Use of Certified Medication Techs in a Prison

  1. HELP!!!!!! I am an 18 year veteran RN in a State Prison for male offenders who also have a mental illness or behavioral problem. We are suffering a 25% vacancy and Management has come up with this "brainchild" of taking unit personnel (who are NOT CNA's by the way), giving them a 60 hour hybrid course in medication passing at a local vocational tech. college, and then putting them under our direct supervision to pass all kinds of psychotropic and anti-anxiety (ie controlled meds) meds to guys who don't have a hoot about what they are taking at times. This is making all of us verrryyyyyy uncomfortable to say the least. I have done some research about med techs in other states and there appears to be statutes that govern their certifications. But not so in Wisconsin.....there are no such accredited positions here. Can anyone help me??? I need some info to take to management as I have volunteered to be on the development committee for this outrageous idea and I want some ammo to help me and the dwindling pool of nurses I work with.
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  2. Poll: Do you believe Med Techs should replace RN positions?

    • yes

      6.45% 6
    • no

      51.61% 48
    • what the heck are med techs?

      18.28% 17
    • only in critical staffing shortages of over 30%

      1.08% 1
    • not replace, use in addition to RN coverage

      22.58% 21
    93 Votes
  3. 18 Comments

  4. by   TerriRene
    I am totally confused!!! Are they nuts or what?? I understand the dilemma. However, this is not the answer!!!! I can see an abundance of liablitity not only to the facility but also to the health care staff. I mean CMA'S do not have the medical background which a nurse has and they certainly can not be used as such. CMA's have been used in long term care however their responsiblities have been limited!!! Unfortunately the use of CMA's even within that setting has been unsuccessful relating to the quality of care. CMA's just do not have an adequate knowledge base!!
  5. by   WRCRN
    Thanks for the support!!! I need to hear from more nurses in the correctional field about this matter. I am going up against some "big politics" as the spokesperson for the nurses and I doooo want my ducks in a row. Ironically, I just received my newsletter "NursingMatters" (Wisconsin based) and the letter from the editor said we as nurses should watch out for "dumbing down" of the profession. One of the things she mentioned was just what is happening by me.....replacing a nurse with a Certified Medication Tech. I am going to give her a call for some advice as well.
  6. by   renerian
    Does not sound safe to me????I assume an RN supervises them...........I would need to know more.....

    renerian
  7. by   TerriRene
    I would not want to be the RN who supervises them. I have been in that position within Long Term Care and I was held liable if they screwed up. There is alot more litigation in Corrections compared to Long Term Care. I just think that someone is crazy for even making this suggestion.
  8. by   sjoe
    I would think your state BON would have some information about your responsibilities in this matter. (And this might be a good time to organize a union, since you don't seem to have one.)
  9. by   Orca
    This is dangerous beyond belief. On a psychiatric unit, you pass medications with a potential for serious, even life-threatening, side effects. Would a med tech recognize the early signs of Lithium toxicity? Would a med tech be able to determine whether an inmate was developing neuroleptic malignant syndrome (I have seen one case, and it scared me to death), or severe extrapyramidal symptoms? What about professional judgment in advising an inmate to seek medical attention regarding a possible medication reaction, or deciding to withhold the med altogether because the situation didn't seem right? How about med education, since most inmates have no idea what their meds are for? Most techs would probably just blindly say, "Take your medicine."

    I understand the dilemma of understaffing. If administration wants to hire people to assist the nurses, fine. Just don't stick them in a classroom for 60 hours and then cut them loose with Lithium and Haldol.

    Not on my license. The day they give me a tech to supervise passing medication is the day I hit the door.
    Last edit by Orca on Oct 10, '02
  10. by   sa48sh
    In Florida Med-Tech's are not allowed to pass pills (or pour them for that matter). Even our pharmacy tech's, who are a lot more familiar with meds and dosages,are not allowed to pour or prepare pills unless they are under the"direct" supervision of the Pharmacist. Speaking of "direct supervision". I have yet to figure out how that saves employees. If I were to have to 'directly supervise' another employee, that's exactly what I would do. I'd watch each and every pill that was poured and handed to the IM. Now PLESAE!!!!!!!!tell me how that's gonna help if you're short handed already. Maybe "they" think you'll just let the med-tech pour and pass the meds and sign off the appropriate papers while you're busy doing something else? I don't think I'd leave but I certainly would follow the letter of the law."direclly" supervising."sorry I'm busy now supervising the med-tech for whom I am responsible if a mistake is made". It's time for us to put our foots down!!! Just because there's a nursing shortage(and don't get me started on THAT subject) dosen't mean that we have to accpt every lame-brained idea 'they' come up with. Contact your Board of Nursing and get a copy of the Nurse Practice Act in your state. Review it VERY carefully.
  11. by   susan18
    Quote from WRCRN
    HELP!!!!!! I am an 18 year veteran RN in a State Prison for male offenders who also have a mental illness or behavioral problem. We are suffering a 25% vacancy and Management has come up with this "brainchild" of taking unit personnel (who are NOT CNA's by the way), giving them a 60 hour hybrid course in medication passing at a local vocational tech. college, and then putting them under our direct supervision to pass all kinds of psychotropic and anti-anxiety (ie controlled meds) meds to guys who don't have a hoot about what they are taking at times. This is making all of us verrryyyyyy uncomfortable to say the least. I have done some research about med techs in other states and there appears to be statutes that govern their certifications. But not so in Wisconsin.....there are no such accredited positions here. Can anyone help me??? I need some info to take to management as I have volunteered to be on the development committee for this outrageous idea and I want some ammo to help me and the dwindling pool of nurses I work with.
    Reply to WRCRN: My state prison uses Med Techs, but they are always CNA II's with 1 yr. experience, and we in DOC in our state have to train them through not only a 40-hr. course we administer (that I teach as a nurse educator to these Med techs) but they must also take a final exam, and then complete a clinical skills checklist that is quite involved, for 3 times on each item. Only an RN can sign the tech off. Once the checklist is complete, a certificate is issued from our Nursing Education Dept. that these Med techs have successfully completed the DOC med Tech course, and they are allowed to pass meds (no IM or SQ, or any insulins) to our inmates. We have a prison population of 1300. My state is on the forefront of all this in the South. I don't totally agree that the use of these techs is any answer, but we as RNs in the DOC system have clear guidelines from our Board of Nursing re their role, and our responsibility, where it starts, and also what it encompasses. The techs cannot do any patient teaching, for example. In the NC DOC we have more than 100 techs already since late 2001, and the goal is for 250. All in all, they fulfill a role, but I am kind of old fashioned, and feel licensed staff only should administer meds.
  12. by   ceceliajane2003
    [font=franklin gothic medium]sad4ddark blue
    [font=franklin gothic medium]undefinedundefinedundefined


    dear susan18,
    i thoroughly agree with you. i was thinking maybe your congress man/woman.its election time and you know,with a large pettion, maybe.get in touch if u need mine.

    sincerely,
    lisa
  13. by   psychonurse
    undefinedundefined i would also talk to the ncchc if your state is accredited. there might be something in their guildlines that might keep your supervisors from doing this. i could be wrong but i don't think that they would allow cme's to pass medication in the correctional setting.
  14. by   sbic56
    The practice of using techs in this capacity has long been used in Maine in resdential settngs such as with the elderly and in psych. The tech are called CRMA's, Certified Residential Medication Assistants. Their only requirement is that they pass a 40 hour med course and a refresher every two years. Supervision of CRMA's is part of my job at the mental health agency in which I am employed. They do need alot of support and teaching, but this system does work. Major med errors are not the problem you might expect they would be. The clients we serve receive several medications for psych and medical reasons. No harm has come to them at the hands of the med techs over the years. Would it be ideal to have nurses in all these settings instead? Sure, but the money is hardly there for this nurse, so this is the reality. I am not suprised this is going on in the jails now. I won't be at all suprised to see this catch on as it is a viable solution to the shortage of both nurses and the money to pay them in certain settings. I can see not many agree with this and I understand the fears, as I was quite concerned when I first took this position, but I think you will be suprised to see the outcome is not a bleak as you think.
  15. by   ceceliajane2003
    [font=franklin gothic medium]franklin5




























    to sbic56
    i believe techs to pass meds in a very controlled environment. such as prison. they're in a booth with a window pass them like that.
    yours truly
    cj2003














    red :hatparty:
    Quote from sbic56
    the practice of using techs in this capacity has long been used in maine in resdential settngs such as with the elderly and in psych. the tech are called crma's, certified residential medication assistants. their only requirement is that they pass a 40 hour med course and a refresher every two years. supervision of crma's is part of my job at the mental health agency in which i am employed. they do need alot of support and teaching, but this system does work. major med errors are not the problem you might expect they would be. the clients we serve receive several medications for psych and medical reasons. no harm has come to them at the hands of the med techs over the years. would it be ideal to have nurses in all these settings instead? sure, but the money is hardly there for this nurse, so this is the reality. i am not suprised this is going on in the jails now. i won't be at all suprised to see this catch on as it is a viable solution to the shortage of both nurses and the money to pay them in certain settings. i can see not many agree with this and i understand the fears, as i was quite concerned when i first took this position, but i think you will be suprised to see the outcome is not a bleak as you think.

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