please help!!! - page 2

I work at an assisted living facility in WI and we just had something happen and im worried about what might happen to me and my coworkers because of it. we recently had a respite at our cbrf for a... Read More

  1. by   Hellllllo Nurse
    From WI cna-
    i pass meds,am not a cna

    --------------------------------------------------------------------------------

    "i work at an assisted living facility in WI im not even a cna and all i had to do was take a medication training course(course was 8 hours) and i pass meds. we have narcotics(although the residents dont ever take them) that we have to count at the end of EVERY night. i havent had a problem with it. we dont pass out that many meds really, but i am very careful with what i do.i learned alot in that class about side effects, dosages, dr. orders and the such. ive had to do telephone doctor orders before to discontinue a med and whatnot. i admit its alot of work, making sure everyone gets there med on time, keeping a close eye out for possible side effects and calling the doctor when there is a problem but i love the work i do and i would do anything to make these residents' lifes' better,which is why i feel comfortable passing meds because i have confidence in what i know and have learned."

    An 8 hr course, and you can pass meds? Lord, help us. And in your post, you say you are not a CNA, but your screen name says you are.
  2. by   Nurse Ratched
    I believe the question those with a license to lose are asking is, why is someone *without* a license passing meds? I understand that there are QMA's in certain settings, and the rules governing ALF's are another animal altogether since most of them do not claim to be medical facilities. However, there are clearly not adequate policies/procedures in place if there is some question of whether the pt is getting his meds. If the dosage has changed, the old dosage shouldn't be laying around to potentially be wrongly given. Many ALF's don't even technically "dispense" meds (they can "remind" the patient to take them, but staff may not necessarily be permitted to take them out of the bottle and put them in the resident's hand.

    Bottom line is, if your facility is bearing the responsbility for giving the med (as clearly you are given the reaction of the patient's wife) then there needs to be adequately trained personnel doing so, who know not only what meds to give, but why they are giving them, when NOT to give them, evaluation of potential side effects, toxicities, how to appropriately document (I could go on and on, but you see why there are concerns about an 8 hour class being considered sufficient preparation for this HUGE responsibility.) There should be a nurse on staff doing this.

    I say this not to be unkind or to question your good intentions, but this is a nursing task.
  3. by   Megan-Cho
    I say this not to be unkind or to question your good intentions, but this is a nursing task.
    I'm just thanking God this poor resident didn't get both strengths! I imagine they aren't getting regular labs in this situation.

    I'm also picturing Not-quite CNAs diagnosing "Thin blood" on the families say so. Then prescribing, and administering Corn Starch injections for too thin blood.

    EEEEEGHADS!
  4. by   CCU NRS
    Quote from Hellllllo Nurse
    Coumadin is an anticoagulant, not a blood thinner. Blood thinner is what lay-persons call it. I stick by my statement that CNAs should not be passing meds.
    You are entitiled to your opinion, however you did not just say CNAs should not pass meds but you were less than kind shall we say, your original comment was: ""Thick" blood? No such thing. Another example why CNAs should not be giving meds."

    Apparently th State of Wisconsin feels differently, possibly due to the nursing "shortage" or the inability to get nurses to work in the field.
  5. by   CCU NRS
    BUMP for WI_CNA please don't let the harsh responses offend or frighten you away
  6. by   WI_cna
    Quote from CCU NRS
    BUMP for WI_CNA please don't let the harsh responses offend or frighten you away
    im not even quite sure why ALFs' have non certified people passing meds.ive never had a really big problem with it but i can understand from RNs' and LPN s' point of view,they know quite a bit more than cnas' do.i do trust myself in passing out meds and if i ever have a question or a doubt, i do not hesitate to call the charge nurse(our boss is a nurse)
  7. by   CoffeeRTC
    I know in PA they have Med Aid in ALF who are trained for about 8 hrs in med pass.... yes this is scarey..but this is assisted living, not skilled nursing. They can do this because an assisted living facillity is just like a persons home... where a relative with no medical training can assist in giving the person their medications.

    What I want to know is how medication changes are communicated to the person in charge of passing meds?
  8. by   Megan-Cho
    Quote from michelle126
    just like a persons home... where a relative with no medical training can assist in giving the person their medications.
    Michelle, you make a good point here. We sometimes forget what ALFs are suppose to be. Some of us old timers have seen acuity levels just go up and up. What was in a nursing home 10 or 15 years ago is now in an assisted living facility. What was never done in the patients home and required a 2 week hospital stay is done on an outpatient basis with in home I.V. antibiotic.

    I hate to stereotype based on education because it's true a conscientious Aide can do a better job than a sloppy LPN or RN that doesn't care. The multidose packaging is also suppose to have a full description of the meds on the label. So in theory if it doesn't look like that, someone should question it. But think about it. A night shift person questions it and an on-call pharmacist that may or may not even work in the dispensing area on a regular basis takes the call. Do you know what they will say 99% of the time? "Oh it's probably just a different generic brand."

    I've talked to a corp nurse at an ALF chain just today about this packaging and she said they had problems with their pharmacy sending the wrong meds in the packs.

    It can happen to any pharmacy and any facility. The difference between life and death is the person that actually is handing the med to the patient.

    WI_cna, I hope you seek further training. It sounds like you are a caring person and that is something this industry is always short on.

    Good luck to you!

    - Megs
  9. by   WI_cna
    Quote from Megan-Cho
    Michelle, you make a good point here. We sometimes forget what ALFs are suppose to be. Some of us old timers have seen acuity levels just go up and up. What was in a nursing home 10 or 15 years ago is now in an assisted living facility. What was never done in the patients home and required a 2 week hospital stay is done on an outpatient basis with in home I.V. antibiotic.

    I hate to stereotype based on education because it's true a conscientious Aide can do a better job than a sloppy LPN or RN that doesn't care. The multidose packaging is also suppose to have a full description of the meds on the label. So in theory if it doesn't look like that, someone should question it. But think about it. A night shift person questions it and an on-call pharmacist that may or may not even work in the dispensing area on a regular basis takes the call. Do you know what they will say 99% of the time? "Oh it's probably just a different generic brand."

    I've talked to a corp nurse at an ALF chain just today about this packaging and she said they had problems with their pharmacy sending the wrong meds in the packs.

    It can happen to any pharmacy and any facility. The difference between life and death is the person that actually is handing the med to the patient.

    WI_cna, I hope you seek further training. It sounds like you are a caring person and that is something this industry is always short on.

    Good luck to you!

    - Megs
    thankyou i am looking into further training,i will be taking the cna course soon, and after that, maybe more training, RN or LPN in the years to come, who knows. well see.
  10. by   Twright49015
    Well I too work in a assisted living facility and took a 8 hr course and I am certified to pass meds. I am a CNA as well, but in the LTC Facility I work at the "Med Tech" can pass meds in assisted living but not downstairs in the SNF, you have to be LPN or RN for that.
  11. by   ktwlpn
    Here in Pa in assisted living the aides are only supposed to "assist" the resident in taking their meds...by law the resident is supposed to be with-it enough to know what to take...That's how they get away with non-licensed staff doing this....and that's why I have turned down a Monday through Friday clinical co-ordinator postion in a local ALF...the regs are too loose....It can't compare to LTC and it is scary...Around here they will stretch the rules and keep you in ALF until you run out of money...then-down the road you go....Minus your thousands of dollars you spent getting into the community....I don't think the poster has anything to worry about-there is no way to prove that anyone gave the wrong dose of coumadin and lots of pactors can effect the patients PT/INR-that's why coumadin must be closely monitored...UAP's are doing "technical" nursing tasks in many settings-different regs apply...Groups homes,ALF's.....It is unbelievable how some of these places are run and with little or no supervision by a nurse...
  12. by   nekhismom
    It's a very scary situation. Ok, if it's assisted living, the pt. is responsible for medicating himself. So therefore no one has been negligent. If it's not assisted living, then ONLY LICENSED PERSONNEL need to be giving meds. I'm sorry, I am a RN, and sometimes meds can be confusing even to me, and I've had WAY MORE than 8 hours of training on meds! Knowing their side effects, when to give and when to hold, etc is a very big responsibility. And what about drugs that sound alike or are similarly spelled? They can be very tricky at times. Everyone makes mistakes.

    I personally would NOT allow an unlicensed person to pass meds under my authority. If you are the nurse on the floor in a LTC of ALF, you are in charge, right? Would YOU as a nurse, who worked very hard for your licensing and credentials, want to be resonsible for an unlicensed person administering meds?? How would you feel if a mistake was made and it was YOUR license on the line???? I'm just not willing to do that to myself. Sorry. NO way, no how.

    I think it requires MUCH MORE training than 8 hours to be competent to pass meds. I'm not bashing you, but I do hope you futher your education if you want to continue to be responsible for medicating patients. It's too large of a responsibility to be covered in only 8 hours. Best of luck to you.
  13. by   ayndim
    When I became a stay-at-home mom about 5 years ago I took on a weekend job in a group home for dd adults. We passed meds out. I think we had about 20 mins of training. Some of these clients were extremely low function. There was no way we were "assisting" them in taking meds. We were medicating them. Now that I am a nursing student it sends shivers down my spine to think about it. Not sure what loophole allows it but I wouldn't put one of my loved ones in that situation.

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