My mom lives in small assisted living residence. Her meds are managed by the on-call nurse who is an LPN. I had a concern about an Rx re-fill not happening quickly enough and was worried the med would run out before the re-fill came. The nurse was not around so I checked my mom’s mediset and found the medication had already run out. When I brought this up to the LPN she got very defensive and angry with me. She orders the re-fills and was responsible for following up. She knew when the med would run out. I think this is a pretty serious error on her part. She says I am blowing it out of proportion. Because I did what I did, we got an emergency supply from the pharmacy and mom ended up only missing one dose. If I had not audited my mom’s meds, who knows how long she would have gone without.
What should I do?
After that, I would talk to the facility's administrators. An LPN does NOT have the training to determine whether medicine doses should be altered. Ask them to show you the doctor's orders that lowers or changes the dosage.
Last, how close are you to her as in distance? I would keep closer track of her meds. Maybe they need to log how many pills are left in the bottle each day. This is something done with very expensive meds as well as dangerous meds. Then review the logs every so often.
I feel for you.....
Just a story here. My DD did med passes and found that a patients med was 2x more than it should have been. It was the offsight pharmacies mistake and they were fired.
My Mom had been in Rehab for 2 wks before I found out at a care meeting that Mom was not being given her meds for Graves disease. The nurse was upset. It was found though, that the Rehab doctor felt her labs were normal and didn't need them. Further investigation, the hospital doctor felt since she didn't have them for a couple of days, she did not need them. (She was on 5mg every other day and ER was told this) So because the hospital didn't follow thru, another reason the Rehab didn't. No one asked me or my Moms specialist. Her #s were normal because of the meds.
So good for you Mamma being aware.
The doctor ordered the nurse to come in and fill his pills which I had been filling for the last 15 years for him. So when I noticed the medication mistakes I called his POA's and reported it to them.
But watch it you might get reported to Dept of Human Services for messing with the medication. Why I say this because I was reported to DHS for taking medications from his pill boxes. But I had photos of the pills and what was missing and what was given in morning and nights. Also I had ring cameras in the apartment to show what I found out so I had proof. And yes I was unfounded. That day I found the night meds in the morning meds I called the nurse they told me to call poison control and they told me to call the pharmacy which I did. It was their mistake and it was myself taking care of their mistake. The nurses who fill these pills should check what they are filling but they didn't.
Just watch it when it comes to medications there are eyes out there watching. I was turned into DHS twice but were unfounded and I was turned into Social Security for misuse of funds that was unfounded too. When dealing with anyone they can be vicious.
Prayers
Even with these problems, there is no way I am taking it over again.
Remaining med supplies were locked in a tackle box with a key lock.
Yes, it is tedious and often exhausting but too important to leave assuming the meds are filled and given properly.
I ordered all the refills myself and you may consider this. Use your mom's home delivery pharmacy.
In our case, an LPN told my mom to take a double dose so she wouldn’t have to come back to her room. Mom asked if that would harm her. She told mom no and my mom was not one to argue with authorities and took the double dose of her Parkinson’s medication.
When I saw mom the next day she told me about it. Needless to say, I wasn’t happy about what the LPN did.
The first thing that I did was to call the pharmacist to see if mom would be okay with receiving a double dosage.
The Pharmacist said that if it only happened once, it would be okay but she strongly urged me to report the LPN to the DON because she was probably doing this to other patients with all of their medications.
The DON was responsive in investigating the situation. The nurse admitted that she had been double dosing patients due to the staff being short handed. It’s sad when nurses have to work double shifts because they are short handed but this doesn’t excuse them from over medicating patients.
The DON told me that mom would be assigned a new LPN, so I was satisfied in how it was handled. I was relieved that my mother wasn’t harmed by this nurse’s poor judgment and very glad that she wasn’t going to be caring for my mother anymore.
Double dosing patients? My goodness. I’m glad your mom’s DON was responsive to your complaint and assigned a different LPN.
I agree that each State in different but in NJ LPNs (Licensed Practical Nurses) cannot be in charge of Assisted Livings. They work under an RN and that person is their boss. In NJ LPNs do not give injections. My DD worked in DE which allows it. She has done med passes in both States as an LPN. LPNs are limited in what they can do. In hospitals and Longterm care LPNs work under an RN. Aides work under LPNs. From what I have seen, this is how it is in NJ and DE.
Medtechs are certified Nurses aides with further training. They too are supervised by an RN.
"It is a New Jersey state regulation that ALFs must keep a registered nurse on staff or on call. Mar 16, 2023"
Its easy to check on what your State allows. If an RN is required in your ALs then thats who u complain to concerning the aide. If the RN does not handle the problem then the RNs boss. You go up the ladder.
I reported a double dose of a diabetes drug. The pharmacist was required to take extra credit courses on diabetes in order to keep her license.
You were not wrong, the LPN was and should have apologized. She answers to someone in that facility. RNs oversee LPNs. No RN, in my Moms AL next in line would be the Director/Admin.
When I was putting my LO's pills in the pill dispensers this week, one of the pills that regulate blood pressure was larger than the others. He takes 5 mg and the larger pill was 10 mg. This bottle of pills was mail order from Express Scripts. I'm glad I caught it. because if I hadn't, he'd have taken a dose twice as much as prescribed.
Just cautioning - check and double check what's in those pill bottles.
Go to the meeting and ask how they plan to prevent this from happening again.
(Examples might be that mom's meds will be audited by the DON once a week for the next 2 months; the LPN will be sent for further training or subject to additional supervision.)