Am I worrying over nothing?

[poetryeclipse]

Hi, I'm not sure where most of you stand on the issue of whether or not Direct Care Professionals such as myself, should be allowed to pass Medications out. I am going thru a 4 week course paid for by my employer so that I can become a Medication Technician. I start my training next week and I am very nervous because I'm not sure I will feel comfortable enough passing Meds out with only a month's worth of training. The reason I choose this career path is because I enjoy the company of the 4 individuals I work for and I would be devasted if anything were to happen to any of them because of something I did or didn't do concerning their health. Just the other day, a co-worker of mine "Accidently" mixed up 2 individuals medicines during morning meds and one individual ended up in the hospital for 5 days in the ICU.He could of died all because the med tech was paying more attention to the television than they were to the medications being passed out. Although, I dont feel comfortable. It is in my job description to pass Meds out thru out the day. What do you all think? Is a 4-week training class too short of a time frame to truely know what you are doing or am I just worrying over nothing? I was under the impression that a Nursing Assitant or an LPN usually passes out Meds in a Nursing home or in a group home setting. Maybe it all depends on where you live but I just wanted to see what your opinions were on the subject. Thanks.

Amber

[EmerNurse, BSN, RN]

From a personal perspective, the idea of 4 weeks training to pass meds, scares the heck out of me.

That said, if that is your role, it's YOUR job to do it professionally and with an eye to perfection. Is perfection possible - no - not even for seasoned nurses - but the striving needs to be there.

I can't imagine 4 weeks being long enough - but there's nothing saying that you, personally, can't go above and beyond, to understand what you're giving, how it's given, and when it might not be a good idea to give it. My advice is that before you give ANY med, if you do'nt know what it is, look it up.

I presume it's the nurses responsibility also to know what you're giving her patients, and to monitor for drug reactions/interactions? If anything even remotely smells fishy with a med, go ask the nurse FIRST.

Just my opinion - good luck!

:wink2:

[lindseylpn]

Wow, four weeks. Where I work Direct Care Staff only have to take an 8 hour class to give meds. And, from my experience I don't think Direct Care Staff should pass meds. It shouldn't be in their scope of practice but, you gotta do what you gotta do. My advice is to go to the bookstore and buy a good Med book that you can carry around with you. Write down all your clients meds and go home and look them up, learn as much as you can about what they are taking and, also take the book to work with you so you can look new meds up at work.

[Markthemalenurse]

Wow, four weeks. Where I work Direct Care Staff only have to take an 8 hour class to give meds.

Yep same here. The DSPs at my current employer only take an eight hour class as well. I keep track of medication errors here and I can tell you that there have been alot; 213 total since I started keeping track two years ago. Some of the DSPs take it seiously and others do not.

[Tweety, BSN, RN]

Amber there are some strong opinions on med techs on these forums.

Most nurses don't approve of med techs.

I think in a group home setting for healthy clients on routine meds, it's probably o.k. But it's an awesome responsibility and you should never let your guard down.

[yankeesrule]

I work for a state facility. The state facilty required direct care staff to be med certified. This is a 8hr 5 day course. You then have 3 med pours with the RN at your site the Rn can say ok go ahead and pass or not. I dont agree with it but I have done it. YOu work under the RN licscense. So essentially you screw up it could effect them as well.

With that being said there are some meds you would (or at least I hope you would never give out ) That only an RN or LPN could do.

Just remember when you pass meds for a small or large facilty

1. REad the Mar remember the rule of TRAMP

Right Time

Right Route

Right Amount

Right Medication

Right Perosn.

2. follow the rule of checking 3 times

Mar to the perscription, the Rx to the bottle and the dr order itself.

3. Alway focus on the task the person meds at that time.

4 NEVER EVER EVER PREPOUR MEDS FOR ANYONE. THAT IS ONLY SETTING YOU UP FOR ERRORS.

5. When administiring the med ALWAYS CHECK THE ID BAND IF THEY HAVE NO ID BAND CHECK WITH A VETERAN STAFF THAT HAS BEEN THERE FOR A LONG TIME. (I made the mistake once the person had no band so I asked the unit secretary she told me the person I was looking for was the one in red she walked over to her and said this is jane doe I gave her the meds. Jane doe speaks up about 3 mins later and said she wanted to go to her room. outside of her door said ms. smith.. unit secretary said oh I get confused with some of the people I have only been here 1 month. Needless to say I was calm we called dr. I had the nrsg supervisor speak with the unit secretary and then i became extremely upset over trusting someone. NOw if they have no band I refuse to give meds to that person. Its just unsafe .

IT sounds like alot, meds is a big deal but reading the orders, understanding them and taking your time focus on the meds, decrese all noise in the area you can. Good luck.

[yankeesrule]

I work for a state facility. The state facilty required direct care staff to be med certified. This is a 8hr 5 day course. You then have 3 med pours with the RN at your site the Rn can say ok go ahead and pass or not. I dont agree with it but I have done it. YOu work under the RN licscense. So essentially you screw up it could effect them as well.

With that being said there are some meds you would (or at least I hope you would never give out ) That only an RN or LPN could do.

Just remember when you pass meds for a small or large facilty

1. REad the Mar remember the rule of TRAMP

Right Time

Right Route

Right Amount

Right Medication

Right Perosn.

2. follow the rule of checking 3 times

Mar to the perscription, the Rx to the bottle and the dr order itself.

3. Alway focus on the task at hand the person meds at that time.

4 NEVER EVER EVER PREPOUR MEDS FOR ANYONE. THAT IS ONLY SETTING YOU UP FOR ERRORS.

5. When administiring the med ALWAYS CHECK THE ID BAND IF THEY HAVE NO ID BAND CHECK WITH A VETERAN STAFF THAT HAS BEEN THERE FOR A LONG TIME. (I made the mistake once the person had no band so I asked the unit secretary she told me the person I was looking for was the one in red she walked over to her and said this is jane doe I gave her the meds. Jane doe speaks up about 3 mins later and said she wanted to go to her room. outside of her door said ms. smith.. unit secretary said oh I get confused with some of the people I have only been here 1 month. Needless to say I was calm we called dr. I had the nrsg supervisor speak with the unit secretary and then i became extremely upset over trusting someone. NOw if they have no band I refuse to give meds to that person. Its just unsafe .

IT sounds like alot, meds is a big deal but reading the orders, understanding them and taking your time focus on the meds, decrese all noise in the area you can. Good luck.

[nurse4theplanet, RN]

I am one of those who are STRONGLY against this practice. It's dangerous, and as you stated in your post...another's med error landed one of your facility's pt's in ICU. Another person mentioned that their facility has seen an increase in med errors.

I believe medication administration is to be reserved for those who possess a license, especially when they are legally responsible for that administration regardless. It doesn't take a rocket scientist to give some medications and other medications can be lethal if certain assessments are not made. Med errors happen to the best of us, but you can eliminate those occurrences with proper training and standards (i.e. licensing).

Okay, I'm done ranting and raving.

Now, to address your issue...because obviously your facility does feel it is safe to train UAP in medication administration. You must be aware of possible complications that these medications could cause. Get you a drug book and look up everything, proper dosage, side effects, what to monitor once they are given...you are not a nurse but you are taking on a responsibility that is normally reserved for a nurse so you need to be aware of possible complications to report. It's in your patient's best interest.

Speak with the nurse. Have her go over the medications with you, what to look for, anything you should be aware of, etc. DO NOT give anything that you don't know what it is for, not even once. Just because the doctor orders it does not mean it is safe for that pt. They make mistakes too.

And just out of curiosity, what types of medication are we talking about here?

[Euphrosyne7, MSN, RN]

Hi:

About 4 years ago, when I had first started nursing school, I worked in a group home and was required to get "certified" to pass meds to the 4 individuals who resided in that particular house.

All direct care staff was given a 4 hr. general med pass class and then we were trained specifically for whatever house we would work in and were required to know specifically about the meds that those individuals were taking. We had to complete written tests with regard to specific medications and then had to be observed for 3 med passes per individual.

The nurse who was responsible for that specific house, also would come and give a talk about any new med or adjustment to an individual's medication if it occurred, and you would be required to look up the med in the medication book and were responsible for being familiar with s/e, etc.

In the particular house that I worked in, we also did counts of each and every med for each and every individual with the next shift coming on as an additional safety check to make sure that all meds were accounted for.

We also were required to follow the rules of med administration and each individual had to come to the "med room" one at a time to receive their meds. Our charting was specific, and if a patient refused a med, we were able to call the nurse who covered that house at any time for direction as to what to do, which most of the time would be that the house manager or the nurse who have to come and give the med since it was not something that should be missed. I worked at a level II home which was more behavioral with some medical. Also each shift, only one of the DCA would be the designated medicator for the shift.

All in all I was there for over 8 months and there was 1 med error which was because a direct care attendant gave a med but didn't chart it which showed up during the count. Most of the meds we were giving were psych meds, anti-seizure, and if someone had an infection, antibiotics.

All the DCA in that particular house took this responsibility very seriously and so it seemed to work out ok.

The other thing is that if you are only working in one home with a smaller number of clients instead of an institution, you do become quite familiar with the individuals as well as their medications. I would just take as long as I need to read the med chart, pour the med, etc., and do not let anything distract you while you are doing it. I think as long as you are well trained, and take this responsibility seriously, you will be fine.

good luck,

carla

[edgwow]

I have strong thoughts on med techs. I do not believe that they should pass any meds. If something happens to the patient because of your lack of monitoring of side effects, lack of knowledge that an incident could be med related. Obviously since you are already going to do it, be vigilant and take the instructions of the yankeesrule post.

[jellis]

If you are nervous, you are on the right track. Your anxiety will help keep you honest and safe.

ALWAYS follow the 5 rights and 3 checks (this is a minimum)!

The mistake mentioned by yankeesrule could have been avoided if she would have asked two other staff members of the patients identity.

Don't waste your money on a book (your employer is responsible for keeping an up to date resource available to you). Books are out of date from the time they hit the shelves. Try the internet for medication research.

[TheCommuter, BSN, RN]

I was working as a so-called "Direct Care Staff Professional" over 6 years ago. In a nutshell, I was a glorified aide who administered medications, gave showers, changed diapers, and prepared meals for 6 profoundly retarded adults in a group home for the whopping pay rate of $8 hourly.

Unlike you, I had no training or medication tech certification before being allowed to pass these meds. Even though nothing happened to any one of the residents, I can now look back and appreciate the horror of the situation and my lack of knowledge.