CNA's passing meds in ALF. What's your opinion?

Specialties Geriatric

Published

I have a big problem. I have been observing CNA techs passing meds in ALF's this year with huge med errors. Like not knowing the doses, side effects, checking with Doctor's for old orders.meds not in the drawers and pts. not get their meds for 10 days.What about a pt getting 17 PO meds at 8am!!!! Not one single nurse in the ALFs.

We as nurses go years to school to learn meds and general nursing tasks.

What is your opinion on this?

Thanks.

I have a big problem. I have been observing CNA techs passing meds in ALF's this year with huge med errors. Like not knowing the doses, side effects, checking with Doctor's for old orders.meds not in the drawers and pts. not get their meds for 10 days.What about a pt getting 17 PO meds at 8am!!!! Not one single nurse in the ALFs.

We as nurses go years to school to learn meds and general nursing tasks.

What is your opinion on this?

Thanks.

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Long Term Care Columnist / Guide

VivaLasViejas, ASN, RN

22 Articles; 9,987 Posts

Specializes in LTC, assisted living, med-surg, psych.

Where do you all live, that you have actual certified people passing meds in assisted living facilities? Here in Oregon, the medication assistant doesn't have to have ANY formal education at all, just a few days training and then she's on her own passing meds to as many as 50 or more residents.

I was the DON for three such facilities at one point, and what frightened me most of all was that the administrators would hire people, literally off the streets sometimes, and expect their established med aides to train them in two or three days, max. Then *I* was supposed to be responsible for them....well, I was truly fearful for my license. Although I did have some good med aides, the vast majority were well-meaning but poorly educated people who were basically in it for the $8.50 an hour the position paid, and some of them couldn't even read the names of the medications, let alone know what they were for.

Kudos to you CNAs who at least know enough to be uncomfortable with giving medications! Perhaps if more of you speak out, ALFs will have to change their requirements for med aides without having residents be harmed, or even killed, because of errors that probably would not occur if a credentialed, trained person were passing meds!!

Nurse2B73

53 Posts

Specializes in Med Assistant, EMT and CNA.
Where do you all live, that you have actual certified people passing meds in assisted living facilities? Here in Oregon, the medication assistant doesn't have to have ANY formal education at all, just a few days training and then she's on her own passing meds to as many as 50 or more residents.

I was the DON for three such facilities at one point, and what frightened me most of all was that the administrators would hire people, literally off the streets sometimes, and expect their established med aides to train them in two or three days, max. Then *I* was supposed to be responsible for them....well, I was truly fearful for my license. Although I did have some good med aides, the vast majority were well-meaning but poorly educated people who were basically in it for the $8.50 an hour the position paid, and some of them couldn't even read the names of the medications, let alone know what they were for. Kudos to you CNAs who at least know enough to be uncomfortable with giving medications! Perhaps if more of you speak out, ALFs will have to change their requirements for med aides without having residents be harmed, or even killed, because of errors that probably would not occur if a credentialed, trained person were passing meds!!

Hello,

I live in California and when I was in Sacramento I worked in an assisted living facility where I was a med clerk. I passed meds. I am not a CNA. I am training for that now. 3 years later. I have training as and EMT with 8 years experience and Medical Assistant.

I have to say you have to be careful when doing that kind of job. they tend to hire the wrong people and they use to make me mad changing the med schedules behind my back or on another shift. We had a resident pass away because they were only giving her antibiotics during the day. None in her system at night. I had it scheduled to be in her system at the right times and amount a day and they switched it after my shift. I told the DON about it and she did nothing. I am sort of glad I did not stay there. I hope that they will get a better protocal and policy to deal with medication.

Well enough of me talking.

Take care and God Bless

Med Clerks

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

Unlicensed people passing out meds? What a bad idea....

poe me

46 Posts

Here in St.Louis, there are ads all the time looking for med level 1 aids to pass meds. I thought that a CNA had to be a CMT in order to pass meds, guess I was wrong. I went to a technical school to get my CMT license and there was a pre-test that I had to take and pass before I was allowed in the program. Most ALF's don't hire CNA's to do meds but unfortunatly some places do. There's to much of a risk and anyone who pass medications should have a license to do so. Just my opinion!

jnette, ASN, EMT-I

4,388 Posts

Specializes in Hemodialysis, Home Health.

Wow. I had no idea ! Seems hard to believe ! HOW do they (the facilities) get by with this? I thought there were state and/or federal regulations in place when it comes to passing meds of ANY kind ..... ???

Scary thought. :stone

mittels

126 Posts

The assistants that pass meds here are not considered cna's they are referred to as pca's (patient care tech's). They are trained to assist the residents with giving them their meds. If the the residents are not competent enough to know what they are taking then they are to high a level of care. The PCA's are tested prior to them being allowed to dispense meds and need to pass the test with at least an 80%. Seems a little strange doesnt it? Think about it, assisted living. If the resident was at home would they be able to even open the bottle of pills to even take their prescribed medication? Would their family come every day to do this for them? Would you? As I recall in school with my pharmacology test, it dealt with quit a few meds and what should basically be done prior to giving them.

tmoorelpn

17 Posts

I agree, I think with all of the new medications out there that it's downright dangerous. There's no way for even nurses to know everything about every type of drug but I think there should be a certain education level required to pass medications, IMO

Here in St.Louis, there are ads all the time looking for med level 1 aids to pass meds. I thought that a CNA had to be a CMT in order to pass meds, guess I was wrong. I went to a technical school to get my CMT license and there was a pre-test that I had to take and pass before I was allowed in the program. Most ALF's don't hire CNA's to do meds but unfortunatly some places do. There's to much of a risk and anyone who pass medications should have a license to do so. Just my opinion!

Megan-Cho

52 Posts

In Ohio it's like this, I believe...

If the ALF is run with real MARS and institutional packaging, i.e. each med is in a box strip packed and labeled or bubble card, there has to be a licensed nurse. So, many of the ALFs or group homes get around it, using untrained people, by using the multidose packaging. Some pharmacies sell this to the owners and management by saying that an aide/tech whatever can hand the bubble full of various meds to the resident and the resident can take them all themselves. They sell it by saying that it saves $$$$ by saving medpass time. The part they neglect to inform the unsuspecting customer about is that if there is a change in any ONE of the 5 to 10 meds in that bubble that the entire packaging system has to come back to the pharmacy and be re-dispensed. Well, we all know medicaid isn't going to pay for a re-dispense so the facility ends up paying OR illegally taking the d/c'd or chgd med out of the bubble and putting the new med in. All of this done by untrained people in less than ideal environments. At that point the person is administering meds again and not just assisting. This type of dispensing system is not ALWAYS wrong - just has to be managed correctly. Educate yourselves on the laws in your state down to the letter. Call the State Board of Pharmacy. Make sure that your supervisors, Administrators, Owners know the law. Let them know you are not trying to cause trouble you are just worried that they are being exposed to unneccessary liability. Something NO ONE wants in this industry! Document everything you can personally so you are covered. Once you know the law, and have passed it on. Make sure your policies adhere to it! IF you are told to do something against the law at that point. LEAVE! Not every other 'tech' or 'med aide' out there has your level of training and concern. You AND your residents could be endangered.

WI_cna

5 Posts

i work at an assisted living facility in WI im not even a cna and all i had to do was take a medication training course(course was 8 hours) and i pass meds. we have narcotics(although the residents dont ever take them) that we have to count at the end of EVERY night. i havent had a problem with it. we dont pass out that many meds really, but i am very careful with what i do.i learned alot in that class about side effects, dosages, dr. orders and the such. ive had to do telephone doctor orders before to discontinue a med and whatnot. i admit its alot of work, making sure everyone gets there med on time, keeping a close eye out for possible side effects and calling the doctor when there is a problem but i love the work i do and i would do anything to make these residents' lifes' better,which is why i feel comfortable passing meds because i have confidence in what i know and have learned.

Megan-Cho

52 Posts

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