Nurses oppose measure meant to ease their burden - page 5

SPRINGFIELD -- The ever-increasing demands of routine patient care are swamping some nursing homes in the state, and the Illinois General Assembly is weighing a measure designed to help them. But... Read More

  1. by   MissPiggy
    [QUOTE=QMA_David]Having worked as a Medication Tech and CNA for the past 13 years I can't believe this is still an issue. Actually yes I can, its almost always from new grad Nurses or "Ole Schoolers"
    I spent 2 years in Nursing homes and 8 years in Pediatric Burn and post op floors. I am now the QMA for a 40 bed icf unit in ltc.
    In hospitals I started about 7 IV's in a 12 hour shift, drew more labs then I care to remember, called codes, saved a few lifes by starting CPR and using an automated External Defibb.
    Your only good as your training and better with experience. I have a folder full of awards, cards, and letter of thanks for many many patients. Simply I love my work.
    However I can't believe in the year 2005 when the true Nursing shortage is just beginning that people are still saying " I don't trust a Medication Tech"
    People like this need to wake up, its only going to get worse and giving respect and good training to your aides will only enhance your shift, career and outcome of your patients. Hell I know a guy who wouldn't let a ER LPN start his piv. He didn't think she was a "real nurse" and demanded an RN. So really you see its all about perception. I know some horrible Med Techs, horrible CNA's and some horrible Nurses, even some pretty shabby Docs. People get to wrapped up in titles and forget what we are here for. To work as a team to achieve the highest level of care possible for that patient. I've had Rn's verbally fight to have me and several other great techs paired with them on their assignments.
    Thanks for allowing me to express my experience and opinion.....David



    David - it isn't you personally that we object to (it sounds like you are one we'd be lucky to get) - it is the fact that we nurses are assigned whoever the person who does the assignments wants to send us and we are responsible for that person's actions whether or not they are competent; if they are NOT competent, aw well it is just OUR license on the line... Is that really fair? As usual, we have no say in the matter and are expected to take what we get. The fact that the nurses you worked with fought over you should tell you something. ;-)
  2. by   wjf00
    Quote from QMA_David
    Having worked as a Medication Tech and CNA for the past 13 years I can't believe this is still an issue. Actually yes I can, its almost always from new grad Nurses or "Ole Schoolers"
    I spent 2 years in Nursing homes and 8 years in Pediatric Burn and post op floors. I am now the QMA for a 40 bed icf unit in ltc.
    In hospitals I started about 7 IV's in a 12 hour shift, drew more labs then I care to remember, called codes, saved a few lifes by starting CPR and using an automated External Defibb.
    Your only good as your training and better with experience. I have a folder full of awards, cards, and letter of thanks for many many patients. Simply I love my work.
    However I can't believe in the year 2005 when the true Nursing shortage is just beginning that people are still saying " I don't trust a Medication Tech"
    People like this need to wake up, its only going to get worse and giving respect and good training to your aides will only enhance your shift, career and outcome of your patients. Hell I know a guy who wouldn't let a ER LPN start his piv. He didn't think she was a "real nurse" and demanded an RN. So really you see its all about perception. I know some horrible Med Techs, horrible CNA's and some horrible Nurses, even some pretty shabby Docs. People get to wrapped up in titles and forget what we are here for. To work as a team to achieve the highest level of care possible for that patient. I've had Rn's verbally fight to have me and several other great techs paired with them on their assignments.
    Thanks for allowing me to express my experience and opinion.....David
    I'm sure you do great work. But the Nurse practice Acts make the RN co-signing your work resposible for what you do. That signature won't be mine EVER. Team nursing is great for some, but I am very happy to work in a primary care setting. I will not risk my license on any work not done directly by myself or personally supervised such that I am 100% aware of what I am signing for.
  3. by   Spidey's mom
    Quote from wjf00
    I'm sure you do great work. But the Nurse practice Acts make the RN co-signing your work resposible for what you do. That signature won't be mine EVER. Team nursing is great for some, but I am very happy to work in a primary care setting. I will not risk my license on any work not done directly by myself or personally supervised such that I am 100% aware of what I am signing for.

    Hey, we agree on something!

    Good post.

    steph
  4. by   sbic56
    Just one question...have any of those of you who are so fearful of problems resulting from working with med aides ever actually worked with them? I wonder if it's more fear of the unknown or if you truly have valid concerns based upon bad experiences? I ask because while I have had my doubts in the past, I have been very pleased with the work ethic and abilities of most of these med aides. If there is a problem, then the person is dealt with accordingly, as with any employee. My license it intact and with no blemishes whatsoever. Working with many med aides over the years has by and large been a great experience.
  5. by   Spidey's mom
    Quote from sbic56
    Just one question...have any of those of you who are so fearful of problems resulting from working with med aides ever actually worked with them? I wonder if it's more fear of the unknown or if you truly have valid concerns based upon bad experiences? I ask because while I have had my doubts in the past, I have been very pleased with the work ethic and abilities of most of these med aides. If there is a problem, then the person is dealt with accordingly, as with any employee. My license it intact and with no blemishes whatsoever. Working with many med aides over the years has by and large been a great experience.
    No I haven't - I'm sure there are great aides . . but in end it is my licence. Just like if the CNA or LVN does something wrong - the buck stops with me.

    steph
  6. by   sbic56
    Quote from stevielynn
    No I haven't - I'm sure there are great aides . . but in end it is my licence. Just like if the CNA or LVN does something wrong - the buck stops with me.

    steph

    I still say your fears are unfounded. Has a CNA or LPN ever put your license in jeopardy? Would you rather we didn't have them because they put you at too much risk? I'm willing to bet that statistically the chance of nurse litigation due to CNA/LPN error is very low. Also, willing to bet the chance of error occuring because the nurse just had too much on her plate is considerably higher. I think we need to be realistic. Healthcare is changing and nurses are going to be responsible for more and more. Duties that can be done without actually possessing critical thinking skills need to be delegated. I see more med errors being made by frenzied nurses trying to take on too much than by well trained, competent med aides who are responsible for completing specific tasks.
  7. by   wjf00
    Quote from sbic56
    I still say your fears are unfounded. Has a CNA or LPN ever put your license in jeopardy?
    To answer your question: no. But I also have never seen an NG tube wind up in an airway, does that mean I don't need to check the placement? The issue is not the quality of work being done by unlicensed personel, the issue is me signing for work I have not performed. If I were to simply sign off for the work of others, it would be the same thing as me gavaging an infant without checking tube placement.
  8. by   Spidey's mom
    Quote from sbic56
    I still say your fears are unfounded. Has a CNA or LPN ever put your license in jeopardy? Would you rather we didn't have them because they put you at too much risk? I'm willing to bet that statistically the chance of nurse litigation due to CNA/LPN error is very low. Also, willing to bet the chance of error occuring because the nurse just had too much on her plate is considerably higher. I think we need to be realistic. Healthcare is changing and nurses are going to be responsible for more and more. Duties that can be done without actually possessing critical thinking skills need to be delegated. I see more med errors being made by frenzied nurses trying to take on too much than by well trained, competent med aides who are responsible for completing specific tasks.
    Well, I have had an LVN make a med error. Not that RN's don't. But we are responsible for ourselves AND the LVN and CNA. Especially when I'm working with 10 patients and I have to assess all ten patients but the LVN does the meds and patient care on 5 patients, except for IV meds. It is a little daunting at times - it is hard to keep track of everything that is happening with all 10 patients. Which is my responsibility. Last week a physician order was missed by the LVN and wasn't found until the end of a very busy day for the RN . . and we had a very disappointed physician on our hands and a patient with compromised care.

    I think passing meds does require critical thinking skills. It also requires knowledge of pathophysiology and pharmacology. Not exactly a piece of cake.

    And wjf00 is right - the crux of the issue is signing off on something I actually have not for the most part witnessed and that I have not performed. Hey, if you could change the laws to make the buck stop with someone other than the RN, maybe we could talk.

    steph
  9. by   sbic56
    Quote from wjf00
    To answer your question: no. But I also have never seen an NG tube wind up in an airway, does that mean I don't need to check the placement? The issue is not the quality of work being done by unlicensed personel, the issue is me signing for work I have not performed. If I were to simply sign off for the work of others, it would be the same thing as me gavaging an infant without checking tube placement.
    If you fail to check NG tube placement that would be neglect of duty, incompetent practice and placing the patient in danger of aspiration. All poor practice that no one would argue against. How does that compare to a qualified and competent med aide performing their job?
  10. by   sbic56
    Quote from stevielynn
    Well, I have had an LVN make a med error. Not that RN's don't. But we are responsible for ourselves AND the LVN and CNA. Especially when I'm working with 10 patients and I have to assess all ten patients but the LVN does the meds and patient care on 5 patients, except for IV meds. It is a little daunting at times - it is hard to keep track of everything that is happening with all 10 patients. Which is my responsibility. Last week a physician order was missed by the LVN and wasn't found until the end of a very busy day for the RN . . and we had a very disappointed physician on our hands and a patient with compromised care.

    I think passing meds does require critical thinking skills. It also requires knowledge of pathophysiology and pharmacology. Not exactly a piece of cake.

    And wjf00 is right - the crux of the issue is signing off on something I actually have not for the most part witnessed and that I have not performed. Hey, if you could change the laws to make the buck stop with someone other than the RN, maybe we could talk.

    steph
    steph
    I don't see where you cite much evidence of liability. Patients are not being injured. RN's are not losing their licenses. The practice of utilizing unlicensed personell has been going on for years and it works! If med techs were harming patients, no facility would take on the liabilty of using them.

    Certainly you are going to know what meds your patients are taking and assess for effacacy and side effects. The tech is only passing the medications you are aware the patient is getting. I would think you'd be concerned that the CNA's aren't doing V/S' s correctly and worrying about that. There is room for error there. I think we agree we can better serve the patient by delegating duties as appropriate, it's just which duties our comfort levels allow us to give up.

    I know this idea is not popular, but I still contend it is mostly because most nurses have never practiced with med aides and have an unwarranted preconceived notion that it will mean the end of their careers if they do.

    One last thought; if nurses insist on doing it all, and the projected shortage of nurses reaches 750,000 as predicted, what are we going to do?
  11. by   CHATSDALE
    I have never worked with an med aide..how does it work...are the meds poured up per nurse and handed out per aides...a horrible thought in my estimation
    do they count for narcotics...can they give a narcotic...
    are b/p and pulses ect done per med aide??
    did he say he started iv's??what about pushes
  12. by   Marie_LPN, RN
    the crux of the issue is signing off on something I actually have not for the most part witnessed and that I have not performed.
    I wouldn't be comfortable doing that either.
  13. by   sbic56
    Quote from CHATSDALE
    I have never worked with an med aide..how does it work...are the meds poured up per nurse and handed out per aides...a horrible thought in my estimation
    do they count for narcotics...can they give a narcotic...
    are b/p and pulses ect done per med aide??
    did he say he started iv's??what about pushes
    Here's how it works in my experience. Med aides put up and pass the meds. They counts narcs and pass them. There is accountability for this just as there is with nurses. Nurses are not the ones responsible if narcs end up "missing", in case you wonder. They can take V/S.

    I don't know what training QMA David had...looks like he starts IV's, but I doubt he would do IV pushes. Realistically, I've met many nurses, myself included, who got their IV experience on their own! It usually doesn't happen in nursing school. Not good, but true.

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