What is your opinion on CNA's being med certified?

  1. I just read a post by a new Nurse who admitted to making a medication error, and as I was replying to her post I was wondering about something and I'd like to get opinions from others.

    In my area, there are several state run facilities for the mentally and physically retarded, either as a large institution or as an ICF house in the community. In thees places, CNA's are medication certified, they go threw a 3 or 4 week crash course on administering medications. I'm not saying CNA's can't do a great job, they can. What I'm concerned with, we as LPN's or RN's have spent a year or longer learning dosage formula's, different names, side effects, differing nursing interventions etc. of medication administration. In addition to this, we have to take continuing education courses. As far as I know, all a CNA has to do is once a year show proficientcy in administering one medication in front of a staff nurse. They are only allowed to administer PO medications, so a licensed Nurse has to be available for IM, SQ, and for feeding tube care, med administration, and so on.

    Do other states, counties or area's allow CNA's to administer medications. And what is your opinion on this?
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  2. 58 Comments

  3. by   MollyJ
    In a perfect world, all med administration would be done by RN's and LPN's, but nurses are at a premium and care homes can only do the best they can do. The fact is, I would guess, that care homes simply cannot hire enough licensed folks to do med admin and that is why the role developed.

    I think a more interesting question is whether nurse aids and Med aides should come under the auspices of boards of nursing so that their can be more quality control in their training and certification. In my state, nurse aids are under the department of health, which licenses care facilities. The diversity of meds makes my head spin and I do wonder whether CMA's get enough info to help them be accountable in their med administration.

    Good thread.
  4. by   BrandyBSN
    As a project last year, I sat in on the Med Certification class offered by the ISO houses in my area. It was a 3 week course, and I was pretty unimpressed. The entire whole of what they were taught was covered in the first week of my Pharmacotherapeutics class at my university. They learned abbreviations, PO, subL, and topical administration, but they did not learn any drug calculations, how to check dosages, use body surface area dosage, or what to do if there is an accidental overdose, or the steps to take if meds were given to the wrong patient. I do NOT feel this class was enough! During clinicals I asked many Med Techs what they were giving, how, and why. No one could tell me why! I hope nothing ever reacts for an ADR, or no one will be able to tell the ER what happened!
  5. by   catlady
    And I'd bet the farm that these CNAs are still working under the RN's license. Anyone can be taught to pass a pill or give a shot. My cats could do that. But it takes a lot more to know what you're giving, why you're giving it, when not to give it, what the interactions are, etc. It takes nursing school. Even a new licensed nurse is merely adequate, at best, at medication administration. It takes years, as with most other nursing skills, to become truly proficient.

    These places'll do anything to get the work of a nurse done on the cheap.....
  6. by   P_RN
    These state run places. Are they like group homes? Are the clients mostly well, but take routine meds for their various "conditions?"

    In that case I'd imagine a CNA/Med Tech would act In Loco Parentis(in place of a PARENT). Most Moms and Dads aren't med certified but we trust them to give their offspring their medicines. They do just fine.

    Now in an acute facility it would be a different thing. People who have an acute or a newly diagnosed chronic illness, need to be medicated by a NURSE. Many times the NURSE is the o ne who clues the doc in to what the side effects are.
  7. by   realnursealso/LPN
    hi nursedora....in ny state cna's pass meds in adult homes. they are given minimal training. this is allowed by the state. but as someone posted previously...not in an acute setting.i don't think it's a good idea either...but it is allowed. not enough of us to go around now...how could they get nurses to do it when acute facilities don't have enough staff as it is?
  8. by   CEN35
    well............if the rn/lpn is willing to put their license on the line fine? however, definately should not be allowed in acute situations. i wonder? would this include...not a 3 week class.......but likea 10-14 week pharmacology class?
  9. by   MollyJ
    I am not a LTC nurse, but OF COURSE the CMA works under the auspices (and license) of a LPN/RN and I don't imagine they are charged with dosage calc etc. Rick, 12 to 14 months of education would overwhelm many of these folks, but I too have to wonder if you can transmit the essence of the responsibility of med administration in a 3 to 4 week class.

    When it gets right down to it, it takes a lot of horse sense on the part of the CNA, CMA or other person to let the LPN or RN know if the elderly client is doing or experiencing something different that might be drug related and the elderly are a notoriously hard to evaluate population.

    I have never heard of CMA's being used anywhere IN A MED ADMIN ROLE but in care homes but the CMA "credential" often allows the nurse aide some career mobility.
  10. by   CJM
    Originally posted by nursedora
    I just read a post by a new Nurse who admitted to making a medication error, and as I was replying to her post I was wondering about something and I'd like to get opinions from others.

    In my area, there are several state run facilities for the mentally and physically retarded, either as a large institution or as an ICF house in the community. In thees places, CNA's are medication certified, they go threw a 3 or 4 week crash course on administering medications. I'm not saying CNA's can't do a great job, they can. What I'm concerned with, we as LPN's or RN's have spent a year or longer learning dosage formula's, different names, side effects, differing nursing interventions etc. of medication administration. In addition to this, we have to take continuing education courses. As far as I know, all a CNA has to do is once a year show proficientcy in administering one medication in front of a staff nurse. They are only allowed to administer PO medications, so a licensed Nurse has to be available for IM, SQ, and for feeding tube care, med administration, and so on.

    Do other states, counties or area's allow CNA's to administer medications. And what is your opinion on this?
  11. by   CJM
    I really don't think that certified nurse's aids should be doing anything with passing out medication. This is just one more step toward replaceing RN's with unlicensed personal. What 's next ?Giving chemo to cancer patients? This opens up Pandora's box.
  12. by   duckie
    Our facility uses QMA's (Qualified Medicine Aids), CNA's with training, to pass meds and assist with some treatments. I find them very valuable and most helpful. Many nights I would be forced to do an entire unit of 43 residents by myself, with med passes totaling 3+ hours each time if I didn't have a QMA to assist me. Our current problem is we have a lot of nurses that call off just because it's a pretty day, in other words, they don't care. The supervisior is trying to weed them out but it takes time. In the mean time it is the QMA's that help pick up the slack and they do a very good job. Our facility requires frequent inservicing for the QMA's and when state comes in yearly, they are the ones that get targeted to be followed on med passes. My husband is a QMA and he frequently not only works my hall but goes to another hall to help as well, working two halls at the same time. Many nights he gives up breaks and stays late just to do what he can do to help. There are many things a QMA cannot do, so I do those jobs and my QMA assists me on my end with the things they can do, we work as a team. It took me a while to trust them but the ones that work with us are very caring and very observant. My husband floats to all the halls and quite frankly, he has a better eye for catching medication errors and order transcription errors than any nurse in the building. He catches at least 4-5 every month because he works all the halls and knows what the residents take. If it's different on the MAR, he always checks the orders. Perhaps the training differs from state to state but my husband can tell you side effects for nearly ever drug he gives. Yes, his initial class was only 6 weeks but then he had to have a certain number of hours with an RN to even qualify to take his test. My husband takes his job very seriously and monitors the residents very closely for any symptoms which could mean they are having an adverse reaction to a new medication. Many of our nurses have encouraged him to go on to nursing school but he doesn't want to, but he is good at what he does. Yes in an ideal world, only nurses would pass meds but if I am faced with doing my very hectic, heavy duty unit alone with med passes that would total nearly 6 hours, not counting blood sugars, insulins, breathing treatments, treatments galore and at least 2+ hours of paperwork, I am very happy to work with my husband. Everyone comments that we make an excellent team. One the surface, their training does seem trivial compared to what we go through but we have many excellent QMA's where I work and the ones that aren't, we get rid of or put them back to the floor. Just as one should not make the generalized statements about RN's or LPN's, until you have actually worked with QMA's, please do not be so quick to judge. Many of them take their job more seriously than some of the nurses.
  13. by   maikranz
    Originally posted by MollyJ
    I am not a LTC nurse, but OF COURSE the CMA works under the auspices (and license) of a LPN/RN and I don't imagine they are charged with dosage calc etc. Rick, 12 to 14 months of education would overwhelm many of these folks, but I too have to wonder if you can transmit the essence of the responsibility of med administration in a 3 to 4 week class.

    When it gets right down to it, it takes a lot of horse sense on the part of the CNA, CMA or other person to let the LPN or RN know if the elderly client is doing or experiencing something different that might be drug related and the elderly are a notoriously hard to evaluate population.

    I have never heard of CMA's being used anywhere IN A MED ADMIN ROLE but in care homes but the CMA "credential" often allows the nurse aide some career mobility.

    Oops! CMAs are not CNAs. Certified Medical Assistants (CMA) do NOT work under the auspices or license of a RN/LPN, nursing assistants do. Too many letters, not enough spelling out. CMAs are used in ambulatory care settings (read: office and clinics) and DO in fact give many medications under the direction of a MD/PA/NP.
    I am vaguely familiar with med techs; the assisted care facilities in this area train their own and are not under the Board of Nursing, altho NA certification is. They are limited as to what meds they can pass out and where they can be employed.

    Duckie, your point is well taken!
  14. by   Dixiedi
    Quote from CJM
    I really don't think that certified nurse's aids should be doing anything with passing out medication. This is just one more step toward replaceing RN's with unlicensed personal. What 's next ?Giving chemo to cancer patients? This opens up Pandora's box.
    In my state and neighboring states they onlly pass PO meds in LTC facilities. They are not taking away RN jobs, they are taking away LPN jobs! I have hung chemo, and ya know what? You still have a job!
    It is my understanding that the certified med tech passes meds that allows the nurse more time to actually assess their pts. A lot of time is spent taking meds out of the packaging and giving it to the pt, if not for the med tech, that time would be taken away from the time the nurse has to assess her pts.
    We are talking about meds these folks have been taking for years (usually). The likelihood of adverse reaction is slim. There is always a chance and it may be missed if the nurse is busy opening single dose packs instead of assessing.

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