Letting CNA pass your meds, bad idea? - page 5

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   balutpinoysabutuan
    :angryfire
  2. by   hikernurse
    I wouldn't even let a certified med tech pass my meds. Not worth my license. If the tech messes up, then I'm on the line, too. I'd rather spend the extra time it takes to pass my own.

    Anyone can be taught to give meds in a real short course--unfortunately, there's a lot more to passing meds than knowing how to put them in a cup.

    Your essay topic is a pretty good one :-).
    Last edit by hikernurse on Oct 18, '06
  3. by   paigeRN1962
    I work for a plastic surgeon where we do office-based surgery and see this practice done everyday. I am not sure what, if any laws have been violated due to the lack of regulation of doctor's offices in general. Nor am I sure what MA's are able to do legally. Basically. the antibiotics and pre-op sedatives are placed 1 per cup on a counter and given to surgical patients by the receptionists, medical assistant or myself (an RN). The other RN in charge sets all this out prior to the start of the day and whatever isn't used, gets put back in the narc box at the end of the day.
    I feel very uncomfortable with this. If meds can be passed to patients by a CMA in a nursing home, I suppose the powers that be where I work see no problem with this situation and no reason not to continue administering meds to surgical patients in this manner. The med is charted and a box is checked on the chart as to time and date. I am not taking responsibility for the MA who is giving these pre-ops nor am I delegating nursing duties to her. The MD states she works under his supervision and he accepts the liability. I don't like any of this but am having trouble finding anything in the Nurse Practice act to back me up in the physician's office.
    If the patient has a reaction, if there is an error, if the MA is found to be at fault, she has no license to be concerned about. I am worried about where I could be held liable. I do not set up any of the morning pre-op meds for these surgery patients....the nurse in charge doesn't "allow" me to do any of that or touch any meds..........I am basically working as another MA although have been a nurse for 15 years. Yes, I know this is bizarre......I am searching for another job.
  4. by   pagandeva2000
    Quote from hptogram
    To add to this topic I'll share with you what happened to me.

    I work at a ALF and took a med tech class that was provided by the facility. I have pulled and passed pills on the weekends when the CNA who usually does this is off. It was a Thursday morning and I went into my residents room to give her her pills (they were pulled by the CNA). The next day the resident got very angry with me because I gave her the wrong ones. For that reason, I will not pass any med that I did not pull myself. I triple check the MAR and everything just to be sure I'm doing it right. I've also found other mistakes that the CNA has made (for instance, she's signing for pills that I know she isn't passing). In any event, its a bad idea to pass pills that you didn't pull yourself. And always triple check yourself.
    One of the main things they speak about in nursing school is that you should NOT administer medications that are poured or prepared by someone else. I am an LPN working in a clinic and in this particular facility, an LPN cannot administer a flu shot until the RN makes an assessment. Because of this inconvienence, it takes a great deal of time for the RN to assess, then, turn the patient over to me to give the shot, so, she will just go ahead and administer it. One day last week, she came to me and said that the patient didn't want for her to give the shot, so, she did her assessment (we have computerized charting), and from there, I can go into my program and give the shot. She told me that she prepared the syringe already, and left it in the room with the client. I walked in, threw the syringe away and prepared my own with the vial of influenza vaccine. While I can say that I like this nurse, there is no way that I can tell that she actually had flu vaccine, urine, or spit in that syringe (not trying to be gross, but, you NEVER know people). The patient said to me "She already fixed it". I told him that I was not present when this happened, therefore, I had to do it myself, and I told this nurse later on that I will NEVER do this...because if something happened with that patient, it was ME that actually administered the medication and would have to explain what I did.
  5. by   pagandeva2000
    Quote from FutureNurse2005
    well, at my previous job, I took a 3 day training course and was able to pass meds to residents. I never gave an injection though. This was a private facility and this is totally legal. I was considered to be under the supervision of an RN during my shifts. Any mistakes that were made fall onto the RN. We had a 3 strikes and your out policy though...once we got written up 3 times for med errors we could no longer give meds.

    It is not a bad idea, as long as it is done correctly and is a well supervised program. I learned alot from that job and I appreciated the RN's confidence in me.
    It is a great opportunity for you as a future nurse, but remember what you stated, the mistakes fall on that licensed nurse. I think that because you will be a nurse in the future, that you would be one to realize that and look out for the patient, yourself and that nurse. Many other aides would not appreciate the implications of that and do what they want.
  6. by   HRLRN
    Quote from FutureNurse2005
    well, at my previous job, I took a 3 day training course and was able to pass meds to residents. I never gave an injection though. This was a private facility and this is totally legal. I was considered to be under the supervision of an RN during my shifts. Any mistakes that were made fall onto the RN. We had a 3 strikes and your out policy though...once we got written up 3 times for med errors we could no longer give meds.

    It is not a bad idea, as long as it is done correctly and is a well supervised program. I learned alot from that job and I appreciated the RN's confidence in me.
    Just think of 3 "strikes" as 3 dead pts... it changes your perspective...
  7. by   nurse4theplanet
    It is against the law in my state. Med administration cannot be delegated to unlicensed personnel
  8. by   Cardiac-RN
    Quote from walla189
    Wow great response, to save some face, I'm a student doing this for a essay so don't string me up just yet...
    You should have stated that in the first place. What do you think are negatives associated with this??
  9. by   pagandeva2000
    Quote from Cardiac-RN
    You should have stated that in the first place. What do you think are negatives associated with this??
    A trained nurse, indeed...one of the main things they taught us in school is to turn the question back to the client to get them to think more, and an instructor would turn the question back at us to encourage critical thinking! Thanks for reminding us of that, Cardiac-RN!
  10. by   91C_ARMYLPN
    No thanks! Definitely not on my watch! Patient safety is number one. I sure would not like to do the tango for the courtroom, and try to convince the jury about keeping my nursing license. If you prepare the medication then you give that medication. CNA giving meds...that's a first one for me.
  11. by   AfloydRN
    I don't know what state you are from, but it is ILLEGAL for a non-licensed professional to dispense meds. I believe we all learned this nursing 101- first week. Do cna's get trained as far as side effects of durgs and what to look for? How about drug interactions? Bad idea.
  12. by   casi
    I work in an Assisted Living Facility as a CNA where I pass meds that a preset up in weekly strips that are locked in each resident's apartment. It's my job to check the MAR against what's set up and initial off on what I give. Needless to say I've seen some very stupid med errors on the part of CNAs. I've seen CNAs go into an apartment and get a strip, and somehow take it to someone else's apartment and give it to the wrong resident. PM meds given instead of AM meds. Husband gets both his and his wife's PM meds, and the list could go on.

    As a CNA with very little med training I really don't think it's our job to be handing out medications. I'd much rather leave it to the nurses who have the education to do it.
  13. by   NurseTomasAZ
    It's legal in my state -- AZ. I'm a new LPN, 2/3 of the way through an RN program, and I attended the inservice today. I'm also very glad to be reading up on the topic on today's boards. Despite the fact that I know, respect, and approve of the two CNAs who are being trained for the job, I'm a little worried. Reading some of your posts, I guess I should be. It's my brand new license, and AZ is a state well-known for looking straight down the totem pole to assign blame.

    Thanks for the posts. Color me watchful.

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