Med Passers at Nursing Homes 8HR course and giving out NARCS ... - page 2
Greatly appreciated opinions on this thought. Nursing Homes, Assisted Living Facilities ...etc. Having a 8 Hrs Course to CNA's for Passing medication to residents. Why does anyone think this is a good idea? I am not new to this... Read More
- 0Oct 21, '12 by itsmejuli GuideI work in a seniors' lodge as a homecare supervisor.
Our HCAs (homecare aids) assist clients with meds, the meds are packed in bubblepacks so there's little chance of error. Some clients require that the meds be popped from the bubblepack while others just need to be observed. The HCAs do not assist with PRN meds nor insulin administration. The HCA can watch the client click the insulin pen to the correct dose and then the client must administer their own insulin.
All of this is a helping hand, nothing more.
- 0Oct 23, '12 by RN-CardiacQuote from SpeakUp4everWhen I first became aware of this, I too thought no way,...but then I got to thinking,....When my children were small,..before I became a nurse, I was qualified to give them meds,...When I discharge someone home with 3 prescriptions, I don't send them home with a nurse to administer them. When my Mom came home from facial surgery on antibiotics and narcotic pain meds I was 14 and completely capable of reading the bottle and giving meds a prescribed. I'm sure that before these "elderly/mentally challenged" patients came to assisted living a spouse, friend, neighbor, grandchild etc gave the meds. While I've never worked in LTC and I see your point about being responsible for what a med tech does,...how hard is it to give one Norco every 6 hours?
I understand also that not all Narcotics are dangerous, but keep in mind that its the elderly.. or mentally challenged, wouldn't feel horrible if you gave the wrong dosage of a controlled substance to someone or overdosed and not have known because of lack of knowledge?
- 0Oct 23, '12 by ~*Stargazer*~One could easily be horrified at the thought of an unlicensed layperson with no medical background giving their 80yo grandma IV push antibiotics through her PICC line at home, but I teach people how to do it all the time. It's not that hard. Even people with less than average intelligence can learn to do this safely.
So no, I'm not shocked and have no problem with med aides passing routine meds to stable residents of assisted living facilities.Last edit by ~*Stargazer*~ on Oct 23, '12
- 0Jan 4, '13 by jacquelyn.I am a new grad and throughout school I worked as a med tech in an assisted living for memory care. And yes the course is only 8 hours of boring stuff I didn't pay attention to. However we have a nurse to over see all of the medication administration. We have bubble packs for each pill everyday. I feel these are idiot proof. We do administer insulin and prn medications. However most of my coworkers do not have medical training of any kind. Just the other day a med passer gave antacid instead of milk of magnesia because she thought they were the same thing. I mean all you have to do is read the MAR and the bottle. And another one didnt record the blood pressure before she gave metoprolol so did she take the BP and just give the pill?? I wrote her up and she was mad at me cause she forgot to write it down. I know I would feel uncomfortable if my mother lived there you never know what they are giving. The nurse we have is very hands on and is always educating staff on how to give meds. And you have to be to run this type of facility. There is protocol in place that after so many med errors you get fired though. So many of the techs work hard not get any errors.
- 0Jan 5, '13 by KatieP86I'm just going to throw some thoughts out. Feel feel to disagree, also note I am a) not in the USA and b) not a nurse.
In assisted living (suppose our nearest thing is residential home, here) most of the patients are medically stable. Surely someone following a MAR and giving routine medications is different from a more acute area where nursing judgement is needed? As someone else said, it's no different from a family member giving the medication. The med tech can give these routine meds (that the patient may have been on for years with no issues) whilst the nurse can focus in on the stuff only he or she can do. I do think that a nurse should be giving PRNs and insulin and any new meds- so they can use their nursing judgement in whether to give them or not.
On the other hand, if something were to go wrong- say a med tech gave a pill which the resident has been on for years and NOW, suddenly, they have an adverse side effect such as a crashing B/P or HR - who is to blame?
ETA: I used to be horrified by the thought of a non-nurse giving out meds. I'm starting to think now, that in LTC/Rehab environments it might not be such a bad idea. Still in two minds!Last edit by KatieP86 on Jan 5, '13 : Reason: added a final thought.
- 1Feb 3, '13 by PunkBenRNWhen I worked in a nursing home, we had MNAs (Medication Nursing Assistants). This is essentially what you are talking about; CNAs that can pass meds after a brief course and test out. First of all, MNAs are a godsend, and especially in SNF/Nursing Home setting (beyond Assisted Living) they are incredibly safe.
Food for thought: Any mistake an MNA can make, an LPN/RN/ARNP/MD can make. Med errors are universal, and even with the background and education to prevent them they continue to occur. It is unfair to assume that MNAs will inevitably make med errors because they don't understand what a beta-blocker is.
As far as dispensing narcotics -- Yes, they can dispense them. No, they can't hand out PRNs as they feel. Anything that requires an assessment (i.e., pain meds and BP meds) has to be ok'ed by the RN before being administered. Most MNAs are very good about checking with you first. If you need a BP checked before administering Metoprolol, just write it in the freaking MAR so the MNA/LPN/RN knows to.
Working with an MNA, I am free from the incredibly elaborate and tedious med pass - I can focus on assessments, dressing changes, etc. Before every shift, I would still thumb through the MAR, just to be aware of what is going out during the day.
My two cents.