.

If you feel like she is suffering from medical malpractice it is your responsibility to report it to the authorities, you are a mandated reporter. Do not count on being anonymous.

Be sure and follow the protocols outlined in your contract.

You work in a facility. Your facility should have a procedure for you to follow, a chain of command. You need to follow your faculties procedure. You just admitted that 2 nurses one of whom is your sister and both of whom have more training than you, have said her stool is normal. So I wouldn’t take it upon yourself to contact the patients family.

thank you, I forgot to mention that I have only been working at this nursing home for about a week but have already started to see a decline in this particular resident. Also I showed the nurse her stool as it was backed up in the toilet and he, and my older sister who has been a nurse for 15 years and worked at various nursing homes, said that this was normal because, in the elderly iron is not absorbed into their blood stream so they have to have higher doses in order to receive any.

First, THANK YOU for the work that you do as a CNA (especially during Covid) and for having the moral strength and conviction to know that something needs to be done to help this poor soul!

I am not a medical professional and have never worked in a facility so I don’t know what the rules and/or regulations are where you work.

But from one human being to another, please show a sample to another nurse, the nurse manager or grab one of the doctors before something horrible happens to this person.

Bless you!

Can you speak to the patient's family about it and tell them what you think? They may want to speak to her primary care doctor or the in-house nursing home one. I'm sure the family would appreciate this information and would not have a problem keeping your name out of it if you ask them too.