CNA Suspended After Patient Adds Her to IRA and She Administers Morphine

A CNA in Rhode Island recently faced a six-month suspension after crossing major professional boundaries. According to the Rhode Island Department of Health (RIDOH), Christina Goncalves Depina allowed a patient to name her as a financial beneficiary and administered morphine without authorization. Following her suspension, she’ll be on probation for another six months.

Boundary Violations: A Serious Issue

Depina’s first misstep involved financial entanglement. She allowed a patient to name her as a beneficiary of the patient’s IRA—a clear violation of professional boundaries. Even if the patient insisted, this is a hard no. Professional boundaries exist to protect both caregivers and patients, and the National Council of State Boards of Nursing (NCSBN) emphasizes that financial relationships with patients are major violations.

The second issue was medication administration. Depina reportedly gave morphine to the patient multiple times, claiming the patient was “too weak” to self-administer. However, CNAs are not authorized to administer medications, especially controlled substances like morphine. This task falls strictly within the scope of licensed nurses or providers with proper training.

Why Scope of Practice Matters

Scope of practice rules are non-negotiable for a reason. CNAs play a vital role in patient care, but their training does not include pharmacology or medication administration. Studies, such as one in the Journal of Nursing Regulation (2022), show that med errors by unlicensed personnel significantly increase patient risk. Depina’s case highlights why adhering to these rules is essential for safety.

Even if a patient seems too weak or insists on something, caregivers must know their limits. It’s not about being difficult—it’s about protecting both the patient and the caregiver.

Lessons for Caregivers

Depina’s case serves as a cautionary tale for all healthcare professionals. She is now required to complete two educational courses: “Personal Care of Patients for CNAs and HHAs” and “Professional Boundaries for the CNA.” The RIDOH aims to ensure she learns from her mistakes rather than simply punishing her.

For those in nursing, especially in home care settings, this story is a reminder of the importance of maintaining boundaries. Home care can blur lines due to close relationships with patients, but proper training and supervision are key to staying professional.

🤔Nurses, share your thoughts in the discussion forum below!