Should medication aides exist?

Mentos - don't fell guilty about what almost happened. The administration at your facility is not utilizing CMT's properly. Experience can be the best teacher and in your case you did not have adequate experience before being thrust onto that position on short notice.

I trained detention center youth care workers on medication administration. This occurred in a former place of employment. These individuals that I trained had to be observed passing medications every six months and they regularly passed medications when it was my day off. In many ways, they did a better job passing medications than I, a nurse. They were more self conscious of making any errors than a seasoned nurse.

Experience is a teacher - ask for more opportunities to pass medications under supervision.

Agreed. Mentos, you rock and you're going to be an amazing RN. Thank you for your story.

Way too dangerous. They are just not well trained enough to know when to hold a medication or what all the side effects are that they need to be mindful of. I would never work with one.

You guys are to sweet!

Mentos- The facility I work at has a similar program. They have offered it to me before but I never went, because of witnessing situations like you described. I think it is very admirable of you to admit your mistake, and learn from it. Most CMTs I work with would have never gave it another thought, and kept passing meds.
I think it's awful that LTCs, driven by the almighty dollar, are recruiting CNAs with promises of "easier" work and better pay. Seriuosly, that's what my DON told me when trying to get me to go. That I wouldn't have to do bedside care, and that passing meds was less stressful! I can see why a burnt out CNA would jump at the chance. Sadly, not all of them are as mature as you.
Thank you again for your post. It really reinfoced in my mind that I made a good choice and hopefully it will inspire other CNAs faced with the same desicion.

As a fresh new grad, I certainly didn't feel that I truly knew enough about when to hold a med or what all the side effects were that I needed to be aware of. Outside of the basics of looking out for low BP when giving anti-hypertensives and checking blood glucose when giving insulin, I would have to look up almost every medication to be able to confidently tell you when to hold a med, the side effects, etc. That would be the same for a responsible medication assistant. Their first few weeks and months might required a lot of oversight and self-study. Key to that, though, is a strong training course for CMAs that not only teaches the basics of safe medication administration (5 rights, double checking pt ID, etc) but also emphasizes the importance of knowing the basics about what they are giving (is it for constipation? high blood pressure? what are contraindications? what are potential side effects?) and that emphasizes the importance of utilizing one's drug book and other resources and to communicate with the nurse whenever they aren't sure about something or soemthing doesn't feel right.

I could easily see the argument that nurses shouldn't be allowed to administer many medications because they don't have the same depth of knowledge as physicians. What depth of knowledge IS relevant to practice in different contexts? Memorized lists of drug purpose, contraindications, & side effects? A cursory grasp of medication classes and mechanism of action? An understanding of the drug's actions at a cellular and molecular level? If nurses can serve at a level of between the average lay person and physicians, is it impossible that CMAs can serve at a level between the average lay person and nurses?

I personally didn't feel that my nursing program trained me up all that well in pharmacology. I like to thoroughly understand things and the nursing school approach to pharmacology was not much more in depth than a good nursing drug book. Without a strong foundation in biochemistry, you can't do much more than memorize the mechanisms of action and get the "gist" of it. The class gave me a broad overview and a framework for looking at meds (classes of drugs, pharmacokinetic, pharmacodynamics, etc) but I didn't retain much of the details of any specific drug and it's contraindications, side effects, etc. That was learned by coming across a drug in clinicals several times and looking it up several times and seeing the drug in context of a real, live patient in and real, live health professionals (actually seeing the symptoms, reactions, the precautions and actions taken by the professionals, etc). I imagine that would be the same for CMAs.

Anyway, my view on the topic is that if a med course is well-structured and of good caliber and the CMAs are well-supervised and their job role well-regulated and the meds being given are "routine" - such as the type administered to oneself in the home environment, then I don't see it as an unsafe practice. Of course, there are budget conscious administrators who would push the limits to what's beyond safe and there are issues of where responsibilities fall when mistakes happen (a nurse shouldn't have to take the fall for a CMAs error) and that's where strong regulation & clear boundaries in job responsibilities comes in.

I am still a student and think that there is room for medication aides, but only if the are well trained and well supervised. I may well change my opinion on this later...or not.

I note that in my state they permit CNAs, who are nursing students, who have completed their pharmacology course, to be medication aides. The other alternative is they must have completed something like 1000 hours as a CNA, be recommended by two RNs, then take a state approved course.

I don't know if this is universal, but our med techs are required to take continuing education classes. They, along with my fellow CNAs and the nurses, have to have a minimum of I think 12 continuing education hours per year. Wait, 12 doesn't sound right--it may be 20. Our med techs and nurses are required to attend inservices and learn what the meds they are giving are for and when they shouldn't give them. The med techs work directly under the nurses and if they're unsure about something, they ask the nurse.

Most of our med techs are awesome and good at their jobs. There is, however, one who kept insisting that Metformin was for the thyroid. Then again, we also have a nurse who keeps insisting that Geodon is a benzo. Uh, no. I used to take Geodon and Metformin and I know what they're for and that ain't it. Metformin is for blood sugar and Geodon is an anti-psychotic. (I'm not schizophrenic, I have bipolar 1 and went into a mania.)