Is anyone else uncomfortable with this? - page 2

I know I should be thankful when a CMT is on my floor and passes my meds for me, but it makes me somewhat uncomfortable and I feel the need to pass the meds myself. I'm just not sure that a CMT will... Read More

  1. by   Tiwi
    Quote from RNsRWe
    If they are permitted to give medications only with an RN standing there, what is the point? I'm not about to STAND there while someone else is medicating my patient...?

    Anyway, I wouldn't do it, or rather wouldn't have it done FOR me. I draw up my meds, I give it to the pt after deciding that they should have it, and I am responsible both for the consumption and any after effects. No way would I have someone else medicating my patient, unless it was ANOTHER nurse that I asked to do it for one reason or another (like if I was covering an IV med for an LPN, and asked her to give a PO med for me at the same time).
    I don't blame you. Thats why I stated:
    1. RNs don't have the time to supervise an non-med endorsed Enrolled Nurse to give medication
    2. Medication Endorsed ENs can give medication as they too are nurses but have had the six month extra pharmacology training to legally do so.
    3. I would/did not give any medications that the RN had prepared so that I could give them. That compromised both me, and them, legally.
    4. Every other state in Australia recognises medication endorsed ENs (similar to LPN/LVN).
    5. The only difference between me and a med-endorsed EN was the pharmacology course. I could still check IVABs, narcotics etc, with an RN, but I couldn't give them, and I could only give a limited range of oral, nebulised and PR meds without anyone watching me, legally.

    The system is very frustrating and it is one of the major reasons why I did my RN. Southern Australian states are much more logical...
  2. by   chenoaspirit
    I agree with you. It also makes me nervous when students pass my meds. I would rather pass them myself.
  3. by   Tiwi
    Quote from chenoaspirit
    I agree with you. It also makes me nervous when students pass my meds. I would rather pass them myself.
    Can students in the US give meds without supervision?
  4. by   BrnEyedGirl
    I have never worked w/CMT's or in long term care. The only time I've worked on the unit w/an LPN she was there to assist me and didn't take her own group of pts.
    With that said,.I have a good friend (who used to work in a stepdown/tele unit w/ me), who is the DON of a rather nice LTC owned by a hospital. We have had this discussion several times,.her point was that A) her pt's were not supposed to be acutely ill enough to be hospitalized,.B) the meds that are given are routine meds that these pts have usually been taking for years and many of the pts will be leaving the facility to go back home and obviously will be taking the meds themselves. How many pts at home check their BP everytime before taking their Toprol? Especially if they've been takning it for years and know their BP still runs a bit high? I can see the PP point on someone choking from taking meds,.but again if they have a swallowing problem why are they even given PO meds from the DR.? In the limited exposure I've had w/LTC I can't imagine how the nurse, who is often the only nurse for 40 residents (or more) could possibly function w/o someone to help pass routine meds! It's a tough job and my hats off to those of you who have chosen this field of nursing.
  5. by   WingsEarned21
    I know I do not like this idea .I feel what the heck did I bust my butt in school for then.I have to agree after watching some of my coworkers it kinda scares me.It was so bad and someone licensed gave too much insulin that now we have to have a coworker check and co sign our insulin we give.I also do not agree with aides or assistants whatever you would like to call them in assisted living facilities passing meds either especially those that are predrawn up .I do not even like giving predrawn meds that the pharmacy has drawn up n sent to the floor .How do I know that tech or pharmacist didn't make an error.(despite what some pharmacists would like to think they are human too).I already know of incidences in assited living facilities where the med passer took narcs and it was under the nurses license ,now how do you think that looks and the strain it puts on her license she worked hard for .I say nah nah to this.
  6. by   Tiwi
    I was agreeing with you ppl in my usual confusing way by saying I refused as an "underling" to pass/give meds simply for my own and the RNs protection. I think the difference in the two systems should not weigh this conversation down - my 2 cents worth became 2 dollars worth *grin*. So I'm going to look for my pillow, and give this poor keyboard a rest. Its 0050 CST in Oz, on Tues March 6th... so, nighty night.
    Last edit by Tiwi on Mar 5, '07 : Reason: messed up yet again - its too late/tooearly in the morning
  7. by   charebec65
    Quote from Tiwi
    Can students in the US give meds without supervision?

    Hey Tiwi,

    After your later post I understood what you were saying.... Anyway, here in the states give meds but only under the direct supervision of their clinical instructor or preceptor, at least in the PN program. I'm just getting started with the RN program so I don't know yet how it works.
  8. by   Atl_John
    Yes, as a student I can give meds, but I have to get the meds from a RN or my clinical instructor. However, I go into the room alone and I administer the meds, be they PO, SQ, IM, IV. My instructor asks me things on each med, and then I have to prove that I am capable of giving the meds. Some watch you do it multiple times, others only once or twice. But they ask lots of questions which we are more than happy to answer to show we are being safe with our patients meds.

    When I precept, I will from what I am told be getting them on my own but with my preceptors supervision, that will entail her/he becoming comfortable with me, and maybe asking me questions on certain meds like digoxin , etc, and then I give them. But the preceptorship is supposed to be a way for me to "learn to be a nurse" with less strings so to speak then as a student doing clinicals.
  9. by   ccyrrus
    Good grief! Not this discussion again! :smackingf This is a very controversal subject.

    I can't speak for every state, but where I live, the CNA-M course is 120 hours. A person has to have worked at least one year as a CNA, before they are even accepted into the class. There are some prerequisites that have to be completed, as well. I have heard the argument many times from RNs who said that they had to go to school for two years, to be able to pass meds. But RNs are learning so much more than that! They didn't spend two years in school just learning to pass medications!

    I personally don't see anything wrong with the CNA-M course. (Although, I guess I am in the minority when I say this.) However, I remember a time when RNs were upset because LPNs were given the right to pass meds. Now nobody even thinks twice about it. Times change, and we have to change with the times. As long as people are properly trained, I really don't see the problem.
  10. by   Tiwi
    Quote from charebec65
    Hey Tiwi,

    After your later post I understood what you were saying.... Anyway, here in the states give meds but only under the direct supervision of their clinical instructor or preceptor, at least in the PN program. I'm just getting started with the RN program so I don't know yet how it works.
    As an RN student giving meds, I had to have an RN observe me dispensing and giving to the patients, and every med had to be countersigned, even acetominophen (we call it paracetamol in Oz, so I hope I have spelt it correctly). And of course, like anywhere, those RNs loved asking curly drug questions :imbar . When I finally started giving meds as a qualified RN, it was so weird - I was still looking for the apron strings!
  11. by   cmatobe
    Quote from ccyrrus
    Good grief! Not this discussion again! :smackingf This is a very controversal subject.

    I can't speak for every state, but where I live, the CNA-M course is 120 hours. A person has to have worked at least one year as a CNA, before they are even accepted into the class. There are some prerequisites that have to be completed, as well. I have heard the argument many times from RNs who said that they had to go to school for two years, to be able to pass meds. But RNs are learning so much more than that! They didn't spend two years in school just learning to pass medications!

    I personally don't see anything wrong with the CNA-M course. (Although, I guess I am in the minority when I say this.) However, I remember a time when RNs were upset because LPNs were given the right to pass meds. Now nobody even thinks twice about it. Times change, and we have to change with the times. As long as people are properly trained, I really don't see the problem.
    Thank you, ccyrrus, for such a diplomatic answer.

    I just started the cma training program in SW Ohio, and I will say it is intense! Perhaps I will have time this weekend to put up a course outline - so far it has been study, study, study!

    There are 8 students per class, 80 hours of classroom, and 40 hours of clinical, which will be done 1 on 1 with an instructor. Then we take the state tests, both written and skill test, with state nurses.

    I suggest that the people who are in such doubt over this program read up on it - the OBN has a website that explains everything, including the fact that the nurse is NOT responsible for the cma`s actions - only in extenuating circumstances. And there is much information in the nursing magazines and newsletters.

    We will be accountable to, and answer to, the OBN the same way the LPN`s and RN`s do. And that is as it should be.

    :deadhorse
  12. by   nursejohio
    While I didn't read all (or even the majority) of the 68 pages of regulations related to the medication aids in Ohio, what I did read made sense to me. The aides only give PO, topical, inhaler or suppository meds. No narcs, IVs or injections.

    The RNs delegate to them, but the OBN says "A registered nurse or a licensed practical nurse acting at the direction of a registered nurse, who delegates the administration of medications to a certified medication aide in accordance with section 4723.67 of the Revised Code and this chapter, shall not be liable in damages to any person or government entity in a civil action for injury, death, or loss to person or property that allegedly arises from an action or omission of the certified medication aide in the administration of the medications."

    It also says that the aides do not give the initial dose of any medication, and as far as I can tell, only applies to ltc type facilities. It really wouldn't do any good to have them in hospitals anyway, because almost every day at least one med is new or changed. If I was an ecf nurse, with 16-25 residents to make multiple med passes on, I'd be saying bring on the CMAs. I watched the nurses push the med cart up and down the halls literally all day, often staying over to chart because of the amount of meds, treatments etc they had to do during their shift. Anything to safely reduce the load on those angels is a step in the right direction
  13. by   stillpressingon
    What are CMT's and EN's?

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