Replaced by Certified Medication Aide! - page 3
Yes, fellow LPNs, its happening here in Northeast Ohio! Trained and oriented CMA and was then given extreme partime hours(as were the other LPNs) while CMA gets 40hrs and benefits! And of course,... Read More
13Quote from CapeCodMermaidI think passing meds SHOULD be something only nurses can do. So if today we say it's okay for UAP to pass meds, what will happen tomorrow? Will they say dressing changes take too much time and train CNAs to be "certified wound techs"? Why not certify aides to suction trachs? Straight cath? If they can pass scheduled pills now, it's only a matter of time before nursing home administrators push through legislation allowing CMAs to give injections, or give PRNs. Why not just delegate *all* of the "tasky" stuff licensed nurses do to UAP? Is all we need licesnsed nurses for is assessments and supervision, how many nurses will LTC facilities actually need?All the studies I have read indicate that medication aides make FEWER med errors than nurses do. They just pass pills. Tney don't assess, they don't teach, they don't plan or evaluate. They pass pills. If medication aides were allowed in my state would I hire them? You bet I would. It would give the nurses more time to do what only NURSES can do.
Be careful what you wish for. If we give those at the top an inch, they will replace as many of us (LPNs AND RNs) as they can with $10.00 an hour techs.Last edit by BrandonLPN on Feb 3, '13
1Feb 3, '13 by NurseGuyBri, BSNBrandon, I hate to tell you this but many states already allow and have for years a CNA to get certified for basic dressing changes...
2Feb 3, '13 by NurseGuyBri, BSNOk. I am not incredibly happy that I keep seeing "Our jobs are duties are being given away by nurses." First, these duties are being given away by MCR/MCD. This is a money issue, pure and simple. Facilities cannot continue to pay for an LPN to be a medication passer. I will tell you this, sadly, many LPN's have become medication passers and nothing more. IM NOT DOWNING THEM, IT'S NOT THEIR FAULT- LTC med passes have become monsters and that is all they have time to do!! There are MANY MANY THOUSANDS more drugs than there used to be. The average patient in facilities in this area (I have worked at a few) has more than 10 pills! Many have more. This, plus reduced funding, is causing the shift to CMA's, not nurses giving it away. Now- if a CMA program is implemented appropriately, it can be effective. It is up to the BON and facility to do this. VA's BON requires a higher amount of training (no, it's still not enough). The goal is to allow the CMA to pass the tablet, a medial, repetitive, non-changing and expected outcome physical task. If my CMA is passing tablets to 30 patients, then I can more appropriately assess, talk to, sit with, and NURSE those patients. I would PREFER an LPN do it, absolutely! BUT, I would prefer an LPN to only have 15 patients if they have to pass the meds- that will allow them to give the the meds AND assess. With 30, it just isnt possible, so having the CMA pass and the LPN to assess, I feel much better supervising that building because even though the "number of licensed hours per patient" will drop, the ACTUAL time that LPN spends with the patient should increase. The second part to this of course is the facility. They MUST implement the system correctly and be vigilant in their on-the-job training. I, for one, when working with CMA's in other facilities, assess them often for safety. That's my job as an RN. The facilities I've seen with CMA's also monthly challenge their CMA's to review, in house, their basic knowledge of the meds. Think about it- if their job is to PASS THE PILL only, they dont need to know too much about the drug because the LPN now has more time to spend on assessing for the change that he/she should STILL BE AWARE OF as that patient's nurse! Yes, rose colored glasses, I know- but it only works if the staff makes it work. It's not going to change, and it's not going to stop. Our facility does not allow CMA's yet. They will, it's inevitable. I will also lose a nurse or two. I will, as a facility and a professional, do my best to at least assist them in changes. Just trying to stop the "Nurses are giving away their duties" thing. Nah, it's all about the money...
I'll leave this last bit of information. I will not down a person for going to get their CMA by calling them puny or whatever else that prev. poster called them, that shows your professional ability and mindset (not too good). CNA's come in all types, just like LPNs, RNs, MDs, NPs, housekeepers, store owners, etc. A good CNA who gets their ability to pass meds is good- its up to the facility to find the good ones, that reflects your facilities hiring process, not the CMA... STOP PUTTING PEOPLE DOWN!!! Ugh...
2Feb 3, '13 by netglowOh I don't think there was any down putting going on. When we talk about reality, those that want to feel down, will try hard to get put down even if they have to do it to themselves, you know?
3Feb 3, '13 by nguyency77Quote from BrandonLPNThis is example of when the "slippery slope" fallacy does NOT apply. I agree with you 100%, Brandon. I hope that when my class graduates, we won't be facing the uphill battle against "permissive licensure" like some of you did when you were new nurses. Remember when licensure wasn't mandatory? It is a terrifying thought; people could just see a classified ad seeking an RN and apply if they thought they had the "skills." The only catch was that the person couldn't call themselves an RN. Same thing is happening now. Every state has mandatory licensure, but it seems like new job titles are being invented every day for UAP. Pretty soon, I'll be a CNA XII and I'll be able to do everything an RN can do! Only I just can't call myself an RN.I think passing meds SHOULD be something only nurses can do. So if today we say it's okay for UAP to pass meds, what will happen tomorrow? Will they say dressing changes take too much time and train CNAs to be "certified wound techs"? Why not certify aides to suction trachs? Straight cath? If they can pass scheduled pills now, it's only a matter of time before nursing home administrators push through legislation allowing CMAs to give injections, or give PRNs. Why not just delegate *all* of the "tasky" stuff licensed nurses do to UAP? Is all we need licesnsed nurses for is assessments and supervision, how many nurses will LTC facilities actually need?
Be careful what you wish for. If we give those at the top an inch, they will replace as many of us (LPNs AND RNs) as they can with $10.00 an hour techs.
3Feb 3, '13 by nguyency77Quote from netglowExactly. I never said I hated CMA, or that it's the CMA's fault that facilities are shifting to a "cost-effective model." In fact, I am one!Oh I don't think there was any down putting going on. When we talk about reality, those that want to feel down, will try hard to get put down even if they have to do it to themselves, you know?
I just do not think our training is adequate enough to perform a previously nursing-only function. Yes, we CMA can just blindly hand out pills like items on a checklist. We do not have the judgment to assess the patient's condition, which would decide whether to hold or give the med.
Someone here said that you can be a nurse in a year, as though that somehow makes nurses non-professionals. I don't think that is a very conclusive statement, given the amount of time LPN spend doing the required science classes and clinical hours.
LPN programs around here require 2 semesters (at least) of pre-requisites, which is one full academic year. Then, students have another full calendar year of nursing coursework. My brother is in an LPN program, and he will have spent 1,566 hours in clinical by the time he graduates. How many clinical hours does a CMA have? When I got my CMA, I spent (get this!): ZERO HOURS in clinical.
EDIT: Some of you have stated that there is no evidence that CMA make more med errors than professional nurses. I did examine some of the studies that were done, and it is true. However, this seems to be the case because there is still some LPN/RN supervision going on.
I refer back to the OP's post that he/she was indeed replaced. What is the error rate going to look like when LPN/RN are no longer utilized in such settings? Can we depend on people who cannot exercise nursing judgment to make nursing decisions, if professional nurses are continually being replaced by unlicensed personnel?Last edit by nguyency77 on Feb 3, '13 : Reason: Added something. :)
1Feb 3, '13 by mortewhat you need is better funding, so you could hire more nurses.
5Feb 3, '13 by OCNRN63, RN ProQuote from Susie2310I remember one time when I was at the doctor's office for something and the MA come back to do "patient teaching," and the information was lacking, to say the least. I usually don't throw the nurse card, but I said something to the doctor about her patient education. The doctor seemed surprised because she said she hadn't told her to come back to talk to me.While some of the public may not care, some do. I think that those that do often have a hard time even finding someone to voice their concerns to, let alone being heard and receiving any kind of corrective action in response. To give a personal experience: When a close family member and I observed the MA taking my family member's blood pressure incorrectly in the doctor's office, we mentioned this to the doctor. Our concern was courteously received, and the MA continued to take my family member's blood pressure just as incorrectly on following visits. We concluded it was not worth our time to pursue our concern again with the doctor, but we made sure to bring my family member's own blood pressure readings in each time to discuss with the doctor. If the doctor was tempted to make a medical decision based on the MA's reading that was not consistent with our blood pressure data, then we referred to our data. But without me, an RN, to advocate for my family member, medical decisions would have been made on the basis of incorrect readings by the MA.
I believe it is difficult for the public, without medical/nursing training, to even perceive that their quality of care is being compromised, and even if they sense or know it is happening, it is not easy to find someone to complain to who will take action on their behalf. At the large medical practice we go to there is no office of the patient advocate or patient complaints person present in the local main office that I know of. One can take a concern up with their doctor, or there is an address one can write to if one has a complaint about their medical care. There is a number to call for the practice manager who is based on another medical campus.
I also believe patients are afraid of alienating their doctors/nurses by saying anything negative about their care, and being ill and in need of medical care is not a strong position from which to complain. Without medical/nursing knowledge, and with illness/infirmity and often no-one to advocate for them, the public is in a weak position. I often think that as a patient or family member, one needs medical/nursing training, and probably legal training.
I do agree with you that patients may feel intimidated and afraid of the consequences of speaking up. It's a shame; patients should feel that they have someone with their best interests when it comes to health care.
0I don't think saying I'm against CMAs replacing LPNs is putting anyone down. I will admit I have an obvious bias..... Being an LPN.
I should also clarify that I'm not against CMAs in an assisted living or adult foster care setting. I just think skilled nursing is too high an acuity level for meds to be passed by UAP.
6And I want to add that even though I usually function as a "med nurse" and spend most of my time passing pills, I still serve a vital "nursing only" role that a CMA could never fill. When I pass pills to 49 people, that's like 49 little assessments on each resident. My RN supervisor doesn't pass medications or do treatments and she only interacts with a fraction of the residents on a daily basis. I've caught so many potential disasters during my med pass that a CNA would never catch. Pulmonary embolisms, extreme bowel obstructions, changes in moods or behaviors CNAs don't see. You lose that when you cut the LPN med nurse out of the picture. You're left with residents who have one RN and a bunch of unlicensed aides. I *know* my residents would be worse off if a CMA passed their meds rather than me.
0Feb 3, '13 by CapeCodMermaid, RNReally!?! See an ad and become a nurse like when we were new grads? I about had my tea coming out of my nose reading that drivel. Look back in the early 1900's perhaps. Zowie but people here say all sorts of preposterous things. And a CNA XII....never heard of such a thing. You're NOT a nurse and you're NOT capable of performing as such.Last edit by CapeCodMermaid on Feb 3, '13 : Reason: Typo
3Feb 3, '13 by OCNRN63, RN ProQuote from CapeCodMermaidI'm pretty sure that "CNA XII" comment was sarcasm.Really!?! See an ad and become a nurse like when we were new grads? I about had my tea coming out of my nose reading that drivel. Look back in the early 1900's perhaps. Zowie but people here say all sorts of preposterous things. And a CNA XII....never heard of such a thing. You're NOT a nurse and you're NOT capable of performing as such.
0Feb 3, '13 by nursel56 GuideDescribing a nursing program as a finite time period is becoming less functional with each passing day, anyway. It never told you very much, especially when we include Canadian programs in the mix but there are just too many options and individual people pacing their education. It's usually used to put somebody else down, as well.