How the heck does this happen?

  1. My friend works at a group home for children with autism.

    She told me that she and her friend who also works there give PO meds on a daily basis to these children. (Seroquel, Risperdal, Lexapro, etc). She told me that they administer these drugs to the children and they got maybe 5 minutes tops on how to administer them. OMG, whats up with this??

    She said they even have some sort of 'MAR' with the patients name and the med lists with the times to be given, etc. How is this legal?

    She said its scary to them because they dont even know what the drugs are for. ahhhh

    Just wondering.
    Thanks!
    Last edit by Jesskanurse on Feb 18, '07 : Reason: added a comment
    •  
  2. 11 Comments

  3. by   Jesskanurse
    anyone??
  4. by   RNsRWe
    Quote from Jesskanurse
    anyone??
    My, you're impatient

    Well, I imagine there's a loophole or something that deals with that kind of setting that allows it. They are not in a hospital, they are in a residential environment, and perhaps having parental or guardianship permission is sufficient. I don't know the laws relating to this specifically, but apparently there's something there.

    In my child's school, children who are to be given medications prescribed by the children's MDs/NPs have a MAR in the nurse's office. The nurse there administers the prescribed med with the parent's written permission. When the nurse is not there, a substitute is, and it is NOT always a nurse. And the MAR is still kept: the child will receive the routinely-administered dose of the prescribed med at the prescribed time, regardless of the fact that the person handing over the pill is a substitute and not a licensed nurse.

    As far as the group home goes, I wouldn't mind if my child were to be receiving the meds prescribed by the child's doctor and supported by myself from a non-licensed person *IF* the person had a clue what the meds were for and what side-effects could occur. I don't like the idea that they are passing meds without a clue, but like I said, I imagine there's some legal loophole allowing it. You said "children with autism", but I'm wondering if they actually are minors...? Or are they adults with guardianships in place? And not all adult group-home residents require guardianships, either: some can act on their own behalf, regardless of having that dx.
    Last edit by RNsRWe on Feb 18, '07
  5. by   htrn
    My daughter was in a residential facility with type of set up. She has PDD, an autism spectrum disorder, and has been on many different medications. The facility had her meds set up in a punch card/blister pack for easy administration and they had something similar to a MAR that was used to keep track of her meds. These facilities work under different regs, so that is how they are able to administer meds like this.

    btw, she was 13 when she went and was there for 8 months.
    Last edit by htrn on Feb 18, '07 : Reason: additional info
  6. by   Franksters
    I think it is partly due to the state of health care today. In an effort to keep up with the demand, we are spitting out nurses, techs and drug passers. I am very concerned with the direction health care is going. Nurses are being asked to do more and more with less education and resources. From the way we are treated by a lot of patients, nurses no longer receive the respect we deserve.
  7. by   ZippyGBR
    do you have to be an RN to give a medication , all ready prescribed by a doctor (or other independent prescriber) to someone else - especially when it';s their drugs from their packet prepared by (or under the supervison of )a pharmacist ?

    in UK law that is acceptable for all oral , topical and inhaled drugs, only parenterlas have to be adminstered by Health Professional - As long as the drug is suppled for the named patient

    so the situation with blister packs is entirely legitmate - i regularly used to do that i nthe 'residental' unit of the care home i worked in before going to Uni to do my Pre-registration ,

    compare that to the hospital setting where the drugs are i nthe drug cupboard as stock and the RN has to select the right drug i nthe first place not just pop the pills out of the individuals pre-perpared ( by a pharmacist) pack
  8. by   Antikigirl
    Dependant on the licensure of the facility, caregivers can administer PO and Topical medications with little or no training. Look at some Assisted Living Facilities or group homes that don't have nurses 24/7...they have caregivers pass meds.

    However, I would urge your friend to spend some time looking up the medications or have a medication reference book nearby! It is her bottom in the boiler if something goes wrong! If anything..teach the five rights of med admin (patient, dose, date/time, route, med...now there is MAR, Effect, and reaction last time I checked), and have her make up some med cards with that info or highlighted in a medication book.

    IF there is an RN deligating this to them...the RN better get on the ball and do proper delegation (training, information printed and available at all times, and testing of med administration every 90 days documented..well at least that is the rule in my state, others may differ in delegation/assignment of tasks!).
  9. by   Jesskanurse
    She told me there isn't one RN in the total facility. I actually did sit down and teach them the rights and told them to get a drug book.

    Just very scary to me. She said no one there is a nurse. I asked her if she knows the signs of an allergic reaction and she's like, "haha... NO"
  10. by   PeachyERNurse
    I worked in a group home where the clients were developmentally disabled. As a residential counselor, I administered meds daily to these clients. The meds were in blister packs. We received a 2 hr training from an RN on medication administration/how to fill out a MAR and that was it. I now work in a different residential setting where the clients are have mental illness and substance abuse issues. I received no med training, and I routinely hand out meds to these clients. The only difference is at this facility we hand the meds to the clients and they administer it to themselves (just as if they were on their own at home). They say it's illegal to administer meds if you're not a nurse or doctor, so I'm wondering why I was doing it at the first facility I worked at.
  11. by   ritarunningfeet
    In michigan I know the rehab/residential facilities can pass meds under an RN, once they had a training class. I worked in a facility like this before becoming a nurse(brain injury rehab/residental). The RN was only part time and durning the day, so the only time I ever saw her was when I took the initial med training class when I was hired. We could pass PO, do topical, and do an accucheck and give insulin. The nurse had to check the MAR's every month before it was time to use them to make sure they were correct. If something was changed she was the only one who could make the correction. The MAR's looked like the kind you find in nursing homes, and our meds came in monthly blister packs. If we made a med error it was written up and after 5 we would be terminated, so they took the accuracy seriously. When I started there I had inquired as to why we could pass meds, they said state regulation allowed because of the rehab facility, as long as it was under an RN's license, and she held a med passing class. I know this much, I wouldn't want to be that nurse!!
  12. by   chuchie
    I'm a nursing student working in a group home and I am allowed to give medication to our residents. There is an RN assigned to each house (we worked under her license) and we had to go through an 8 hour medication class before we could pass meds. I think home health has different regulations regarding this vs LTC facility. If we make documentation or med error we can only get so many before they decide if we have to go through the med training class again or if we will be terminated.
    Last edit by chuchie on Feb 18, '07
  13. by   fultzymom
    A woman that I work with now has told me that she used to work at a Mental Health group home type setting. She passed meds and she is not a nurse. In fact, she used to be a beautician. She did not seem to think any thing about it but I am with most others. I think they should know what they are giving and what they are for and what possible side effects to look for.

close