pct debate - page 6

Has anyone heard of PCT *patient care technicians* ? PCT 1 is a CNA PCT 2 can do blood sugars, catheters, etc PCT 3 can start iv's etc I live near Chattanooga and I work as a PCT..in another... Read More

  1. by   lpnga
    thanks to everyone
    Last edit by lpnga on Mar 13, '03
  2. by   caroladybelle
    Interesting crematory story in that area,too.
  3. by   lpnga
    YES and that was awful. I knew the people. His mom and sister had been my teacher.
  4. by   eltrip
    Originally posted by lpnga
    catrn

    your right......DIE county.......aka tri county.......yes the nursing home is excellent........havent seen a bedsore since i have been there........
    lpnga,
    Please be careful about the information you post about your facility. There have been instances where folks have been "tracked down" by their coworkers and turned the poster in to management.

    Some people live to act ugly. One of those harsh facts of life.

    Thanks for the info on the hospitals. I won't work at either one in the future.
    Last edit by eltrip on Mar 13, '03
  5. by   emily_mom
    Originally posted by lpnga
    yes some aides don't know as much about meds as needed..even me..I only pass to those pts I know the meds they are given and the side effects.....that is my big concern I hate to take meds..I wont even take advil for a headache...i would like to be offered a longer class on it
    So you only pass meds that you know about? Don't you think that contributes to med errors as someone else has to go behind you and pass the rest?

    Why don't you want to know about the other drugs? Get a drug book and learn! I don't pass a single med unless I know what it's for, what it does, and how it works. How else can you monitor for adverse reactions?

    Ditto on telling people where you work. You can get fried for that.
  6. by   askater11
    Vsummer why I asked your profession...is because you sound like an instructor. And no one is looked down. We should treat each other well....we all need each other.

    I would like to say....one reason I don't like a PCT...implementing medication is....it's my licence on-line. I have a question: Do PCT's...at facilities that do facilitate the use of PCT's for meds...do they allow PCT's to give insulin?

    Also...giving meds you need to look at the "whole" patient. Pt. medical history, signs and symptoms and etc.

    ...one thing I can tell not even Dr.'s know EVERYTHING about medications. Nobody knows everything.

    Medication's are always changing. That's why they use PDR's....I'd rather have a Dr. that thinks he "KNOWs everything" and doesn't use a PDR....then one that realizes he doesn't "KNOW" everything. At my past two facilities I knew Dr.'s that thought they new "everything" believe me that gets them into problems.

    I was on a medication. I had the side effect of bruising. I was so eccymotic I looked as though I was beaten. I read in my nursing drug book...bruising wasn't a side effect listed....I looked all over the Internet still couldn't find it as a side effect. I went to the Dr. he pulled out this little tiny hand held computer thing and found out bruising was a side effect.
  7. by   MishlB
    Originally posted by emily_mom
    So you only pass meds that you know about? Don't you think that contributes to med errors as someone else has to go behind you and pass the rest?

    Why don't you want to know about the other drugs? Get a drug book and learn! I don't pass a single med unless I know what it's for, what it does, and how it works. How else can you monitor for adverse reactions?

    Ditto on telling people where you work. You can get fried for that.
    You know what...that isn't even the point. CNA's should not be passing meds.
  8. by   emily_mom
    Originally posted by MishlB
    You know what...that isn't even the point. CNA's should not be passing meds.
    Oh, I totally agree! But, at this point, I don't think anyone really knows what she is or what she does. However, we do all know where she works...

    Personally, I wouldn't want an unlicensed and obviously untrained (or poorly) person "helping" me out by passing drugs they have no clue about.

    Well, at least you know where NOT to get a job....
  9. by   lpnga
    WELL IF YOUR EVER IN THE CHATTANOOGA AREA AND YOU NEED MEDICAL ATTENTION THEN YOU WILL BE SURPRISED THAT THE LEADING HOSPITAL IN THAT AREA ALSO ALLOWS PCT'S TO DO ALL OF THIS. YOU MAY HAVE A HOSPITAL IN YOUR AREA THAT ALLOWS THIS.
  10. by   Brownms46
    Originally posted by caroladybelle
    Thank You Brownie!!!!!!!
    You're very welcome caroladybelle..!.
  11. by   Tweety
    Originally posted by Brownms46
    First this was a discussion about unlicensed or PCT/CNAs.
    Second here is an statement taken from the Florida Nurse Practice Act:

    <The professional nurse and the practical nurse shall be responsible and accountable for making decisions that are based upon the individual's educational preparation and experience in nursing. >

    Now in my view if you made the decision to delegate a task to a PCT, and that PCT performed that task wrong, you're responsible for your decision to delegate that task to that PCT.

    Also in one of the links I provided it said this:

    Can the task be performed improperly without life-threatening consequences? No -> Do not delegate

    Are the results of the task reasonably predictable? No -> Do not delegate

    Now in order for the task to be reasonably predictable, you would have to know that there was no way for the resident to fall and break a hip...if you decided to leave the room.

    Is appropriate supervision available? No -> Do not delegate

    Can the task be performed improperly without life-threatening consequences? No -> Do not delegate

    The above is from the Washington BON

    The following is from Mass BON:
    Generally, appropriate activities for consideration in delegation decision-making include those:

    which frequently recur in the daily care of a patient or group of patients
    which recognize that UAP do not have a knowledge base upon which to make nursing judgments;
    which do not require complex or multi-dimensional application of the nursing process by a licensed nurse;
    for which the results are predictable and the potential risk is minimal; and
    which utilize a standard and unchanging procedure.

    http://www.state.ma.us/reg/boards/rn/advrul/ruldelg.htm

    The following is taken from MA. BON


    Responsibilities and Functions - Registered Nurse

    A registered nurse shall bear full and ultimate responsibility for the quality of nursing care she/he provides to individuals and groups. Included in such responsibility is health maintenance, teaching, counseling, collaborative planning and restoration of optimal functioning and comfort or for the dignified death of those they serve. A registered nurse, within the parameters of his/her generic and continuing education and experience, may delegate nursing activities to the registered nurses and/or health care personnel, provided, that the delegating registered nurse shall bear full and ultimate responsibility for:

    (1) making an appropriate assignment;

    (2) properly and adequately teaching, directing and supervising the delegatee; and

    (3) the outcomes of that delegation.




    the delegating licensed practical nurse shall bear full responsibility for:

    (1) making an appropriate assignment,

    (2) adequately teaching, directing and supervising the delegatee(s), and

    (3) the outcome of that delegation:


    Now I was attempting to answer the question posted. From what I read, it seemed to say that the licensed nurse is held accountable for the decision she/he makes. In other words, if you don't feel comfortable delegating a task to an unlicensed person..don't.

    Brownie that is excellent information. (Sorry for getting off topic with the LPN thing, as RN the delegation question is the same LPN or PCT for myself.)

    What if I do feel comfortable delagating the task. What if every answer to the questions is "yes" and I delegate the task (i.e. bedbath) to a patient of mine and there is a bad outcome. What then? Whose responsible, me? I guess with #3 it's clear, I am responsible for the accident.

    When you think about there is a risk with just about every patient. Most all patients I work with are fall risks. What if I ask a PCT to walk a patient to the bathroom and the patient falls and breaks a hip? Am I liable because I knew the patient was a fall risk? Or am I not liable because part of the PCTs training and licensing by the state includes how to ambulate a patient? If in my assessment it was safe for one person to ambulate the patient (i.e. this has been done previously with no fall). Say, if it is reviewed by peers in a court and the delagation was deemed appropriate am I still liable just because the PCT had an accident?


    Just babbling again. Thanks for the information.
    Last edit by Tweety on Mar 13, '03
  12. by   emily_mom
    It is my understanding that if the pt were to fall and break a hip in the presence of a PCT/CNA, they are responsible (if licensed). If not, it's the RN's butt. If a lawsuit were filed, the RN would most likely be named, I'm sure.

    lpnga and I had a wonderful conversation via PM, and she said that they get certificates to pass meds. Now, a certificate isn't a license. I advised her to not do anything that could put her future in jeopardy.

    Does anyone know of hospitals that allow this? We have a nursing home that does, but they are nursing students and Certified Med Techs. We don't have any at our hospital. I would be wary of someone with a "certificate" passing my meds for me.
  13. by   Brownms46
    Thank you an you're very welcome 3rdshiftGuy..! If you answer all the questions with a yes, than you are "supposed" to be able to delegate. But no matter what happens...you are still utimately responsible for that delegated task, and the outcome. Not a answer that sits very well with me, but that is what I have consistently read from all the boards I have looked at.

    See the problem is that PCTs, CNA, and HHAs, although they are certified, they are still unlicensed personnel. I know doesn't make sense right. Being held responsible for someone else's mistakes or for a fluke.

    The governing bodies of each state, decide on how much education/training is needed to say that this person should be able to safely perform the tasks described in their job description. But if you delegate a task to that person, and the same person performs the task incorrectly...you get the blame. Yes.... Yes I do beleive that same person would be disciplined by the board that has authority over them, but so would you.

    I guess the only recourse anyone would have in this case, if the PCT/CNA performed the task in a manner inconsistent with their usual way of doing things.

    Let's just say...that the CNA/PCT..was having a bad day...and this is an unusual thing for them to let this get in the way of how they perform their duties. But one day...they do something totally out of character for them. Well in that case I couldn't see how you could have known they were about to go off, and therefore couldn't have bought their unusual behavior into your decision making process. Did that make sense??

    All in all I guess you really need to know who you're delegating to, what they're weakness/strengths are, what acutal training they have, and you really have to trust them.

    Case in point. I had a CNA give me the results of a Blood sugar. Well before giving the insulin to that pt. I went back to check her "brains"(cheat sheet). I found out the blood sugar reading she gave me was written down for another pt in the same room!

    Well on a fast paced tele unit, and working shorthanded I could understand how this could have happened. BUUUUT I no longer trusted her to do my blood sugars. Even though I always tell the pt. what the amount of their blood sugar reading is, and the amount of insulin I planning to give them, there is also going to be that pt. who couldn't remember or didn't bother to find out what their blood sugar was, and even be aware of what the dosage for the reading would be.

    Yes I wrote up an incident report. This allowed me to have authority over who was assigned to do the blood sugars for my pts., without me as a traveler looking bad for making waves. Everyone understood the problem, and didn't blame me a bit. And the CNA also understood how this incident placed a shadow over my confidence in her. She never acted like she held a grudge about it. I just was very glad I tend to check and re-check things to be totally sure of what is what.
    Last edit by Brownms46 on Mar 13, '03

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