Medication Nurse Assistants - page 2

Hi everyone. I just found out that an MNA will be working on our 50 bed LTC unit:eek: ! Has anyone worked with an MNA? I'm a new LPN, just got used to passing meds to 25 pts, and am really on the... Read More

  1. by   Luv2BAnurse
    I'm just wondering if a CMA is in addition to the RN or LPN, or instead of because the LTC I Prn at keeps telling us they have no money....

    What would the nurse's responsibility be when a CMA gives meds...the treatments? Assessment? Basically everything else? Is that all the CMA does is give meds?
  2. by   Thunderwolf
    Another issue is that a 10-20 hours of training does NOT make one knowledgeable about medication. To be knowledgeable means understanding "why" a med is given, the normal ranges of meds, the risks of those meds, the side effects of those meds, the contraindications of those meds, understanding the labs relevent to those meds and what do those values mean, ekg results in relation to meds, knowing when to hold that med, the issue of polypharmacy on a patient, etc, etc. Again, it is much, much more than knowing how to read and document on the patient's med form, the passing of the med, and watching the patient take it. The risk is compounded when being responsible for many patients on a med round. I, as a nurse, can not tell you how many times I communicate with docs on a daily basis just regarding meds alone...and as a result, meds either being d/c'd, doses or frequencies changed, meds switched or added...you name it. How can a med tech or med aid be even comparable? There is no comparison. Sorry, I believe it is a dangerous practice. I mean no disrespect for the aids who perform/have performed this function...but, not on my license you don't.
  3. by   dkp59
    You know some of you nurses are closed minded. I'm glad when I was a CMA I had some great LPN and RNs that helped me grow into the LPN I am today. Yes I passed pills in LTC and if I didn't understand something I could go ask but tell me what LPN or RN knows all the answer to everything tell me what doctor knows everything. Open your mind and the world would be a better place.
  4. by   TexasPediRN
    :quote:
    "you know some of you nurses are closed minded. i'm glad when i was a cma i had some great lpn and rns that helped me grow into the lpn i am today. yes i passed pills in ltc and if i didn't understand something i could go ask but tell me what lpn or rn knows all the answer to everything tell me what doctor knows everything. open your mind and the world would be a better place."

    i know im just jumping into this discussion, but im another one who really isnt for someone else, who is unlicensed, passing my meds. however- in response to the above quote, im so glad you would ask if you didnt understand something, but i highly doubt every person will. there lies the problem..someone going to school for nursing is more likely to ask questions pertaining to the meds then just some person who has no medical/ nursing background.

    i do have a question though regarding this- can a cma pass every type of med or just po meds? curious, since in the hospital i worked in lpn's couldn't give iv pushes, so are they allowing a cma to do this? if so i would have an even greater problem with this..

    just curious...very contraversal topic here.

    -meghan

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    "to the world you may just be one person; to one person, you may just be the world"
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  5. by   NRSKarenRN
    reason why nurses concerned re med techs:

    "an adverse drug effect occurs in one of every four patients"

    ...from the time a prescriber orders a drug to the time the patient receives it, the process of drug administration may involve between 80 and 200 individual steps....



    from nursing spectrum -viewed 10/16/05

    [color=#ff6600]five rights still resound
    d.c. & baltimore edition
    (10/10/05) recently published statstics have sounded the alarm once again — an adverse drug effect occurs in one of every four patients. these numbers tell nurses that achieving clinical excellence in administering and monitoring drugs has never been more crucial. [color=#ff6600]>>>
    Last edit by NRSKarenRN on Oct 16, '05
  6. by   K205
    As far as I understand it, the MNA holds a license, but the responsibility would fall on whomever's delegating to the MNA. If the MNA makes an error, what happens? They probably will lose the right to admin meds and go back to direct pt care. If I lose my license, I lose my livelihood and all I've worked for. Also, I am NEW! I need to learn, grow, and experience as a new nurse...now this I know life ain't easy, but sheesh. I have a hard enough time prioritizing my care, and fielding all the info, complaints, and situations that come my way any given shift. I find it difficult delegating to the LNAs( not so long ago I worked with them as an LNA myself) I'm just finding my feet. Like I said in a previous post, MAYBE the MNA will be a big help, but I dunno. Thanks so much to all of you for your valuable input. I'll keep you posted
    Quote from ELKMNin06
    question...do these MNA's work on your liscence? Our instructors told us that PCAs or CNA's are essentially working on your lisence and you are ultimately responsible if something were to happen to your pt. while they were providing care...I am wondering is it the same for these MNA's? If so, I definetly wouldn't be comfortable with that....
  7. by   Chel
    We have certified med techs at my facility. They do the po meds..except for schedule II narcs. The nurses do the med pass for the tubes. They make about 2.50 less than starting nurses. In Kentucky, they have to take a six week pharmacology course, and pass a certification test. Most of them are pretty good. If they have a question, they ask.
  8. by   DusktilDawn
    Quote from dkp59
    You know some of you nurses are closed minded. I'm glad when I was a CMA I had some great LPN and RNs that helped me grow into the LPN I am today. Yes I passed pills in LTC and if I didn't understand something I could go ask but tell me what LPN or RN knows all the answer to everything tell me what doctor knows everything. Open your mind and the world would be a better place.
    Medication administration in a health facility should be done by a trained licensed nurse. The qualifications for CMAs vary depending on state. Some have as little as 10 hours training.

    The fact that LPNs, RNs, or doctors don't know the answers to everything is hardly a valid argument for CMAs. The fact that LPNs, RNs, and doctors also make mistakes is also not a valid argument for CMAs. LPNs, RNs, and doctors are subject to discipline under law, by their governing bodies (state BONS, AMA) and have standards of practice that they must adhere to. Nurses accountable for their actions and the actions they delegate, that means if I make a mistake I am accountable, it also means I am accountable for the assistive personnel whether they are CNAs or CMAs.

    FIVE RIGHTS STILL RESOUND
    D.C. & Baltimore Edition
    (10/10/05) Recently published statstics have sounded the alarm once again-an adverse drug effect occurs in one of every four patients. These numbers tell nurses that achieving clinical excellence in administering and monitoring drugs has never been more crucial. >>>
    Thank you Karen.
    Medication errors and the prevention of them is an on going issue with nurses, if it is an issue with nurses with the educational requirements that we have, how can it not be an issue with CMAs who have far less of an education?
    This is a subject I will remain "closed-minded" on because it is not about making the world a better place, it is about making the facility I work at the safest possible place for patients.
  9. by   DusktilDawn
    Quote from K205
    As far as I understand it, the MNA holds a license, but the responsibility would fall on whomever's delegating to the MNA. If the MNA makes an error, what happens? They probably will lose the right to admin meds and go back to direct pt care. If I lose my license, I lose my livelihood and all I've worked for. Also, I am NEW! I need to learn, grow, and experience as a new nurse...now this I know life ain't easy, but sheesh. I have a hard enough time prioritizing my care, and fielding all the info, complaints, and situations that come my way any given shift. I find it difficult delegating to the LNAs( not so long ago I worked with them as an LNA myself) I'm just finding my feet. Like I said in a previous post, MAYBE the MNA will be a big help, but I dunno. Thanks so much to all of you for your valuable input. I'll keep you posted
    Check out whether or not Medication Assistants are required to hold a license or whether they are certified in your state. I haven't heard of Medication Assistants requiring a license.
  10. by   sjrn85
    A certification is not the same as a license. If a CMA/MNA makes an error, it's the licensed nurse who is supervising who has to shoulder the bulk of the responsibility. Actually, it's a perk for the CMA/MNA: look like a nurse, act like a nurse, but none of the peskly legal liability to worry about.

    You don't know what you don't know. Nurses (especially those with many years of experience) understand precisely just how quickly something that seems so simple, i.e. med admin., can go wrong. Many of us here have been nurses for a long time and realize how dangerous it is to consider medication administration a rote task. (And those of us who are older than dirt remember writing out by hand all of those med. cards and carrying them around in recipe boxes...like handling the "crown jewels." :chuckle )

    Let a CMA/MNA give meds under my licensure? No way, no how.
  11. by   dkp59
    When I became a CMA I didn't know anything about meds I learn alot in that course I took because I had a teacher that cared. and about that adverse effect occurs in 1 out of 4 well just think that just don't mean for med techs that means for us all.
  12. by   sjrn85
    Quote from dkp59
    When I became a CMA I didn't know anything about meds I learn alot in that course I took because I had a teacher that cared. and about that adverse effect occurs in 1 out of 4 well just think that just don't mean for med techs that means for us all.
    No one is saying nurses don't make med errors. What many of us are saying is that it takes more than a cursory education to fully understand medication administration, and many of us are uncomfortable, even unwilling to assume responsibility for an unlicensed individual to give meds.

    If something serious happened and a lawsuit resulted, the atty's. aren't going to go after a medication assistant...they're going to gun for the person with the most to lose. That person is the one supervising the med. aide...the RN/LPN.

    Sorry, healthcare is too stressful these days for me to have to worry about an unlicensed aide giving meds. No matter how conscientious that individual may be, it's my license on the line.
  13. by   DusktilDawn
    Quote from dkp59
    When I became a CMA I didn't know anything about meds I learn alot in that course I took because I had a teacher that cared. and about that adverse effect occurs in 1 out of 4 well just think that just don't mean for med techs that means for us all.
    No it's not meant just for med techs, read the article provided via the link in that post, it was published in a nursing magazine.
    "An adverse drug effect occurs in one of every four patients" What that means is that 1 in 4 patients will have an adverse reaction (harmful, unintended effect) to a medication they receive. An adverse reaction is one possiblity in regards to medication administration.
    There is also:
    Additive effects.
    Antagonistic effects.
    Drug interactions.
    Incompatibilities.
    Side effects.
    Synergistic reactions.

    It's about:
    It's about checking your orders.
    It's about the 5 rights of medication administration.
    It's about triple checking the medication prior to administration.
    It's about knowing not to give a medication if we don't know why it was prescribed.
    It's about knowing the onset, peak, and duration of a medication.
    It's knowing about absorption, distribution, metabolism, and the excretion of a medication (IE: very important in regards to geriatric patients and children, important to all patients).
    It's about knowing how the patient's medical history impacts medication (IE:liver, kidney, & cardiac diseases, home remedies, dietary habits, food & drug allergies, etc).
    It's knowing about the medication you are giving and when to question an order (IE:wrong dose, misinterpretation of orders, incorrect calculations, misreading of decimal points, and labeling errors).
    It's about knowing the purpose of that medication and why you are giving it to that particular patient.
    It's about knowing what the normal response should be to that medication and assessment of that response.
    It's about knowing what to assess for in regards to side effects and adverse reactions.
    It's about know how different medications can affect each other when administered to the same patient.
    It's about knowing what labs to check for which meds(IE: Lytes, therapeutic drug levels for instance).
    It's about knowing when to hold a medication and contact the doctor for new orders.

    Education is on going for nurses from the time they first learn pharmacology, throughout their education and up to where they are in their current practice.
    There's alot of critical thinking that goes on in regards to medication orders.
    Last edit by DusktilDawn on Oct 16, '05

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