Letting CNA pass your meds, bad idea? - page 7

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   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.
  2. by   Marie_LPN, RN
    I don't understand why some of you are talking about giving narcotics as if that is soooooooooo different from the other meds.
    Because they are sooooooo counted and sooooooo more likely to 'disappear', unlike tylenol or colace.
  3. by   goingnuts
    Quote from Marie_LPN
    Because they are sooooooo counted and sooooooo more likely to 'disappear', unlike tylenol or colace.
    I realize that. I don't think that is why they were more concerned. If you draw them up for the aid then you are not giving her the keys so she can't very well get to them.
  4. by   DusktilDawn
    Quote from goingnuts
    I realize that. I don't think that is why they were more concerned. If you draw them up for the aid then you are not giving her the keys so she can't very well get to them.
    Because narcotics are controlled substances and as such can only be dispensed and administered under certain guidelines. Once they leave YOUR hand, once you hand them to the aid and they leave your sight, they are no longer being monitored by YOU. Unless you actually watch them being administered, unless you are administering them yourself, you can only ASSUME they are being administered.
  5. by   Marie_LPN, RN
    Quote from goingnuts
    I realize that. I don't think that is why they were more concerned. If you draw them up for the aid then you are not giving her the keys so she can't very well get to them.
    In other words, how would I know the pt. received the med (especially a narc. considering the potential for abuse) if i didn't see it myself. How would i know that it wouldn't go into that person's pocket.
  6. by   goingnuts
    Of course you wouldn't know. Same with anything else. All I was getting at was I don't think narcs are anymore important. YOu don't know a med aid gives or other nurses. Like I said in Texas you can't let an aid give meds. Bottom line. To me it doesn't matter whether it is colace or vicodin I am not taking a chance on an aid getting me in trouble by telling on me. Would I tell on a nurse if I knew she let an aid help her this way. Absolutely not. But I would not take the chance since I have trouble sleeping as it is. LOL.
  7. by   pagandeva2000
    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.
    If a narcartic is missing and the CNA can be brought across the table for it, then maybe I can say that it is no big deal, but in the cases that I am aware of, the nurse is responsible and accountable if the CNA makes an error.I do certainly agree, though, that a nurse does not have time to access each and every detail before giving medications...that is not realistic, either.
  8. by   rgroyer1RNBSN
    Oh this is a wonderrrrfull Idea(not), hell why dont we go ahead and let them (CNA's) go ahead and start are IV's and give are IM's to. Hell why dont we even have them intubate and defibrillate pts. to. Bad ideas I wouldnt risk my license this way.


    Rod RN:spin:
  9. by   goingnuts
    Quote from pagandeva2000
    If a narcartic is missing and the CNA can be brought across the table for it, then maybe I can say that it is no big deal, but in the cases that I am aware of, the nurse is responsible and accountable if the CNA makes an error.I do certainly agree, though, that a nurse does not have time to access each and every detail before giving medications...that is not realistic, either.
    I don't see how anything could come up missing if I keep the keys. The whole thing is just stupid anyway. My point was I wouldn't be so much concerned with whether or not a resident got the med as I would someone reporting me for letting the CNA help.
  10. by   PANurseRN1
    Oh my.
  11. by   dijaqrn
    Your patient is in pain, requests a pain med and you dispense it to the CNA... for whatever reason the patient doesn't get it, the CNA gets busy, another resident falls, or they could even (rarely) pocket the med........
    Your signature is on that MAR!!!!!!!
    Either you leave the resident in pain for 4 or more hours or what?????
    This is unethical and illegal so why risk that license you worked so hard for!
    All the SNF nurses I know concurr that they do focused assessments during med pass...you're giving a patient Lasix..... do they have crackles or SOB? Lets ask the CNA, who has enough of their own work to do, how the lungs sound......
    SNF nursing is difficult and challenging due to staffing and patient loads but assessment is still the function of the NURSE as is passing medications. I never want to work that hard again but you get attached to those residents and they deserve good care.
  12. by   pagandeva2000
    Quote from goingnuts
    I don't see how anything could come up missing if I keep the keys. The whole thing is just stupid anyway. My point was I wouldn't be so much concerned with whether or not a resident got the med as I would someone reporting me for letting the CNA help.
    But what about the guarentee that the patient actually received the medication? I am not arguing that things are busy, but for all of that, and the patient didn't receive the medication, can be an issue. I posted this earlier in this thread that once, as an aide, an LPN asked me to give medication to a patient who had a roommate. I almost gave it to the wrong patient. The one I was about to give it to was coherent, and told me that this wasn't her medication. It belonged to the other one that was 'out of it'. What if it were both of them that were unable to advocate for themselves. I took the medication back to the LPN and told her that I almost made a mistake and was not giving it. As an aide, I didn't appreciate the safety issue of what could have possibly happened. Hey, I was not going to be blamed...the nurse was. You cannot guarentee that something was/wasn't done if you were not present to witness it for yourself. And, if something were to occur, the aide will simply say "I didn't do it". Are you going to ask the aide to take the apical pulse before she gives digitalis? That is like me as an LPN giving an IV push for the RN...that is not my job. If there something occurs behind me giving the push, and the RN had to take the fall, what does that mean?
  13. by   goingnuts
    In life there are never any guarentees. I can't go around worrying about everything when working in a nursing home. I do the best I can and take care of what can get me in trouble first and foremost. Hate having to be that way but there just is no other choice. So bottom line is no matter what else is going on there is no way I am letting a CNA give my meds. Not because of the reasons stated on this thread necessarily but because I could get into trouble. Many yrs. ago I worked with an RN that didn't know what to do when she found a resident dead that was full code [the man should have been a DNR trust me on that] anyway I asked her if anything was wrong and when she told me and I tried to tell her what we needed to do she wouldn't listen and then it was such a mess. To make this shorter when I got home I called the board to see if I could get into trouble and the investigator told me it was highly possible. Well I couldn't hardly eat or sleep for three weeks. I asked him what for and he said I should have pushed past the RN and done the right thing. I have since found out I am not reguired to do that. Anyway I told him I will do things different next time and he said hopefully I will do what he said. I said no--- I will know better than to ask if anything is wrong next time. After getting my statement the state did not even report me. The RN board took four months to write me for a statement. By then I had cooled off and wasn't about to give a statement that would cost a RN her livelyhood. She made a mistake and I think she learned from it. Without my statement the BON decided to do nothing. The CNA's word alone would not be enough. Had they asked me right after the incident I was so angry at that RN that I would have gladly given a statement. I have never regretted my decision not to. It does make me sick however to know there are people out there who would salivate at the chance to get someone in trouble. Don't get me wrong---if I see any kind of abuse I wouldn't hesitate. But all of this reporting for mistakes thast anyone could make and are not that big of a deal is just ridiculous. And I might add just plain mean.

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