Assisted Living Med. Administration

[annlet]

HELP!!!!

Here in our state (NV) "Caregivers" (not CNA's) are allowed to administer medications (yes even narcotics) to residents. They must pass a 8 hour medication class as their only requirement. Our facility then gives them additional training. We make it as "simple" as we can but they are continuely making BIG mistakes!!! (i.e meds to the wrong person!) Our current system has caregivers assigned to one or two halls giving meds and ADL assistance. I'm sure one answer would be to have certain caregivers become med techs just not sure how to schedule this most cost effectively! HelP!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

[mandykal, ADN, RN]

Apparently, our a local Assisted living, the CNAs there are passing meds too. They too are working around the system(company). Meds are prepoured by a license nurse...ie Monday-Friday, and/or a color coding system. CNAs pour it for the residents but does not "administor it directly." That's how it works. So, the care plans would say "Aide to cue resident on meds...ie 9am, 1pm, 5pm, 9pm.

But even if its against the role of a CNA as we were taught in school, they still do it. Its part of their job, and if they want a job, that's exactly what has to be done. They all agree, and so do we all that its inappropriate. How the hell are they going to know what are the effects if there is any?

I'll tell you what, I have to call the state board of nursing today for my personal matters, but I will mention and question how a law can be in-place for "CNAs," who work for any facility or under any roof that has more then 2 residents to not have them play any role in "Cueing, assisting, prepouring meds, watching, and/or playing any role in any tasks that deals with prescription medication. I will follow through and post my results. This is frustrating.

I just got off the phone. And Yes, it's within the law(Connecticut). CNA's can cue residents and give them meds but as long as it is already prepoured by a nurse. and prns have instructions, a nurse to be notified if a prn is to be given. They are not to take any meds out of a bottle or prepour it by themselves. If a certain med like lasix is to be given, the CNA's are to be alerted by care plan or task assignment as to the reactions of the med. Which is why the state gets on the company's butt on documentation. I still disapprove because even narcs are prepoured.

[annlet]

I totally agree with you!! No argument here, I can't believe the Nursing Board went for it.

Annlet

[Marie_LPN, RN, LPN, RN]

If i'm going to pour it, i'm going to administer it. Period.

[Lil_Skipper04]

Sorry, entirely disagree with unlicensed care givers providing medications.

By unlicensed, do you mean not RN's or LPN's? Or someone with no certifications? Because I'm a Level 1 Med Aide in an Assisted living facility, and we don't really have any problems. I think the biggest problem we've had recently was a PRN girl mixed up 2 resident's meds. That and 3 nurses popped pills when they didn't check against the MAR, and kept giving double doses of a few meds on one resident (she's okay now).

But generally when I do a med shift, we administer all medications, even narcs. Our pills come through the pharmacy in cassettes that are labeled by color & day, so it's quite simple. Even our ditzy nurse can do it, :chuckle . However we had to pass the whole course and test thing.

But, med mistakes make me feel uneasy. It tends to also make me a little upset, because you can't afford to make mistakes when doing meds. People need to pay more attention to what they're doing.

[Antikigirl, ASN, RN]

Well...I have never been up for the idea of the passing of meds by CNA's or unlicensed care givers. But my DON did tell me something that did hold some truth to it...

She reminded me that given that still...so many of the people that can use assisted living to really help their lives, many can't afford it. Now those people are either doing their own meds whether they can do it or not (in most cases proably not correctly), family doing it (which maybe you will get lucky and you have a medic in the family...but chances are not), or have a caregiver that does them for you. So in essence the situation of at least a CNA or caregiver that has gone through training and overseen by a nurse 24/7 (we are lucky and have a nurse on staff 24/7..most facilities don't!), is a step up from a normal situation! Okay...I can see that!

But then again...my residents are charged over 300 dollars per month for med passes, average rent over 4000, and I won't go into charges for meals, laundry, or nursing treatments and glucose monitoring/insulin (well okay add another 350 for insulin!). That is a ton of money! Why not hire a a few med aides or nurses at that rate!!!! SHEESH!

Just shows me that I can't afford to get old..LOL! And I won't be able to even afford a CNA or unlicensed caregivers to do my med pass when I am unable to .... Reminds me of the old addage...be kind to your children...someday they will pick where you live! LOL!!!!