Medication Aides

Yancy SPN · May 6, 2004

I am w/rusty on this. I believe STRONGLY no one but a licensed nurse should pass meds. These aides simply do NOT have all the pharmacology, pathophys, etc to truly understand the implications of what they are "passing"; jeez it is SO MUCH more than just sticking pills in a cup and handing em over!!!!! Yet, I WOULD BE HELD LIABLE for ADR's and other untoward effects? How bout med errors? How can an AIDE be held to this standard when they lack the education and training? And don't tell me a 2 week crash course would meet the standard. I do not buy it.
Would I want my loved one medicated by an AIDE? NO way! In that same thread, how bout we train SCRUB NURSES to perform surgeries? Hey, why not in the cost-cutting environment we are in. COME ON!!!! This is wrong!
I am NOT putting down aides, but to me, this is just dangerous practice and should be ILLEGAL! Therefore, ......I disagree w/.t totally. Just Another way for greedy suits and companies to save money in my opinion.

Here in kansas, it takes alot longer than two week to gain the knowledge and experience of passing meds and yes, it is more that just sticking a few pills in a med cup and handing them to someone. As far as med errors goes, med aides aren't the only ones that make them. I've seen nurses make them as well. Were all human and we all make mistakes. If your careful and you do your 5 rights, and pay attention, med errors are hard to make. I strongly disagree that this is wrong.

Yancy SPN · May 8, 2004

Really? 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 old scrubs and 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.

I am from Kansas and worked in a hospital where I received my CNA II training. I received a certificate for catheterizations and sterile dressing changes. I also did enemas and I'm also a CMA, and just because I'm not a nurse, does not mean that I dont know what I'm doing or how to do it right. I think sometimes nurses kinda let it go to their heads that just because theyre a nurse, theyre better than me. All you have is higher education. I have been professionaly trained by the best RNs and some of the local Doctors as well. If the Doctors feel like I'm trustworthy to do an invasive procedure such as a cath, then hey, what's wrong with that??? Also, the RNs I worked under, trusted me with their life. Some of them came to me to ask my opinion about a patient. I've been in this field for 14 years and have seen lots of things and I pay close attention to what's going on around me and to what I'm doing. Please, don't knock me just because I'm a CMA. You still get paid more!!!!!!!!!!!

Hellllllo Nurse, BSN, RN · May 8, 2004

You want someone to pass your meds....Hire a nurse!
-Russell

I second that.

Hellllllo Nurse, BSN, RN · May 8, 2004

All you have is higher education.

That's all, huh? :rolleyes:

Hellllllo Nurse, BSN, RN · May 8, 2004

I'm just a peeon for the nurses who dont want to pass meds and just do the charting. CNA's and CMA's are the backbone to nursing here in Kansas and without us, they'd be in a lot of chaos.

CMAs are not hired because nurses "don't want to pass meds." They are hired because facilities are too cheap to hire enough nurses.

CMAs and CNAs are not nurses, and therefore cannot be the backbone of nursing.

That would be like saying "Security guards are the backbone of law enforcement."

NOT.

obeyacts2 · May 8, 2004

In CA, in the assisted living , "board and care", and facilities for the developmentally disabled, aides can pass meds. They only have to say the aide has been "trained" by the facility. If you have a good facility, you may see classroom time. More typically, you buddy up with a more experienced aide and learn on the job. I started my caregiving career working in a carehome setting for developmentally disabled adults with multiple handicaps. So, the meds given were (typically) lots of antiseizure medss and the like. I look back and see how little I knew then and it is scary. I am in nursing school now and I probably wouldnt feel too uncomfortable passing meds. This is perfectly legal, because it isn't a "skilled" nursing facility. I have mixed feelings and think that some sort of classroom time (not OJT the facility can lie about) should be required. Some of the people who work as caregivers are scary (the work to welfare population). In home care settings, if the aide is agency, they may only "remind" the patient, as in "Mrs X, it is 3 pm and time for your pills" and bring them to the patient unopened in the original container. If the aides work for a private homecare company (not agency, in CA there is a big legal difference) all bets are off and as long as there is a signed contract between the patient and family spelling out the permission to give meds, it is perfectly legal, and not circumvents the nurse practice act.

Laura

Cherish · May 8, 2004

In maryland Medicine Aides, are CNA's with medicine aide training, they go to a community college to get the classes. The classes are board certified.

caroladybelle, BSN, RN · May 8, 2004

I am from Kansas and worked in a hospital where I received my CNA II training. I received a certificate for catheterizations and sterile dressing changes. I also did enemas and I'm also a CMA, and just because I'm not a nurse, does not mean that I dont know what I'm doing or how to do it right. I think sometimes nurses kinda let it go to their heads that just because theyre a nurse, theyre better than me. All you have is higher education. I have been professionaly trained by the best RNs and some of the local Doctors as well. If the Doctors feel like I'm trustworthy to do an invasive procedure such as a cath, then hey, what's wrong with that??? Also, the RNs I worked under, trusted me with their life. Some of them came to me to ask my opinion about a patient. I've been in this field for 14 years and have seen lots of things and I pay close attention to what's going on around me and to what I'm doing. Please, don't knock me just because I'm a CMA. You still get paid more!!!!!!!!!!!

Then let YOU take all the legal responsibility for anything that goes wrong with those procedures. Instead of the RN.

But unfortunately, that's not how it works.

Quite frankly, I am always most comfortable in primary care, where there are no aids at all.

And while I know that there are awesome CNAs, until they are given the FULL LEGAL Responsibility for their actions, they have no business doing procedures that the responsibility must fall on a licensed professional.

PeninsulaRN · May 8, 2004

Then let YOU take all the legal responsibility for anything that goes wrong with those procedures. Instead of the RN.
But unfortunately, that's not how it works.
Quite frankly, I am always most comfortable in primary care, where there are no aids at all.
And while I know that there are awesome CNAs, until they are given the FULL LEGAL Responsibility for their actions, they have no business doing procedures that the responsibility must fall on a licensed professional.

ITA! I am also most comfortable in primary care. I'd much rather be held accountable for my own actions than for the actions of an unlicensed person whose experience and knowledge is suspect.

gypsyatheart · May 8, 2004

ITA! I am also most comfortable in primary care. I'd much rather be held accountable for my own actions than for the actions of an unlicensed person whose experience and knowledge is suspect.

EXACTLY! In my area there are Medication Aides for LTC facilities and DD facilities. In clinics there are MA's or Medical Asst.'s. They attend a training course at a community college type place and then they are in offices passing themselves off as nurses, drawing up meds, giving advice, doing assesssments, you name it. It is scary, I too, have seen mistakes that would curl your hair! That is why I will not work anywhere but primary care, I will not be responsible for another (untrained, IMO) persons work!

Very scary for nursing these days, and as we can see, so many of these "unlicensed assistive personnel" have huge attitudes to accompany their positions..... :stone

or-nery · May 8, 2004

I started out in a children's group home for six kids with severe/profound developmental disabilities plus serious medical issues. Yes, we passed medications, including narcotics and injections. The staff nurse was on call for consults whenever needed, or I would call the peds office on call doc.

I feel our state mental health agency set a high standard of care. We were state surveyed for our med passes without problems; But, I'm sure there are places which do not train or monitor well. These facilities have enormous financial burdens...Sadly, the state agency divested itself of this group home and the private non-profit does not operate at the same high standards

I'm the second "aide",or direct care staff, at our small facility to go on to pursue an RN; One recently graduated and I'm starting school this year. Another woman is going to apply for the nursing program next year. When interviewed for the nursing program, I felt my experience was respected.

Aren't lots of these "aides" potential future nurses??

All the wonderful RN's I've met have certainly inspired me. I hope to encourage aides with the potential to further their education. :)

PeninsulaRN · May 8, 2004

Wendy, yes, some of these aides may be future nurses. I see nothing wrong with encouraging aides to further their education and become nurses. I think that's great and I have encouraged aides to go on to PT/RT/RN school.

Its just that aides are not nurses. In my opinion, medicating patients is a job for a nurse with pharmacology and pathophysiology knowledge.

Further, in such a litigious time for healthcare providers, I would prefer to be accountable for myself, not any number of aides who have limited knowledge, experience, or freely give advice as if they are nurses.

Arh, but that's another thread.