Med Prepouring Question (CNA)

Nurses Safety

Published

Hi all, I'm so sorry if this is in the wrong place - please lead me to the right one if that's the case.

I'm a CNA/CHHA in a big retirement facility with independent, assisted, rehab, and LTC. For the past few months I've been working as a caregiver on their assisted living side because I changed to pt status to return to school.

All the other caregivers (no license or certification) pre-pour the patient meds into envelopes that later shifts dispense to patients. I have always felt uncomfortable with this because I know as a CNA I sure as heck am not allowed to go anywhere near the meds.

They want me to go to a 1 hour training session tomorrow to become a "med tech aide" and learn to pour the meds myself. They have let me slide on it but they say that the training must be done by the end of the year, so here I am in this predicament.

I feel very uncomfortable with this and feel like something is fishy. I've never even heard of a "med tech aide" and Google brings up ZERO search results on it.

Please advise me on whether caregivers are allowed to do this, and if so, would it affect or endanger my CNA certification?

Thank you all very much in advance.

There is alot more to giving meds than getting the right med, right dose to the right patient. Meds should only be given by a nurse with a license no matter what the state law allows.

Well mam you can funnel that aurgument to that Nurses should not be allowed to give meds since they don't prescribe them, but only MD's...

In anycase, the thread question was about the legitamacy of the CMA Certification, not opinions on who should/not give meds....

V/r

I did err also: the CNA & CMA Certifcations are over all run by the Federal DHHS, not the States. I'm sure there are plenty of good Nurses and MD's that work with the programs to over see it's legitamacy and accuracy.

Specializes in Psych, Assertive Community Resource Team.

Actually it is perfectly legal for "med techs" to give ROUTINE meds to residents in assisted living or group home settings. I work as a community outreach psychiatric nurse and I supervise the residential techs that supervise our residents taking their meds.

The logic behind it is this: The group home is the resident's HOME and at home they wouldn't have a licensed nurse come to their house everyday and dispense their meds to them. The techs are not dispensing the medication, they are simply reminded the residents that they have pills to take and assuring they take only the pills that are prescribed. When ever a resident has a new pill, I come to the house and give the first dose, monitor for reaction, educate both the techs and the resident about what to watch for and when to call me. After that the med is considered routine. I assume this is kind of the same logic used in assisted living.

I never understand why nurses get so upset over this. It is the same as sending a pediatric patient home with a prescription for Mom to fill and give to the child. Nobody gets upset that Mom is not a licensed nurse. Nobody gets riled up over patient's taking their own meds at home without supervision by someone licensed.

With that said, though, I am absolutely against med techs in hospital or skilled nursing home settings. Med techs shouldn't really be used outside of a residential setting in my opinion.

Durr, I blended two sentences into one, Dutch. I MEANT to say that the PTA program was suggested to me by several people, and as far as the PT program, I knew it required a master's, yadda yadda...gotcha! Thanks for your help.

I went to the session and raised my concerns with the lady who seemed totally baffled by them, but she said she would talk to her higher up and see if we can't make ends meet on this, since I flat out told her I do not feel comfortable prepouring. We not only do routine meds, we also handle and dispense narcotics as needed, and I was NEVER comfortable with that anyway.

Also signed up with one home care agency nearby today and plan to do another one next week. :-) So we will see if any good will come of this.

Jelli, I get freaked out about this not only because this goes against what I was taught as a CNA, but it is also a liability issue. I don't want my butt in the fire if I can help it. I see where your comparison makes sense, but I unfortunately am not Mom, I am the responsible party on my shift - AKA, the one to point the finger at if something doesn't go right or somebody has an adverse reaction to a medication mispoured by the last shift. I know that nobody is going to stick up for ME but ME. That is why I am making a big deal out of it.

Specializes in OB, M/S, HH, Medical Imaging RN.
I know that nobody is going to stick up for ME but ME. That is why I am making a big deal out of it.

You're not making a big deal out of it you're doing what is right and you're right to know it's your neck in the noose when there's trouble. Administration will not stand behind you except to help push you out the door. Best of Luck.

Specializes in Psych, Assertive Community Resource Team.
I am the responsible party on my shift - AKA, the one to point the finger at if something doesn't go right or somebody has an adverse reaction to a medication mispoured by the last shift. I know that nobody is going to stick up for ME but ME. That is why I am making a big deal out of it.

You are absolutely right about this one. I NEVER allow my techs to pre-pour meds and advise them against giving the residents anything that they did not pop out of the blister packs themselves. No one should be giving anything out that they didn't prepare themselves- nurse or tech.

I think it is great that you are so concerned about the care and safety of the residents there.

Best wishes!

It is routine for the other caregivers to prepour days ahead of time. :S

I thank you all for every bit of advice and encouragement. I have taken it to heart and I will also DEFINITELY be looking more at the PTA program Dutch. I'd rather put myself through PT school making $35-40k a year doing something I'd be delighted to do every day (and in fact, have already had practice with at times) than eke my way through 8 more years of school making $10.50 an hour. LOL

PS: I just today found the CNA forums...they've moved since the last time I visited here! LOL Sorry I didn't put this thread there!

Actually it is perfectly legal for "med techs" to give ROUTINE meds to residents in assisted living or group home settings. I work as a community outreach psychiatric nurse and I supervise the residential techs that supervise our residents taking their meds.

The logic behind it is this: The group home is the resident's HOME and at home they wouldn't have a licensed nurse come to their house everyday and dispense their meds to them. The techs are not dispensing the medication, they are simply reminded the residents that they have pills to take and assuring they take only the pills that are prescribed. When ever a resident has a new pill, I come to the house and give the first dose, monitor for reaction, educate both the techs and the resident about what to watch for and when to call me. After that the med is considered routine. I assume this is kind of the same logic used in assisted living.

I never understand why nurses get so upset over this. It is the same as sending a pediatric patient home with a prescription for Mom to fill and give to the child. Nobody gets upset that Mom is not a licensed nurse. Nobody gets riled up over patient's taking their own meds at home without supervision by someone licensed.

With that said, though, I am absolutely against med techs in hospital or skilled nursing home settings. Med techs shouldn't really be used outside of a residential setting in my opinion.

When these individuals are at home and their spouse, or other relative are helping them to take there meds, they only have that one person to help/give meds to, not an entire wing of them. If RNs and LPNs can get distracted and make medication errors, it only stands to reason that CMA's, who have no idea what they are doing, can and will make signigicantly more mistakes than an RN or LPN. One only has to read this listserve and the threads concerning Nurses who have had to supervise these Med techs, to realize that it is still bad policy to allow this. If nurses had stood their ground, refused to "supervise" these Med Techs, pressured their elected officials who allowed this, it could and would have been stopped in its tracks. I would never put myself in a situation that I would have to "supervise" incompetant Med Techs to perform what still is a professional responsibility. I don't care if they THINK they know what they are doing. There is more to giving or helping someone take meds than just handing them a pill. Period.

Lindarn, RN, BSN, CCRN

Spokane, Washington

Specializes in Geriatrics, Med-Surg..

I am from Canada and this issue is also occuring here. There are some assisted living facilities that use med techs, but not a lot. They are allowed to give out routine meds only. It is a concern because here there is a very acute shortage of nursing homes as the government is not willing to pay as even our privately run homes receive some government funding, thus leaving our assisted living homes populated with residents who are waiting for long term care spots. These residents are often coming in with many issues that really do require care from a licenced nurse.

Okay, I think I have one more question for everybody...you have been so helpful and I hope I am not wearing out my welcome!

I've given it some thought and am sure that I will put in my two weeks very soon. I am just done. I happened to talk to one of my best friend's clients who has been an RN since the dawn of time (ha) and she said the exact same thing that many of you have iterated to me - Run, and run fast!

My question is to when to put my two weeks in. I see the trainer lady again next Friday to finish up the training videos for the med tech cert - should I wait until they give me that, so that in a sense my butt might be covered if someone raises a question, or would it not matter? I have been passing prepoured meds for months, though I have not and refuse to prepour them myself. Would the med tech cert matter at all? I am ready to get out, out, out!

I just want to know if the certification would help cover my hiney or if it wouldn't matter either way. Thank you all again for your continued advice!

I was a med aid at an ALF and I am a caregiver at my current job but I also do the meds. In Oregon an unlicensed person can dispense medication and they do (yes it is scary but true). The laws vary depending on your state maybe contacting the local BON would help clarify the confusion.

Specializes in OB, M/S, HH, Medical Imaging RN.
Okay, I think I have one more question for everybody...you have been so helpful and I hope I am not wearing out my welcome!

Don't apoligize for asking questions. This BB is public and has endless resources available to you. If we didn't want to respond we simply wouldn't. That's the beauty of it although sometimes you may get too much advice.

I just want to know if the certification would help cover my hiney or if it wouldn't matter either way. Thank you all again for your continued advice!

I would wait until you have another job secured. Whether or not you have that certification will make absolutely no difference if something goes wrong. That certification means nothing. The issue is more about what timing that is right for you just be sure to give a 2 week notice and work it till the end.

I never understand why nurses get so upset over this. It is the same as sending a pediatric patient home with a prescription for Mom to fill and give to the child. Nobody gets upset that Mom is not a licensed nurse. Nobody gets riled up over patient's taking their own meds at home without supervision by someone licensed.

No a child's "mom" is not licensed, but she does love and care for her child, and therfore, has a personal stake in the outcome of the situation. Also, a mother does not usally give multiple meds to multiple people several times a day.

A nurse has a license, and this gives her a professional stake in the outcome of her care and the welfare of her pts. A med tech has no such stake.

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