CNA's passing meds - page 5
I have heard tales that in some states the CNA's are the ones who pass meds. I was just wondering if any of you live in any of these states that supposedly do this and if the CNA courses are more... Read More
Sep 4, '02Hiring "trained" med passers is not going to allieviate the nursing shortage or enable better care.
Promoting the profession and fighting for better wages and working conditions will help.
I feel that NMDD and NMMF facilities have taken a step backwards with their use of CMA's.
All facilities both acute and LTC are becoming more and more inundated with redundant paperwork and regulatory watchdogs that todays nurse must not only have his/her skills top-notch but must also be acutely aware of regulation changes, osha requirements, federal and state guidlines and regs. as well as the many legal issues.
I know there are times when we all would be glad to have the extra help to pass meds and we could concentrate on dealing with "more important issues" but it will be difficult to convince me that med aides are a viable answer.
Sep 4, '02I often wonder why, if tasks that were once the responsibility of RNS continue to be delegated to PCAS, LPNS, etc , do we even need RNS at all? To do all the mounds of paperwork? I always hear LPNS and others indignantly say things such as, " Well, I do the same things the RN does...I just get paid less," hmmmm.....
Sep 4, '02Originally posted by fab4fan
A bigger MANSION?????????
That speaks for itself, or else you need training in using metaphors.
Sep 4, '02Personal attacks go both ways, my friend. You made assumptions about my background, presuming that I was ill informed on this matter. Do you really know that? I didn't think you had to post your CV to be able to respond to a post.
I said it before and I'll say it again: There are always people who will excuse ways to de-skill nursing until a lawsuit happens, then that pesky little priciple of respondeat superior rears its ugly head, and where is the poor charge nurse. Will management defend her? Probably not...they will find some way to make it her fault. So as long as there are people who try to excuse this, I will respond with "both guns blazing." There's a real Western metaphor for you.
If this level of care is OK, then it has to be OK for all...your family and VIP's. Somehow I think a VIP would not be getting his/her meds in this manner (This reminds me of the old commercial, "I may not be a doctor, but I play one on TV...").
Healthcare on the cheap is not care. And that is my final answer.Last edit by fab4fan on Sep 4, '02
Sep 4, '02"Both guns blazing" on the issue, is one thing. However, just for what it's worth, and I'am quite sure that you won't think it's much, if your attacks on ADONDONNARN are any indicator, she simply stated her views on the subject matter, and the fact that she's a teacher.
You are the one that began the personal attacks, not her.
I work in Texas and med-aides are one of the most useful tools that can be imagined; properly supervised, and it sounds like they certainly are in her case.
I hear fear for your job more than a fear for your patients. Any nurse worth their salt will use the best of what is available to them to enable them to care for their patients, not attack someone else for doing their best.
I don't usually respond to these things, I just read. However, your unwarranted attacks on her are enough, already! I personally hope that the last post WAS your final word!!!
Sep 4, '02I am a LPN currently enrolled in a RN/ADN program and just this morning I had a conversation with a classmate who is a Medicaid nurse aid that left me a little concerned and worried. My classmate said she works as a nurse at the nursing home. I said you mean as a nurse aid..she said NO...I WORK AS A NURSE! I asked her to clarify what she had just said thinking I had heard wrong and she cocked her head to the side and repeated herself. I asked her to go into detail as to HOW she represented herself and worked as A NURSE. Apparently she is the ONLY employee on the unit at her nursing home and she does all of the nursing care for the patients.( There are nurses close by on the other skilled units.) She got really mad at me because I said that she better be careful since she was working under the license of the charge nurse! I asked her what she would do if she ever got into trouble and she said " I will drag them them down with me. I ain't goin' down alone!!!!)
I am NOT saying that this person isn't a FINE Medicaid Nurse Aide. This has got me to thinking.....and it's NOT GOOD what I am thinking at this point.
Scared to stick with it,
Sep 4, '02To turn this back to the issue . . .
One of the things I've worked very hard at is understanding the chemical reactions involved in medications. I've studied those kinds of reactions (chemistry and cell biology) until I thought my brain was fried. Some would say it already was. But, in learning those chemical reactions, and what happens at a molecular level when a chemical compound is introduced into the body via a medication, gives me a different perspective on the idea of medication aides. As mundane as a med pass often becomes, we are still initiating some very real actions on tissues and muscles. A med aide can certainly watch for "side effects" and "adverse reactions" if they are listed in a PDR or whatever drug book they happen to use. Yet, it makes me very uncomfortable that they can't evaluate the drug's effects until that reaction becomes so pronounced that it would be obvious to anyone.
In all my previous posts on this topic, that is the one element that no one has commented upon. The fact that these CMTs/CMAs, no matter how conscientious or kind-hearted or dedicated they may be, can NOT evaluate a medication's effectiveness, whether or not the med is achieving it's desired effect, or whether it is causing a drug interaction or indiosyncratic effect or adverse reaction. These meds often start "working" within 20-30 minutes via a po route, immediately when via nebulizer.
How can the nurse doing ANYTHING else, no matter how "important," evaluate the results of these meds if he/she isn't there on the floor to see it?
There's talk of fear being a factor in this thread. I'm not talking about this from a fear point of view. I'm talking about this as a part of the responsibility of delivering a medication to a client, part of the "nursing process." The evaluation is just as important as giving the right med to right pts., at the right time, etc. How can we possibly forget the evaluation process and deem it unnecessary? How can you evaluate if you aren't giving the med? How can such an important part of our care and treatment be delegated? How does the nurse know, for example, when Lanoxin is being effective if the NURSE isn't the one listening to the apical pulse before administering the med?
I fear, yes. I fear that those who are proponents of this are doing so from a lack of understanding or knowledge about the effects of medications and the entire responsibility for that, a lack of exposure, perhaps, to the fairly recent changes in Standards of Care, and the ANA's position on the "Nursing Process." Please don't take that as a putdown. If it sounds that way, it is a lack on my part of finding the appropriate words, or less offensive language.
I've sat here for two days reading the "pro" posts and trying to have an open mind to new ideas and ways of doing things. But, I just can't shake off this feeling that surely you've forgotten, or don't understand, that "evaluation" is just as important as the "implementation" of ANY aspect of nursing. A CMA/CMT is not qualified to evaluate without assessment and critical thinking skills.
Sorry I've taken up so much of the baud rate on my thoughts.
Sep 4, '02Again, a bandaid to put on an oozing wound. Using the nursing shortage as an excuse is lame. It goes to show in every area of nursing there are issues that need to be address. Hiring unlicensed individuals to pass meds and making licensed nurses be held responsible is crazy. Why should a LVN/RN go behind anyone when they can pass them med themselves. Redundancy is the mother of all fcuk ups!!!!!!!
When the powers that be face the nursing shortage issue head on without sugar coating then maybe just maybe things wouldn't get so bad.
Sep 4, '02I live in Pa and at the facility I work at now, the CNA'S are permitted to pass the meds to the personal care residents. A lot of personal care facilities do this. I have never been happy with that d/t the fact that altho some of them may have been giving meds to loved ones at home/ taking care of family... that does not qualify you to pass meds. There are sooo many things to be alert for that even licensed nurses may miss. I just am not comfortable with them doing that. What's worse is who do they calll when they are in trouble... or a resident doesn't look or act right... you know it... the nurses. I am not down on CNA'S... I used to be one, but I feel a problem/ accident will happen if the state permits this to continue. I hardly ever give a lot of prn meds... just 1 look at their medex's, some nurses's aides are "prn med queens" I would feel alot better if a nurse was assigned to do the med pass or....send the CNA'S to class. But that's just my 2 cents worth. Laura LPN
Sep 4, '02Where I work, only RN's pass meds. I wouldn't be surprised if this wrongful med passing was taking place in small LTC facilities. I worked very hard to have my education and licence, no one should be able to replace part of my job. Passing meds is part of being a nurse. A nurse is a nurse, aides are not nurses!
I know many excellent nurses aides, but they don't know what we are thinking or assessing when we walk in a pt's room. I was an aide where I now work as an RN, so I know how aides think.
They are not qualified for the responsilibity, and if they want the responsibility, they should go on their own licence.
Looking in med book doesn't cut it either.
If you want to be a nurse, go to school to be a nurse.
Sep 4, '02Originally posted by Flo1216
I often wonder why, if tasks that were once the responsibility of RNS continue to be delegated to PCAS, LPNS, etc , do we even need RNS at all? To do all the mounds of paperwork? I always hear LPNS and others indignantly say things such as, " Well, I do the same things the RN does...I just get paid less," hmmmm.....
I'm sorry...but I just couldn't resist!
Sep 5, '02I have to agree, Brownie.
Although I presently do almost as much as the Rn, I probably have less difficulty doing it for I make more!
Isn't life funny?:chuckle