Nursing Issue - Medication Aides

LadyFree28, BSN, LPN, RN · Feb 27, 2005

So by the time you've done all the above, you could have passed a whole shift of meds already... wouldn't it have been quicker/easier/safer to have just done it YOURSELF already???
Don't nurses have ENOUGH to do, and enough responsibility ALREADY without having to take on this one as well? :angryfire

Absolutely! It seems responsible to just give the meds ourselves....

FutureNrse · Feb 28, 2005

How about an outside opinion, but one with a bit of knowledge? First of all, I mentioned this debate to my mother, who has no nursing or medical experience, but does do in home care for a lady with MS. She thought it was a great idea, and asked where she can train for this because she'd enjoy working in a hospital setting. When I started pointing out to her that passing meds wasn't as easy as one would think, she eventually did get the point and wonder how it was possible to learn it all in 24 hours. I think that shows that the average person would have no idea what they were getting into with this position. They don't stop and think about the complexities and varieties of medications.

I took a course in college on pharmacology, and I have never worked so hard for a good grade. That class very nearly ruined my 4.0 average. So I do see why no one seems to like the idea of a medication aide. There is too much room for error, and the amount of training seems terribly inadequate.

I can see how a medication would be helpful to nurses, if more training was given to ensure less room for mistakes. Can anyone take a guess at how much time they would save on an average shift if they were relieved of passing meds? If it's a good chunk of time, then maybe there's a way to get things changed so that you can have aides who are more adequately trained. If it won't save you that much time, find a way to squash the idea like a bug.

GLORIAmunchkin72 · Feb 28, 2005

I'm a QMA at an LTC. I had 60 hours classroom and 40 hours practicum. I have to agree, it doesn't seem enough. Fortunately I worked closely with a nurse at first until I got routine developed.

Hi. I am new to the post. Very shortly a bill will be presented to our legislation on Medication Aides for my state. I am looking for some feedback regarding these aides. I know other programs have been implemented in many other states. How is it working? What are the current problems? Where can I go to find out more information?
In my state they will be mandatory in non-health focused care settings such as: schools, prison, assisted living, daycares, and group homes. The health focused areas are: long term care facilities, rehab centers, home health, hospice, public health depts., clinics, and acute care settings. However, some say it optional for health care facilities. The training is 24 hours. I feel this is very dangerous. It is being implemented to help alleviate some of the nursing shortage we will experience in the near future. Plus, a lot of these med aides already work in some of these facilities and there has never been any formal training. How they were hired is beyond me, but now there is a need to train these individuals. The only requirement to date is: 21 years old and a high school graduate. No prior medical experience. Scary!!!
I am looking for information on how programs of this type are working in other areas? Any problems experienced with the program? Is there an increase in med errors? Where I can go to gather more information?

medpsychRN · Feb 28, 2005

I think most would agree that there's more to passing meds than giving out a paper cup and a glass of water. For me, it's an opportunity to talk to the patient about their meds, answer questions and evaluate their effectiveness. This often leads to additional questions about their treatment etc. As I work in psych, this process begins a dialogue which helps me to access the progression of their illness, improvement, memory and cognitive abilities.

I have a PCT to take vitals, complete ADL's, pass trays, feed patients and now the possibility exists someone will pass my meds. While these are all time consuming tasks, for me, each provides a time when I can evaluate a patient. Isn't that what we're trained to do?

apaisRN, RN, CRNA · Feb 28, 2005

No way am I going to delegate my meds to anyone without a nursing license. And if I spend my time giving meds and never get to the rest of my work (because the med aide is supposed to allow me to take more patients) I won't be able to do an adequate job. It's just a joke. I don't trust many of my aides to do fingersticks for me, because they either don't do them or don't report back to me. I'm certainly not going to hand over my dig and lopressor to these people! I work ICU and I doubt this will ever come to pass there. Unfortunately, the neglected patients in LTC and other settings are at risk from this harebrained scheme. I hope these nurses stand up for themselves and their patients and continue to refuse to use med aides and/or quit their jobs to make the point.

LPN1974, LPN · Feb 28, 2005

One thing I see happening, here in Arkansas, {someone is trying to get a bill passed now now to allow med aides} is that nursing homes will just hire med aides and RNs.....why hire an LPN at $14 or $15 when you can get an aide to do it for $8?

I fear that is exactly what it will come to.

Like on my job I have now, aides used to pass meds there way back in the 70's.

They had one aide who SET the medicine UP and took those meds to other aides who gave it to the MR/DD people in the homes.

After doing that for several years, they decided to hire LPNs to give the meds and hired 1 or 2 to start giving the medications.

Now we have a staff of 13 LPNs and 2 staff RNs and 1 DON.

So if aides can pass the medications what will they need all these LPNs for?

I am one of the highest paid LPNs on my job and I make in the range of $18/hr and there are several in that range. No LPN there makes less than around $14 or $15/hr.

And nursing homes, too, will do the same thing. Cheaper labor, that's why.

They are fixing to creat a nightmare worse than the one we have now. Problems on top of problems.

Just like with the recent survery we just had. How are aides going to be able to adhere to all the requirements by the state surveryors? The surveryors came last month and went with me and one other nurse for a medication round to watch us pass meds. We didn't do anything wrong, but she had several reccomendations she wanted changed. Then they go over the medical records with a fine toothed comb and find stuff to complain about. Can a staff or 2 RNs and 1 DON keep up the medical records??

Do you all think I'm am exaggerating or just imagining things? I don't think I am.

I think if LTC facilites like nursing homes or the one I work in operated by the state, can find a way to cut costs, they will.

Just my fears, that I pray will not be realized.

I do NOT want to have to live in a nursing home when I get old and have meds pushed down me by someone who doesn't have any real medcial training.

LPN1974, LPN · Feb 28, 2005

I'm a QMA at an LTC. I had 60 hours classroom and 40 hours practicum. I have to agree, it doesn't seem enough. Fortunately I worked closely with a nurse at first until I got routine developed.

Not meaning to disrespect YOU in anyway, but I went to LPN school and studied for a whole year.

And they gave you 60 hours of class room and 40 practicum?

That's 2 and 1/2 weeks altogether, right?

GLORIAmunchkin72 · Feb 28, 2005

LPN1974, in our facilities we have QMAs who have been there for years. Every year they have "adhered" successfully to the rigorous inspections of the State Surveyors. I cannot speak for any other med aides. By the way, who do you think issued our certification? Why would they do that if they didn't think we can do the job? Those who can't will be weeded out, but this program has been in place for a LONG TIME.

One thing I see happening, here in Arkansas, {someone is trying to get a bill passed now now to allow med aides} is that nursing homes will just hire med aides and RNs.....why hire an LPN at $14 or $15 when you can get an aide to do it for $8?
I fear that is exactly what it will come to.
Like on my job I have now, aides used to pass meds there way back in the 70's.
They had one aide who SET the medicine UP and took those meds to other aides who gave it to the MR/DD people in the homes.
After doing that for several years, they decided to hire LPNs to give the meds and hired 1 or 2 to start giving the medications.
Now we have a staff of 13 LPNs and 2 staff RNs and 1 DON.
So if aides can pass the medications what will they need all these LPNs for?
I am one of the highest paid LPNs on my job and I make in the range of $18/hr and there are several in that range. No LPN there makes less than around $14 or $15/hr.
And nursing homes, too, will do the same thing. Cheaper labor, that's why.
They are fixing to creat a nightmare worse than the one we have now. Problems on top of problems.
Just like with the recent survery we just had. How are aides going to be able to adhere to all the requirements by the state surveryors? The surveryors came last month and went with me and one other nurse for a medication round to watch us pass meds. We didn't do anything wrong, but she had several reccomendations she wanted changed. Then they go over the medical records with a fine toothed comb and find stuff to complain about. Can a staff or 2 RNs and 1 DON keep up the medical records??
Do you all think I'm am exaggerating or just imagining things? I don't think I am.
I think if LTC facilites like nursing homes or the one I work in operated by the state, can find a way to cut costs, they will.
Just my fears, that I pray will not be realized.
I do NOT want to have to live in a nursing home when I get old and have meds pushed down me by someone who doesn't have any real medcial training.

txspadequeenRN, BSN, RN · Feb 28, 2005

I dont have a problem with experienced med aids ones that come to me about PRNs , problems and such..BUT...... I am a LVN that works as a Med Aide and I work just W/E. I am allowed to do this cause I oversee staffing and fill the floor as needed . Im rambling my point here is....I was overseeing a MA orientee the other day and she didnt know any of the meds what they were for and this is what I have found with all med aides. They do not have the education right out of school to be turned loose and be responsible for any amount of patients. My med aide (when im the nurse)is very experienced and he knows his stuff, we have been workig together 4 years now. Other than that I am responsible for all the meds on the more critical units.

LPN1974, LPN · Feb 28, 2005

LPN1974, in our facilities we have QMAs who have been there for years. Every year they have "adhered" successfully to the rigorous inspections of the State Surveyors. I cannot speak for any other med aides. By the way, who do you think issued our certification? Why would they do that if they didn't think we can do the job? Those who can't will be weeded out, but this program has been in place for a LONG TIME.

Well, good for you and your co-workers.

I'm glad for you that you feel confident enough to take it on.

But there is more to it that "routine".

I'm still studying and learning something new everyday.

What kind of facility do you work in? I'm just curious.

The one I work in we give meds to approximately 120 MR/DD people.

I'm responsibile for an average of 40 to 60 people depending on staffing any particular day. That's medications, treatments, tube feeders, charting, calling the doctor, sending people out to ER PRN and anything else that comes up.

GLORIAmunchkin72 · Feb 28, 2005

I don't disagree with you at all that the more education the better. I would rather get my pills from a doctor and an experienced one at that! My point is that I have great confidence in the veteran Qs that I work with. They have passed inspection year after year. They also have the respect of our nurses. I just started so I have yet to establish myself.

Not meaning to disrespect YOU in anyway, but I went to LPN school and studied for a whole year.
And they gave you 60 hours of class room and 40 practicum?
That's 2 and 1/2 weeks altogether, right?

M&MRN2005 · Feb 28, 2005

I hate to tell you but the state of Ohio is looking into this. They are in the planning stages and it really looks like it is going to pass sometime in the future from my research. I just spoke to the people on Thursday. Ohio needs to start checking into this. Go to website: http://www.odonaltc.org/pages/bits_pieces.asp

As of December 2004, this shows it is under consideration and it is being backed by the Ohio Directors of Nursing Administration in Long Term Care. Long term care is pushing for it in my state of NC. In July 2004 a pilot program proposal was issued. I called Pete Van Runkle that is mentioned in the article and he passed my call along to some one else. I am sorry but I do not remember her name. She really did not like my questions to her and knew I would not call her again.

Hope this helps. Help me know if you need anything else. Spread the word!!!

:angryfire The first time we hear of a facility doing this in Ohio we are going to picket big time. we want to let family members know the dangers of having med aides.