Letting CNA pass your meds, bad idea? - page 10

I fill the cups and check for all interactions and whatnot, but anyone have any negative experiences or can think of any possible neg exp with this? Thanks... Read More

  1. by   Balder_LPN
    I thought this whole conversation has been around and around and around and around this board. Here is an article on what our sate BON says. http://www.wsna.org/snas/wa/practice/update.asp?id=14

    WA State Nurses Association WSNA (not the BON) position statement
    "WSNA Supports that:
    a. Medication administration to patients in all settings is a critical task that involves
    adequate education and training, clinical oversight and consistent evaluation of
    outcomes.
    b. Medication administration in acute care and other settings with patients having
    complex and unpredictable conditions should be limited to licensed nurses, RN and
    LPN’s.
    c. The RN may delegate medication administration to unlicensed assistive personnel
    (UAP) In settings having patients with stable and predictable conditions."


    But one of the best points was made by one of the mods (srry don't remember who) here who said that this is just one of many changes that are likely coming and sooner or later the changes will be (mostly) embraced, maybe not w/o modifications
    Last edit by Balder_LPN on Oct 25, '06
  2. by   daisey_may
    This seems to be a common topic on here. I think that it's true that eventually things will change and CNAs may pass meds. Do I think it's right? No. I don't think that it's going to happen soon, but I don't think that giving medications will get a whole more 'strict'. Eventually, some sort of system will be in place that will 'check' what is given and people will feel...well safe, you know, that feeling we're not supposed to have. This might mean that the nurse will have even more responsibility having to check a CNA and themself.
    What is the difference between a CNA and a nurse? Education obviously. But procedures, assessments, medications and documentation, right? If CNAs start giving medications and do know the interactions and so on and so forth, I think the roles will start to gray. I mean, I could be wrong. I could be very wrong.
    I think this shouldn't be an issue NOW, I don't think CNAs should pass medication because there's a lot of liability in it for nurses. But what if CNAs do have that responsibility? What other responsibilities are they going to have, too?
  3. by   goingnuts
    [quote=txspadequeen921]Please tell me that you are joking or you just were asleep when you wrote this. I shouldnt have to explain this one to you...it is common sense. If you cant handle a manual BP cuff (cause you know if you want the good cuffs you have to bring them yourself) then you shouldnt be passing meds that require a BP.

    [quote=goingnuts]
    Quote from lmaldo
    ANd no I don't take a blood pressure everytime I give clonidine. Do you think the equipment in the nursing home is accurate? It is not.]
    My goodness where on earth do I say I couldn't handel a Blood Pressure cuff? I plainly stated that the equipment in the nursing home is no good. Geez. And yes I meant what I said about doing assessments and all of that. Never had any problem tho. Maybe I was just lucky or maybe I have learned how to look at residents and know if anything is wrong. Sorry got to give the meds out whether they require BP or not.
  4. by   goingnuts
    Quote from txspadequeen921
    First let me address this junk about documentation. I made the comment that you seemed like you were all for it if you were behind . Now, I see by re-reading your post that you think it is just as simple as reading the MAR and that you would not be concerned with the training of the CNA but that you just dont want to be reported. You have admitted to not taking BP's with meds and doing assessments before you give meds. In other words you are not concerned about the patient just covering your arse and getting by anyway you can , doing the min.
    Well if I documented it then don't be concerned because I always document what I am supposed to do. And you are sortof--kindof right about your last concern. Although I never do the bare min. I always try to cover my behind.
  5. by   txspadequeenRN
    I understand the extra time it takes to take the BP but it is a part of the job. You cannot tell by looking at someone if you need to hold their BP meds( on a normal basis). There is also something else here. If you are not taking the blood pressures when giving the BP meds then are you leaving the MAR blank when it ask for the BP measurement or are you just making the stuff up as you go. Either way you are cutting corners on your behalf and your patients will suffer in the end.




    Quote from goingnuts
    My goodness where on earth do I say I couldn't handel a Blood Pressure cuff? I plainly stated that the equipment in the nursing home is no good. Geez. And yes I meant what I said about doing assessments and all of that. Never had any problem tho. Maybe I was just lucky or maybe I have learned how to look at residents and know if anything is wrong. Sorry got to give the meds out whether they require BP or not.
  6. by   goingnuts
    Quote from txspadequeen921
    I understand the extra time it takes to take the BP but it is a part of the job. You cannot tell by looking at someone if you need to hold their BP meds( on a normal basis). There is also something else here. If you are not taking the blood pressures when giving the BP meds then are you leaving the MAR blank when it ask for the BP measurement or are you just making the stuff up as you go. Either way you are cutting corners on your behalf and your patients will suffer in the end.
    Correct delioso. In the twelve yrs. I have yet to have a problem. A lot of the times residents[not pt.] don't really need all of that junk. But, since the family or the resident themselves seem to think there is a pill for just about any ailment they accomadate. I know and the doctor knows taking antibiotics for a sniffle decreases their effectiveness and helps the ABT. to build a resistance to the infection they still give them since the family or resident insists they are the answer to everything.
  7. by   Nurset1981
    I can't believe that this thread has gone on as long as it has. It shouldn't even be a question. Nurses are held accountable for all our actions, and the actions of those we supervise. Why in hell would you put your patients and yourself at risk? Do the job you were hired to do, that means all of it. Yes nursing is busy. Yes LTC's are understaffed. Yes there are people who divert narcs. Yes med passes are long and tedious and sometimes stupid, we have patients on meds they don't need to be on but the bottom line is,
    this is what nurses do. And delegation does not mean handing out meds to CNA's to pass. It means having a CNA put balmex on a patients rear, not giving a potentially dangerous med. I have worked LTC on a unit with 42 patients and two aides. Somehow they all got their meds and the CNA's had nothing to do with it and it certainly wasn't the medication fairy. Its called busting your hump every night. If you can't find the time to pass meds and do treatments and everything else we're supposed to do then take up forensic nursing. Those patients don't need meds!
    Sorry if I ranted, I am just irritated at some of the things people have said.
  8. by   tired dialysis nurse
    Quote from Nurset1981
    I can't believe that this thread has gone on as long as it has. It shouldn't even be a question. Nurses are held accountable for all our actions, and the actions of those we supervise. Why in hell would you put your patients and yourself at risk? Do the job you were hired to do, that means all of it. Yes nursing is busy. Yes LTC's are understaffed. Yes there are people who divert narcs. Yes med passes are long and tedious and sometimes stupid, we have patients on meds they don't need to be on but the bottom line is,
    this is what nurses do. And delegation does not mean handing out meds to CNA's to pass. It means having a CNA put balmex on a patients rear, not giving a potentially dangerous med. I have worked LTC on a unit with 42 patients and two aides. Somehow they all got their meds and the CNA's had nothing to do with it and it certainly wasn't the medication fairy. Its called busting your hump every night. If you can't find the time to pass meds and do treatments and everything else we're supposed to do then take up forensic nursing. Those patients don't need meds!
    Sorry if I ranted, I am just irritated at some of the things people have said.
    amen, sister nurse!
  9. by   txspadequeenRN
    LAWD, this is the kind of post that makes me wonder what the Texas BON was thinking when they passed out nursing licenses. Sure about 70% of the meds in LTC could be cut out ... but unless you have MD or DO behind your name , you dont decide what the resident takes. We are not speaking of ABT's here either, so I dont even know where that came from. Just because you havent had a problem in past does not mean your practice is safe ..it means your lucky. I guarentee that if you do have a problem because of your incompetent practices the Texas BON will not accept that the residents dont need all that junk anyway or I have to get the pills out and dont have time to take the BP's. I cant believe you have made it this far without a problem either...This is the kind of stuff that gives LVN's a bad rap....



    Quote from goingnuts
    Correct delioso. In the twelve yrs. I have yet to have a problem. A lot of the times residents[not pt.] don't really need all of that junk. But, since the family or the resident themselves seem to think there is a pill for just about any ailment they accomadate. I know and the doctor knows taking antibiotics for a sniffle decreases their effectiveness and helps the ABT. to build a resistance to the infection they still give them since the family or resident insists they are the answer to everything.
  10. by   Nurse`Chief~Chickie
    Quote from TINKERBELL83
    I don't think it is a bad idea. I'm a CNA going to school for nursing and I work in a CBRF facility and I pass meds out everyday that I'm at work. Most places require you to take a class on med passing. Then you have the option of taking a state license test depending on the facility you are working in. In my opinion at my facility the nurse would be over worked with passing out meds due to we have over 1000 residents in our facility and thats all they would be doing all day. We of course don't do injections that is the nurses responsibility unless you are in school for nursing and a nurse is there while you are doing the injection. I guess it all depends on the training on what you are doing. I can understand that if someone has no clue what they are doing or giving then yes I would have to say no they shouldn't.


    I am bothered by this......
  11. by   Nurse`Chief~Chickie
    Quote from goingnuts
    I don't understand why some of you are talking about giving narcotics as if that is soooooooooo different from the other meds. I have worked mostly nursing homes for the 12yrs. I have been doing this. Not once have I seen anyone go beyond looking at the mar and giving what is on there. You simply don't have time to assess a resident everytime you give meds. While I would never ask a CNA to give my meds it is not because of any training but the fact that I just don't want to take the chance of getting reported. There are residents that refuse meds and have for God only knows how many yrs. Still getting around fine. Then there are others who take so many I get sick just from pulling them all up. The truth is if you can read then technically you can give any med. But of course we don't do things that way. Complaints are reported to state constantly for all kinds of things. It is always the same senario. They come in and tell the nursing home they have been bad boys. They supposedly correct the problem and life goes on. By that I mean of course they were cleared. What I am getting at is someone can have a bad reaction to anything at anytime. You can assess till the cows come home and still have a problem. I do think it is just dumb and plain mean to report a nurse for example letting a CNA hand MOM to a resident. But just for that very reason with me the resident will just have to wait until I can get to them. I do know of a RN that did the previous example and someone told. Everyone knows whatever their reason was---it defintely was not because they are concerned about the residents safety.


    How can you not have time for an assessment? That's the core of what we do. It goes beyond simply the MAR and the med.
  12. by   Nurse`Chief~Chickie
    [quote=lmaldo]
    Quote from goingnuts
    Yes, I am in the nursing profession, but, I think you missed the point. You should be glad I am in the nursing profession because I seem to be the only one mentioning the patient as the point of concern. In the hospital I work in and teach in, I see so many new nurses that forget about what the patient is in the hospital for and are too caught up in worrying about their career, and judging from the replies to the email wondering about having the keys to the med drawer, or making sure the MAR is signed for, or that a CNA might take the medication for herself/himself instead of the patient still implies that the best interest of a patient is the last thing considered. And, by the way, I was positing an opinion, not slamming anyone who "disagrees" with me. You do make a very valid point - nursing homes do have a high patient-to-nurse ratio, and you can get absolutely slammed. I know I couldn't work in a nursing home because the loads placed on nurses is beyond safe measures. I applaud you. But, it still concerns me that the first statement you make is that you don't want to get in trouble, not "the patient is in trouble therefore..." It sounds as though the DON may not managing the facility very well. It is still unacceptable that assessments are not made, especially when meds are given. Are you telling me you don't always take a blood pressure before you give a blood pressure medication or having an aide get the blood pressure for you? These are simply reasons that it is not a good idea to let CNA's pass meds. The really neat stuff we use in a hospital is our critical thinking skills that helps us the most. I especially like the stethescope. It is really cool and very helpful.

    Well, besides the fact that I've seen the pt comes first on this thread, let's just say for instance, that the whole picture of putting the pt 1st is being able to also be responsible and think of all these 'minor ' things like keys, and the MAR and all of the legalities we tend to to prove that we, ourselves, have done our very best in the interest of the pt. I'd say that from the concerns of most of these repliers, that they are in tune with their priorities. (Save a few worrisome ones.) And as far as our critical thinking skills, they are awfully good to have to evaluate what all the neat-o equip has to tell us about our pts, doncha think?
  13. by   goingnuts
    I see what you guys mean about the posts be attributed to the wrong person. I am being quoted as saying something Imaldo quoted. I am so sorry some of you think I am just the wrost thing to come to nursing since the cap but I am only being honest. Please consider this. Nursing home residents are not as fragile or critical as hospital pt. as a rule. I have had to learn what is really important and what isn't if I want to survive in a nursing home.:smiley_ab :smiley_ab

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