Medication Aides - page 2
:confused: I am asking this question of you because I have looked for days for my answer and am still empty handed. I need to know where I might find information on medication aides and their... Read More
Jul 12, '02Nurse Ratched,
This is exactly why I am against "med aides".
This is why I say If you want to hire someone to pass meds, hire a nurse.
Jul 12, '02Rusty et al - it's a shame the public in general doesn't realize it (or perhaps more accurately, the suits.) Anyone inwith a week of class is qualified to dispense meds...especially if they're cheaper than a nurse.
Jul 12, '02In my State CMA's are CNAs with six months experience, I believe have 40 hours of class time in the med aide course, and then have 12 hours of med passing time/teaching with an RN. Rather scary at that for a person to be passing meds.
Facility # 1 I worked for would have a CMA pass meds, do all txs. if did not involve a Stage 3 area or greater, chart what they did or things they could obserb, all which had to be cosigned by a nurse. Narcs could be counted with a CMA/Nurse combo, they could not remove a narc, but did pass them. I was 'reassured' frequently when myself and other nurses got very adament regarding what they should/shouldn't do that this fell into the state guidelines and that the facility educated them on how to do things correctly.
Facility #2 : CMAs passed meds, do chem strips, all txs if skin intact or just an simple skin tear and edges were approximated, could not go near the narcs and did not chart anything other then on the MAR.
Facility #3: CMAs pass meds, do no txs, narcs or charting except on MAR. They did some txs in the past, but that was stopped.--I don't know why as I've only been there a month.
I think each state has their own specifics, BUT each facility will create their own policies for the CMAs regarding the needs they need at the time. And the nurse assigned to those res/pts is ultimately responsible for all the CMA does/doesn't do. I've met some very good ones that I trusted, but for the most part it was just something else to worry about.
Jul 12, '02Also here in Iowa we have Medical Assistants that have attended I believe a 9 month diploma program. They are popular in the clinic setting...I have seen them give injections, take VS, and do simple labs. And usually are mistaken for a Nurse.
Also for my above post, CMAs take VS and then report them to the nurse.
Jul 12, '02Incomprehensible to me, especially since I am working in a PCH that doesn't even employ LPNs.
Jul 12, '02Really? CNAS can do foleys and straight caths? I am sorry, but that is just not right. In my hosptial, LPNS aren't allowed to catheterize men or children.Also, often CNAS and medical assistants are mistaken for nurses and what bothers me is that they don't correct the mistake. I also know of some CNAS I work with who don't wear their IDS and wear plain oldand call themselves nurses. I know a CNA who told a pt who was complaining of lower leg pain to massage his calf. When I told her that you shouldn't massage your calf, especially if you have a hx of clots(this pt did) she told me I didn't know what I was talking about and that she never heard of such a thing. I also know CNAS who do trach care and suction vents, etc. They are not allowed but feel it is OK becuase they have worked there a long time. So does that mean if they work in L&D for 20 years as a CNA it isOK if they deliver a baby?Am I wrong to be bothered by these things? I am a CNA and also a student and even though there are a lot of things I KNOW how to do because I am in school, that doesn't give me the right to perform them when I work in the role of a nurse's aid. I am still unlicensed and I don't overstep my bounds.
Jul 13, '02Flo, it is ILLEGAL for a CNA to tell patients he/she is a nurse just as it is illegal for a nurse to tell patients he/she is a doctor. This is quite serious & should be addressed.
There is a reason nurses go to nursing school. We study hard -- learn nursing theory, CRITICAL THINKING SKILLS, pharmacology, and clinical skills. We learn to apply our theory to our practice & know the side effects of the medications we give our patients.
We know when to question a med, hold a med, etc. There is so much to know -- we're not just passing meds -- it involves so much more. I don't even like other nurses to pass my meds for me -- I would NEVER (I'd quit first) delegate a med pass to a CNA even if it became legal. I've worked too hard for my license and the personal/professional liability is far too great.
Have a wonderful healthy happy sunny weekend. Sue
Jul 13, '02I think the problem is that the lines in society between what is and what isn't a nurse are way too fuzzy. I have a cousin who is a rehab assistant and she's got a bumper sticker about nurses on her car (I don't remember what the pun is). She figures that she has the right to call herself a nurse and that the term discribes pretty much everyone working in health care. Most patients seem to think that everyone in a uniform is a nurse anyway.
Jul 13, '02Medication aides are fairly common in my area in long term care settings. Facilities and state agencies govern their practice.
Your state agency that regulates CNA's will have info for you...I believe med aides must be CNA's first in my state although different states will do things their own way I'm sure! LOL!
We teach family members and patients to administer their own meds in chronic settings and home care so this is how facilities get around it....med aides function much like 'extended family' in LTC centers and assisted living centers.
I do wonder how much liability the RN assumes with med aides on duty though....I would worry about a med error going on the RN's records....or a serious error resulting in a lawsuit against the RN.
Anyone know of the laws in this regard???Last edit by mattsmom81 on Jul 13, '02
Jul 13, '02Tatally agree with Rusty here,,,,,,
As DON of assisted living in florida,,,,, they have passed law and rule with four hour class non licensed personal can give meds,,,,,, You have to have resident sign that they know and agree non licensed personel is giving thier meds,,,,, you have to have a MOR instead of MAR,,,, as they are observing,,,,, and they cannot do prn med,,,, as state feels they don't have knowledge to decide if it's right to give prn,,,,,, How did I handle it in my facility????? I have nurses,,,,, no unlicensed person is giving meds,,,, under my watch!!!!!!!!! Moon
Jul 13, '02This is a story that has been brewing in my head for about a year now. I decided to post it and share with you a possibility. Using UAP's IMO is absolutly the last straw. We must do something to stop the insanity in our health care system. I hope and pray that the end of this story is true. It will not happen on ideas alone. Perhaps this story and more talk on BB's will spur some action on our part. Some action that we must take or delve deeper into the dilution of nurses.
I apologize for the length of this post. Maybe I should've posted a seperate thread, maybe I will. But it was the original post that evoked me to post this:
In the beginning there were nurses and doctors. They cared for the sick and injured on thier journey through life. The nurses decided they needed help so they decided to get some student nurses so that they could do the work for them under thier own watchful eye. It was OK though because the students had to abide by everything the nurses said, they lived with them, taught them, feed them, and nurtured them till they became nurses themselves. Everything was great for awhile, then one day, the nurses decided that they needed help dealing with people who had problems that wern't medical, but affected thier health, so they got a social worker to handle talking with the patients and families and figuring out how to feed "Joe" when they got home.
The nurses then grew weary of doing ROM and exercise with the patient, so they got physical, occupational, and speech therepist to do it for them. Then they got a dietician, housekeeping, and eventually a whole army of people to help them provide care to the sick and injured.
Everything was wonderful for the nurses, they had assistants who were trained and ancillary staff who provided specialized services for thier patients.
The patients improved with the nurses managed thier care. Nurses were able to focus on the plan of care, evaluate it, make changes based on the patients responses, re-evaluate it, until the patient improved and went home. The nurses were able to focus on medications by studying all the meds the patient was taking, looking for side effects and contraindications. The nurses were able to keep track of what all the other people who were involved in the care and it was the nurses who had the final say. They had time to advocate for the patient and thier rights. They had time to go to the bathroom and even take a coffee break! The nurses were happy for a long while.
Then they got really good at what they were doing and had extra time so they decided to create some paper work to improve thier care by tracking patient responses. After the awhile the nurses got bored and decided that they used to do all the jobs that others were doing and began to wish that they had kept some of it for themselves but it was too late, for there were too many patients, not enough nurses, and they really did like the people who helped them provide the care.
Then one day, a big person came into thier lives, named Insurance. All the patients became members of Insurances group and were happy to have Insurance around. Another person came along named Corporate. Corporate and Insurance hooked up and decided they would run the show, and make all the nurses do what they wanted, so they could make lots of money and live like kings.
The nurses fought bitterly and strongly but were no match for Insurance and Corporate. The doctors fought too but made little headway. Many nurses and even some doctors lost thier jobs. Other nurses and doctors decided to leave altogether. Insurance and Corporate were so greedy that they placed such a burden on the doctors and nurses by making them work too long, too often, and with too many patients, that the nurses and doctors were too overworked and too tired to fight. It was all the nurses could do to just get the meds passed and do assessments on thier patients and fill out a mountain of paperwork during thier shift because they had too many patients to care for.
Corporate decided the nurses didn't need to have responsibility for pulling meds so they got a machine to do it for them. Only problem was the machine didn't work out as they said it would to the nurses and the nurses ended up spending more time getting the machine to give them the meds they needed then ever before. The nurses left in droves.
Meanwhile another person was lurking nearby named population. Population caused the number of patients to rise, what population didn't know is that thier were no longer enough nurses to take care of them, so some of the population started to die. But, Insurance and Corporate were very good at keeping secrets and hid what they had done.
Corporate then hooked up with Legislature and went out and had a good time. They decided it would be OK to let other people, who were not licensed to give the meds. They really didn't care about the nurses anyway and Corporate decided the nurses were just for show anyhow. So they passed some laws and made some loopholes right under the nurses noses, and hired UAP's. The nurses became angry and wanted to fight. But, they were too tired from thier heavy workloads and nobody was listening anyway.
Population was still unaware of the danger to them. More of Population were dying. More nurses were leaving. Then all of the sudden Government woke up! They saw that the health care system was in trouble and that it was because there were not enough nurses. They began programs to help with the nurse shortage, but it was too late, the shortage was already in full swing. The situation was so bad that nobody in Population wanted to join the nurses.
Corporate hid it's secret that it didn't want the nurses around anyway, they knew too much, and they cost too much. So, Corporate kept hiring unlicensed personell to do the nurses job but cheaper so that they could keep on making money. Corporate also began hiring nurses from other countries with Governments approval. Corporate was sooo happpy that they got nurses who would work like dogs for peanuts and never complain. The auld nurses were wheeping. They had no idea what to do. The new nurses were scared of the auld nurses and they too didn't know what to do about the situation. Many of the new nurses didn't even know that something was wrong, at first. Everyone thought that Union and Association would take care of them, but they didn't. They too were unable to fight Corporate and Insurance, and when Government joined that side, it was almost a total loss to the nurses.
The nurses admitted defeat and hung thier heads low. There was disention in the ranks, fights among the nurses, all the nurses were on edge and fighting for a safe position. Corporate was smiling as it knew that this overall effect on the nurses would further beat them down and allow them to have total control over something that once belonged to the nurses.
After many years of hardship, the nurses couldn't take it anymore. Some very strong nurses decided to take charge. The nurses who were left joined together and stood up and began to speak. They decided to walk out, all at the same time, and show everyone how badly they were needed. But, the nurses couldn't do it and they knew it, for thier very essence of being, was for the patients, they couldn't abandon them, they couldn't let them die.
Corporate started to realize that it couldn't function without the nurses when it heard of the walk out and threatened all the nurses with thier jobs.
The nurses needed another way. So they started talking incognito, to protect themselves and thier families, on internet BB about thier problems. They didn't know it then, but that was the beginning of a new strength. They gained power through knowledge. They gained friendships which started to heal the disention amougst them. They gained even more strength through the shear multitudes of nurses joining together and brainstorming ideas on how to procede to fix the problems. They formed a grass roots effort to stop the maddness and regain what they had lost. There was only one way to win this fight and they knew it. They decided they had to educate Population. It was thier duty to inform Public of the danger it was in. So they each picked a person from thier area to be in charge of this task and they all made videos for commercials and started speaking to large groups of people when ever they could. They all gave a little money to the cause so they could air thier commercials on TV. Pretty soon, nurses were being interviewed everywhere, on radio, even on the tonight show. Then Population started pushing Government to be on the nurses side. Population bullied Corporate into submission. Insurance was left all alone and powerless. The nurses started to make decisions again and took over the management of patients. They got rid of the unlicensed personel first, then they evened out the acuities and nurse ratios. They all got fair raises which made them very happy. The patients prospered and lived. Populaiton was happy and the nurses were happy. But, they had to keep a watchful eye on Insurance, Corporate, and Government. They had to keep educating the public. Corporate tried to stop them using Government but Constitution got involved and sided with the nurses and protected them from prosocution. In the very end the nurses were stronger than ever before. They stayed banned together and kept on fighting. They always put aside thier differences for the cause. They will never be beaten like that again.
Jul 13, '02http://www.nursingworld.org/ojin/tpclg/leg_12.htm
This is from the online journal.
Jul 13, '02My cousin became a CNA, then a QMA, and she never even graduated high school (got a GED.)
I don't think QMAs should be able to pass meds...they don't have enough training to understand what the med is for, how it works, what to watch out for, and when you shouldn't give it. Some of that involves critical thinking, and you don't learn that in 40 hours of class.
I had to go through all but my last year of clinicals, plus the hospital's own med class before I could pass only po meds, under direct RN supervision...
I went with my bf to a medcheck once, and a medical assistant put him in the room and took his v/s. At one point, he made a comment about "the nurse." I educated him that not everyone who wears scrubs is a nurse, and told him to check out her nametag the next time she came in.
I also think it's wrong for QMAs to be called medics. When I hear "medic," I think of EMT-P, which is in no way similar.
Our profession is getting into more trouble all the time, with all the different people getting trained to do nursing tasks...the suits don't understand, or don't care, that nursing is not just about tasks.