There's a very fine line...

... between "honesty" and "occupational suicide".

Reporting a med error, correctly documenting when meds aren't given, correctly wasting a narcotic are all important and require honesty. Writing behavior comments on the back of a resident's MAR, writing on the back of the MAR that you "didn't have time" to take a blood pressure or pulse or give a medication, while "honest" almost guarantee that you'll get a hand-slap or worse depending on how management is feeling that day.

I'm for honesty. But if you "didn't have time" to do something, you should report it to your charge nurse so she can get you some help. If a resident is giving you a hard time, either wanting their meds early or refusing them, state the facts on the MAR and report it to your charge nurse. Last night I had a resident who didn't want to take their meds. The gal in Social Services was there and helped me talk the resident into it. Problem solved without writing inane statements on the back of the resident's MAR.

At some point, we have to decide if our words improve upon the silence. If they don't, we need to keep them to ourselves or rework the situation to make it work for ourselves and the residents. There aren't enough CNA's out there as it is. Committing occupational suicide through "honesty" is not an appropriate solution.