Letting CNA pass your meds, bad idea? - page 20

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   twotrees2
    Quote from hopebewild
    I only read the first couple of pages in this thread so somebody might have already asked this question i dont know. Is it all right in the state of IL as a nurse to put meds in applesauce and then ask a cna to feed them to a patient? This didnt happen to me but to another cna i work with. I told her she should have said hell no but i really dont know what the policies are.


    Also, in Wisconsin, my mom, who had never done anything health related before in her life, took a job in a group home. She did two weeks of training and then was basically a cna but she also passed meds! The nurses measured them out and put them in cups with a patients name on them but she actually passed them when there was no nurse present! Tell me that that is not legal!
    well i will at times ( work alzheimer's and dementia ) ask the cna to give the meds i have in the applesauce if i can not get the resident to take it - i am right there when they do it and am making sure they get it and swallow it and i have been told this is legal as long as i am there close by to watch - ofetn in dementia - just a change of staff can get the resident to take the meds. i do try several times before involving anyone else. i would never just set up the meds and hand em out for the aides to give out, especially if i were not there - unless they are med certified i would think it would not be legal for anyone to give it without direct supervision.
  2. by   BrnEyedGirl
    Quote from Franny2332
    ...and *where* is this practice of allowing CNAs to pass meds legal?

    ""Never attempt to teach a pig to sing. It wastes your time and annoys the
    pig.""
    RHeinlein
    I'm with you Franny,..I've been watching these posts from the begining,.this is the most absurd thing I've ever heard,..who in their right mind would ask a CNA to administer medication?? I can't believe any responsible CNA would ever do it??? I can't believe any RN, or student for that matter, would ever even think of such a thing!
  3. by   twotrees2
    Quote from RN-Cardiac
    I'm with you Franny,..I've been watching these posts from the begining,.this is the most absurd thing I've ever heard,..who in their right mind would ask a CNA to administer medication?? I can't believe any responsible CNA would ever do it??? I can't believe any RN, or student for that matter, would ever even think of such a thing!
    at this link defines delegation - http://drl.wi.gov/dept/papers/pap05.pdf in the state of wisconsin - i feel totally confident that i may utilize my aides as one to help me get a med down a resident as long as i am there - for one thing i always let my aides know what they are giving ( if they dont know what its for i do teach them about the meds - they for the most part are very good at wanting to learn. ) i also know they have experience as they have been doing it supervised - working a dementia unit one needs to do whatever one can to get the job done and if it be asking the aides to help and theya re willing - it isnt a problem in my understanding of the rules at this site. the only thing they are doing is help me get the med in due to residents refusal to allow me to give it - i am the one who evaluates tjhe response or effectiveness of the med and i am also the one monitoring if they get the med into the resident as i am right there. just my interpretation -
  4. by   NurseyTee
    I just had this happen at the facility where I work. This one night I was working on the sub-acute unit and the nurse on the LTC unit had asked the aides on her floor to give a few meds. A BIG NO-NO~!! I told the aides not to do it. I was shocked this nurse of many years would actually give medications to the aides to give, but she did. I think she's becoming senile. She omits some meds and doesn't sign off stuff. She sent a resident out 911 without any info the other night.

    This question may have been asked before but, how would an aide with no eduction on pharmacology giving medications know not to crush meds like KCL or Oxycontin? This just sounds like bad practice to me.

    The situation with a nurse allowing an aide to give a med to an Alz. pt. that is resistant to taking a med from her, but will take it from the aide. I see no issue with that if the nurse is standing right there and the meds never left her sight. I think in any other situation this would not be appropriate.
  5. by   augigi
    twotrees2, the link you posted clearly states:

    "As stated in N6.03(3) an RN shall (a) Delegate tasks commensurate with educational preparation and demonstrated abilities of the person supervised. Although the administration of a healthcare facility or organization may suggest which nursing acts should be delegated and/or to whom the delegation may be made, it is the RN who makes, and is ultimately responsible for making, the decision whether and under what circumstances, the delegation occurs. If an RN knows or should have known that the person supervised is not prepared by education, training or experience to safely perform a delegated nursing act, the RN may not delegate the task."

    An aide is NOT prepared by education, training or experience to safely administer medications, therefore this task cannot be delegated.
  6. by   twotrees2
    Quote from augigi
    twotrees2, the link you posted clearly states:

    "As stated in N6.03(3) an RN shall (a) Delegate tasks commensurate with educational preparation and demonstrated abilities of the person supervised. Although the administration of a healthcare facility or organization may suggest which nursing acts should be delegated and/or to whom the delegation may be made, it is the RN who makes, and is ultimately responsible for making, the decision whether and under what circumstances, the delegation occurs. If an RN knows or should have known that the person supervised is not prepared by education, training or experience to safely perform a delegated nursing act, the RN may not delegate the task."

    An aide is NOT prepared by education, training or experience to safely administer medications, therefore this task cannot be delegated.
    i guess we will have to agree to disagree then as i have asked my facility if its legal and have been told it is. at all facilities ive worked at - it is common practice with dementia residents on occassion to have to do this delegation in order to get the resident to take thier meds, and i have been told at all of them this is ok to do ive even had bossses come help when noone else is around give my dementia residents the meds ive gotten ready - and in my interpretaion of this - i see it differently allowing my aides to assist me in getting my dementia residents to take thier meds as long as i am right there and they have been trained by me to give the med ( which it doesnt take a wizard to learn to give meds via mouth in applesauce) and they are taught by me what the med is and why they are giving it - ultimately i am seting it up - monitoring/ watching the giving and outcome of the giving so i feel confident it is allowable. it is not like they are going to the med cart getting the med out , crushing it and giving it without me there - as a med tech would - which brings me to my next point.............

    what i have a problem with by the statement in that website there - is with utilizing a med tech - i am not at all confident a few month course or however long it takes makes them able to give meds( anymore than you feel my training my aides is not educating or training or giving them expeience even though it does not say they must have formal training at school - it says training or experience or education ) when i am not right there with them when they give it - and i will be bringing this to the attention of my facility as unless i can be right there to make sure they are giving the right med etc - i wont be comfortable having them a wing or 2 away and giving god only knows what. we have only had 2 med techs so far - both gone now - but they wish to look for others - and after listening to those 2 talk about thier "education" and meds, my aides know far more about the meds i give then the techs i met do around here so far lol.

    not to mention our "med techs" can only give meds ( no treatments or even accuchecks) so really they are not much use as we still have to find a nurse to go do their wings treatments , accuchecks , etc so we may as well just take the pills with us as between treatments and accuchecks, trachs, tube feedings and anything else they cant do- that usually encompasses just about the whole wing anyhow. lol.

    but thank you for your opinoon. it is appreciated and noted.
  7. by   augigi
    I don't think your telling them what it is equates to "training or experience" required to administer medications... but hey, it's your license so good luck to you
  8. by   MONTGOMERY
    by no means do i or expect to say that i know all about meds. i do study and read about all meds. i would never give a cna pills to pass for me and i am a med aide. as for treatments i do treatments, i don't do open and invasive treatments but we as med aide can do eyedrops, creams topical, there is alot we can do to help the nurse out. i don't know where you are at but texas we do. now some med aide don't, but in school we are taught what we can do and what we can't. but it could free up some time for the nurse. i just wished nurses could trust more. i understand you lic is on the line, but my cert. is too. i have to sign off everything i do. maybe the med aide you have just don't want to do no more, i want to. someday when my husband is better i would like to go back to nursing school, but i couldn't make it trying to take care of him and try to work. but while i was in school i learned alot. the math is a b----ch. i wished i could figure the drop system. i didn't mean to change the subject, i just want nurses to know that there are good cna's and medication aides out there that really look upto nurses to teach all they can, when they can. i learned alot from nurses and i keep my eyes and ears open all the time to learn more. thanks and take care.
  9. by   twotrees2
    Quote from MONTGOMERY
    by no means do i or expect to say that i know all about meds. i do study and read about all meds. i would never give a cna pills to pass for me and i am a med aide. as for treatments i do treatments, i don't do open and invasive treatments but we as med aide can do eyedrops, creams topical, there is alot we can do to help the nurse out. i don't know where you are at but texas we do. now some med aide don't, but in school we are taught what we can do and what we can't. but it could free up some time for the nurse. i just wished nurses could trust more. i understand you lic is on the line, but my cert. is too. i have to sign off everything i do. maybe the med aide you have just don't want to do no more, i want to. someday when my husband is better i would like to go back to nursing school, but i couldn't make it trying to take care of him and try to work. but while i was in school i learned alot. the math is a b----ch. i wished i could figure the drop system. i didn't mean to change the subject, i just want nurses to know that there are good cna's and medication aides out there that really look upto nurses to teach all they can, when they can. i learned alot from nurses and i keep my eyes and ears open all the time to learn more. thanks and take care.
    actually our cnas once checked out on paper that they have done it ( documented they were trained ) can do more then the med techs - its not the techs - its the stupidity of the facility. the cnas work hard and want to be checked off for treatments and such but the facility is slow to go with the training and its unfortunate - especially that they WANT to do more to help. the med techs - i have no clue why the only thing they can do in our facility is pass meds - if they are trained for more seems a waste to not let them do it!!! i will have to ask the next tech we get what they are trained to do in class. now im curious as to why they arent allowed more if taught how to do it. seems like just a way to add more work on the nurses yet "staff" according to numbers of residents? and a way to save money by not paying for more nursing staff cause i am sure techs are not paid very good either. ??
  10. by   allantiques4me
    Quote from FutureNurse35
    NO NO NO
    The CNAs are not licenced to give meds. Even if is only tylenol.
    I agree! tylenol can be nephrototoxic if given in large doses!
  11. by   allantiques4me
    Quote from twotrees2
    actually our cnas once checked out on paper that they have done it ( documented they were trained ) can do more then the med techs - its not the techs - its the stupidity of the facility. the cnas work hard and want to be checked off for treatments and such but the facility is slow to go with the training and its unfortunate - especially that they WANT to do more to help. the med techs - i have no clue why the only thing they can do in our facility is pass meds - if they are trained for more seems a waste to not let them do it!!! i will have to ask the next tech we get what they are trained to do in class. now im curious as to why they arent allowed more if taught how to do it. seems like just a way to add more work on the nurses yet "staff" according to numbers of residents? and a way to save money by not paying for more nursing staff cause i am sure techs are not paid very good either. ??
    Ya know back in the day(I was a nurses Aid in the early 80s)they didnt require you to be a certified na.And back then it seems that the ones that were certified were the worst.I earned a promotion to do treatments.I was very conciencious and learned a lot .I used to do wound care,document on it,foley catheter insertions,irrigations,IPPD treatments ,Enemas,ect.I thought I was very knowledgable until I was in nursing school.For example,you know you usually cant drain more than 750ccs of urine at once,it could cause dangerous hypovolemia.Or to give albuteral, could increase the pulse,but the nurses always did the Med pass and we always reported to her.the little LPN team leader.then the rules changed where you had to be at least an LPN to do the treatments!Times are always changing.!!Its crazy
  12. by   allantiques4me
    And PS.It seems like nowadays you need aRN with wound care certification to do the wound care job I did as a(treatment aid)before I was a Nurse!Go figure.
  13. by   augigi
    Quote from allantiques4me
    I agree! tylenol can be nephrototoxic if given in large doses!
    ... and hepatotoxic to the point of irreparable damage.

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