Letting CNA pass your meds, bad idea? - page 13

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   DusktilDawn
    Quote from MVH119
    And I suggest you are slightly less snotty.
    All the HCA"S of my exprience can not only read but see as well. They are no more likely to confuse Mr Smith with Mr Jones than I am.
    It is pefectly legal to delegate this task if you are confident that your delegatee is competent.
    I'm confident of that.The notes might bear my name but when the day comes that I cannot let a trusted HCA give a paracetamol tablet in my name then that is the day I quit nursing.
    The question asked and not answered was: Are HCAs in the UK trained to administer medication? By the lack of response to that question, I would say the answer is NO. If that answer is no than I find it very hard to believe that your licensing body, legal code of conduct, or employer would view this as a safe Standard of Practice. In fact I find it hard to believe that you were taught that this was acceptable during your training and education as nurse.
    Well our legal code of conduct allows the delegation of some tasks "as long as the practioner is satisied as to the competence of the delagatee".
    When it comes to delegation in Canada and the US, it is not so briefly worded in such a way so that it can broadly interpreted. I find it hard to believe that this is all your legal code of conduct has to say in regards to delegation.

    When it comes to delegation in Canada and the US:
    1. The Right Task: tasks that are routinely performed, require minimal problem solving or innovation. One that is delegable for a specific client.
    2. The Right Circumstances: appropriate client setting with available resources and right timing.
    3. The Right Person: the right person is delegating the right task to the right person to be performed on the right client.
    4. The Right Direction: clear, concise description of the task, including its purpose, limits, and expectations. Right information about a client must also be communicated if any variation is needed in how the task is to be performed.
    5. The Right Supervision: appropriate monitoring, evaluation, intervention, and feedback.

    I would never hand a medication to an aide or another nurse for that matter to give to a patient because it would be violating a Standard of Practice, even if it's only paracetamol.

    This issue has nothing to do with trust, nor does it have anything to do with the sight and hearing of those that are delegated to. It has to do with maintaining appropriate Standards of Practice, following your facility's policies, AND PATIENT SAFETY.
  2. by   Nurse`Chief~Chickie
    Quote from DusktilDawn
    The question asked and not answered was: Are HCAs in the UK trained to administer medication? By the lack of response to that question, I would say the answer is NO. If that answer is no than I find it very hard to believe that your licensing body, legal code of conduct, or employer would view this as a safe Standard of Practice. In fact I find it hard to believe that you were taught that this was acceptable during your training and education as nurse.

    When it comes to delegation in Canada and the US, it is not so briefly worded in such a way so that it can broadly interpreted. I find it hard to believe that this is all your legal code of conduct has to say in regards to delegation.

    When it comes to delegation in Canada and the US:
    1. The Right Task: tasks that are routinely performed, require minimal problem solving or innovation. One that is delegable for a specific client.
    2. The Right Circumstances: appropriate client setting with available resources and right timing.
    3. The Right Person: the right person is delegating the right task to the right person to be performed on the right client.
    4. The Right Direction: clear, concise description of the task, including its purpose, limits, and expectations. Right information about a client must also be communicated if any variation is needed in how the task is to be performed.
    5. The Right Supervision: appropriate monitoring, evaluation, intervention, and feedback.

    I would never hand a medication to an aide or another nurse for that matter to give to a patient because it would be violating a Standard of Practice, even if it's only paracetamol.

    This issue has nothing to do with trust, nor does it have anything to do with the sight and hearing of those that are delegated to. It has to do with maintaining appropriate Standards of Practice, following your facility's policies, AND PATIENT SAFETY.


    :kiss Thank you!!! I'm having some mind constipation here! So its good to see your great replies!
    :bowingpur
  3. by   goingnuts
    Quote from Marie_LPN
    Well, that was pretty uncalled for.

    WTMIL.:trout:
    Sorry. All I meant by that is if they get into trouble then somebody had to have said something. This subject sure stirred up a lot of emotions. And the person who started it already said they did it for some research paper they were doing and not because they commited this awful, terrible, horrible autrocity. I think the majority of nurses LVN or RN do the best they can. There are bad and good in any profession. But no one does perfect all of the time. So if they don't do perfect all of the time do they report themselves. I think not.
    Last edit by goingnuts on Oct 28, '06
  4. by   rn/writer
    This thread is about a half a centimeter from being closed because of personal attacks, bad manners, offensive language, and a general lack of respect.

    I apologize to those of you who have not participated in the vitriolic exchanges. Unfortunately, there have been so many out-of line posts during my absence (due to computer problems) that I hardly know where to start addressing cautionary comments.

    The hostility and rancor need to stop immediately. This is a message board, not a battlefield. Strong feelings are no excuse for insulting other members or belittling their personalities or practices. Disagree all you want, but stay on point. Focus on the subjects being discussed, not the other posters. Ultimately, each of us has to decide how we will conduct ourselves and what we are willing to be accountable for. No amount of cyber-brawling can change that.

    I am so proud of many threads on this board. We've had members patiently teach each other about nursing practice and procedure. Some posters started here even before they entered school and stayed with us through trying times as students and new nurses. Now many of them delight in passing their knowledge and encouragement to those behind them on the path.

    We've had people share the joy of various achievements--getting into school, graduating, passing NCLEX, weddings, pregnancy, babies and just about every other milestone you can think of.

    We've also rallied around folks dealing with school setbacks, bad jobs, domestic violence, substance abuse, kids in trouble, family illnesses and deaths, and many other situations involving fear and loss.

    That sense of connection is one of the things that makes this board shine.

    Because this board is open to the public, anyone who can find the website can drop in and wander around. I hope the threads that show our solidarity (even in disagreement), resilience, wisdom and humor are the one they see first.

    I do understand how a controversial subject can get out of hand. Emotion rises, tempers flare, and all of a sudden, otherwise decent people are at each other's throats. An online forum provides the same kind of anonymity that allows normally nice drivers to erupt in road rage. Sometimes with great regret.

    I'd like to think there may be some regret floating around right now, or, at the very least, upon rereading the back end of this thread.

    I'm going to confer with the other moderators to see what action(s) should take place regarding this thread and violations of the Terms of Service. In the meantime, if any of you feel you may have spoken rashly or with undue intensity, now might be a very good time to consider how best to set things right.

    Terms of Service - All Users Please Read and Follow
    Last edit by rn/writer on Oct 28, '06
  5. by   goingnuts
    [quote=Nurse`Chief~Chickie]I was
    Last edit by goingnuts on Oct 29, '06
  6. by   Nurse`Chief~Chickie
    the other posters put into better words what i was trying to, i don't get the differences between our practices and overseas. simply, more questions and less meow were in order.
  7. by   rn/writer
    I doubt that we'll settle the issue of medication aides in this forum. The rules vary among facilities, states, and, as we have discovered, countries and cultures as well.

    What I would like to point out is that no one should pass what someone else has poured or set up.

    The education level needed to safely distribute meds will be debated for years to come. On that much I think we can all agree. But apart from education and assessment skills, there is the question of accountability.

    Much like the chain of custody used in keeping track of forensic evidence, the person passing meds needs to be able to monitor that med from set up to delivery. In the case of controlled substances, there is an obvious legal dimension to consider. But even non-narcotic meds such as cardiac or hypertension meds or antibiotics can create problems for residents if they are not properly dispensed.

    There doesn't need to be any malfeasance for something to go wrong. The other person, even if she's a nurse, could take the couple of med(s) she agreed to give and put them in her pocket, only to find them hours later as she's changing out of her scrubs. A new employee might think the med was meant for Mrs. Harris when it really should have gone to Mrs. Harriman. Or the facility could have three women named Aggie and two men named Elmer. Pictures in the Kardex aren't always current and sometimes they fall out. Residents with dementia can complicate matters. So can giving the meds in a dayroom or dining room where identification can be a real challenge.

    Changes in dosages, brand or generic meds, or the introduction of new meds entirely can have residents insisting they have the wrong pills. Has one of these changes taken place or are they really the wrong meds. If you are the one who set the meds up, you will have a much better chance of catching mistakes (probably back in the med room) or explaining that the med is the same one, but it looks different because it's coming from a different company.

    Add to this the unfortunate reality that there are employees who take the lazy way out, or who are dishonest or even criminal, and the risk skyrockets.

    Back when I did those never-ending med passes in several nursing homes, the only things I would leave with the aides were topical meds that they would apply with a dressing or diaper change. The rest--and we're talking hundreds on each pass--went directly from me to the resident. I did have CNAs check pulses and BPs (after I'd determined they knew their stuff), and was always grateful for a heads-up on someone who needed a prn med, but even when I split the pass with another nurse, we each passed only what we poured or set up.

    It isn't just about education. Accountability is sometimes all that stands between you and an unintentional problem or even something more serious like diverting.

    When I pull a controlled substance out of the ADU, the only person I hand it to is the patient. No matter how much I trust my coworkers, I want to be able to say that I kept track of that med from start to finish.
  8. by   pagandeva2000
    >>>>Originally Posted by 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 think that if the facility has made provisions for CNAs to administer medications then at least, there is some sort of accountability (as weak as it may be). And, with you being a nursing student, you may understand better than others what the safety issues have to be considered. However, I was a certified AMAP in psych many moons ago, and I witnessed many aides that took it upon themselves to overmedicate the patients that were a pain in the rear and almost overdosed them. Missing medications, giving the wrong dose at the wrong time as well as neglecting to give meds and treatments at all... While the CNA may be giving medications, if a mistake was made, we would be written up (maybe), but the NURSE would be accountable for it because they were blamed that they didn't supervise the aides to begin with (how that can happen, when you don't have eye behind your head is insane to me). At this point, I would say that it was not a safe practice, simply because the discipline rendered in these cases was not straight across the board for everyone.
  9. by   angle_500
    Im a nursing student and i want to work in the field..should I do CNA,or PTC.HELP..
  10. by   majken
    I think CNA can give oral meds but not injection meds. Well caregiver can give oral meds also so why CNA cannot?

    They have all the practice which I think they can give oral meds.. CNA are not stupid to give the meds to the wrong patient. As if you're saying that student nurses cannot give oral meds to the patient because they don't have their license even their CI with them..

    Oh well just my opinion. Thanks!
  11. by   majken
    Quote from angle_500
    Im a nursing student and i want to work in the field..should I do CNA,or PTC.HELP..
    Finish nursing and pass the exams, there's a greater opportunity for you in US and UK.

    God bless!
  12. by   pedirn06
    Surely you mean CMA (Cert Medication Aide) and not CNA (Cert Nurse Aide)????

    We are all subject to error - not a honest sole who has not made a mistake. CNAs cannot legally even apply creams outside of incont barrier creams and not even all of those in Texas. Give only what you have verified by the 5 rights of medication and have drawn up yourself and never ask someone else to adm what you have drawn up.
  13. by   mart18642
    No,no,no!!!!!!!!!!!bad idea...........do not delegate tasks that only license professional are trained for!
    2 c

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