CNA's giving meds....WHAT???

[Becca123183]

Hi Guys,

I live in Louisiana and i'm in my 3rd quarter of an ADN program. I am hearing rumors that the state is trying to get something approved that would allow CNA's to give meds. From what i hear other states already do this. Is this true? and How do you feel about CNA's giving meds?

I personally am totally against this. CNA's do not have the education to be able to properly administer meds to patients. CNA's in my area get paid about 6 or 7 dollars an hour and have to take a class for a few weeks to a few months at most in order to get certified. How could anyone possibly put something as important and potentially life threatening in the hands of someone that has a few weeks to few months training?

[JettaDP]

CNA's in my state are definitely not allowed to give meds. And I agree that they shouldn't be allowed to. While most CNA's that I have run across are extremely competant, I too don't believe they have the proper education to administer medications. Wouldn't allowing CNA's to administer meds mean that they would have to be covered by malpractice insurance? I'm shocked to hear that some states are allowing this. They must have a good reason and I'm sure they require more education. I would definitely be interested to know more about this subject.

[RNMom2010]

Where i used to work as a CNA/HHA we took a very short certification course to allow us to pass meds. We did not have to know anything about the drug we were giving, we just passed it out. As far as safe? Heck no!! There were always narcs missing and med errors being left unreported. Needless to say I am very glad I got myself out of that situation as it is a disaster waiting to happen. Even worse, it was an alzheimers facility so the pts didnt even know what they were getting or not getting. Oh did I mention we had the power to administer non parenteral PRN's on our own? Yeah BAD idea!!

[casi, ASN, RN]

Minnesota has something called a Trained Medication Aide. CNA's take a month long course and test and are then certified by the state to pass medications in long term care. Most long term care facilities around here seem to use them.

When I worked in assisted living under the title Home Health Aide and later Resident Care Assistant I was trained to pass meds by the facility. There was always an LPN on duty who spent more of their time setting up meds and giving insulin. Thankfully I worked noc shift where I rarely gave anything more than an occassional tylenol. I wasn't very comfortable passing meds now. The scary thing now is that this facility is hiring non-CNAs and training them to do the job.

[Daytonite, BSN, RN]

sigh! this had been an ongoing discussion on the general nursing forum for some time. yes, it's true. some states already have this is place--medication aides.

please don't think that the states that do this just turn the medicine cart over to any cna and say, "here. give the meds." it's not the way it works. the aides who do this have to take a training course and get certified. they usually are only passing specific types of medications as well and often only in nursing homes. this came about because of the nursing shortage.

i would like to point out before everyone gets all up in arms about this that the doctors got all ticked off when they gave rns the authority to start and give ivs. it was so long ago that no one remembers that. back in the 1980s when i was living in ohio, the state gave lpns there the legal right to give oral medications. i remember the lpns i worked with were ready to walk off the job because the hospital i worked in was requiring them to take the 30-hour course to become certified so they could start passing medications. no one remembers that anymore and it is assumed that all lpns give medications and is part of their job--it wasn't always, folks. in fact, many lpns are eager to start ivs and can do this in some states if they take a special course and get certified to do it. i worked on an iv team that had several lpns who were really good at starting ivs. and now, they want to give some medication administration responsibility to aides. they will train them first. i know there are a few students reading this who are already medication aides so chime in and defend yourselves, please. i'm with you on this.

oh, and when the ana went with nurse practitioners the docs didn't like it one bit. but the law prevailed. so, what did the docs do? they came up with the physician's assistants programs. should those of you who want to be nps not proceed with your plans because the docs think its wrong?

how could anyone possibly put something as important and potentially life threatening in the hands of someone that has a few weeks to few months training? how many weeks of training do you get before you give your first medication to a patient in the clinical area? as i recall i was taught medication administration in the first half of my first semester of nursing school in the nursing lab. i was giving oral medications 8 weeks into my first semester of clinicals. i gave my first im injection just before christmas vacation (i'll never forget that!). how about the rest of you?

http://www.nursing.ohio.gov/medicationaides.htm - the ohio medication aide program

[tlvbabysoft]

At our LTC facility we had a pilot med tech program in which a CNA could take classes to be certified to give meds. Surprisingly enough when surveys were done from both AZ officials and a few other states they found that the med techs had a much lower error rate. From their reports they chalked the lower med errors to the lack of other responsibilities (no doctor interaction, reports, etc...). However, they also concluded that due to the lack of experience with the meds that the majority of the med techs would completely miss a dosing error or interaction error that an experienced nurse would easily catch. As a result of that, the state has since dropped this program and our "med techs" have become just CNA's again. Sad for them but great for our patients who might have been a casualty for the sake of saving money on a qualified professional.

[JettaDP]

Daytonite, thanks for the brief history you gave us. And you make a lot of sense. I never knew that nurses were not allowed to start IVs years ago. I guess every position evolves over time. And obviously nurses starting IVs was not a bad idea because they continue to do so today. You definitely added a good perspective.

[amyb2684]

I live in Texas and I never relized that the position Med Aide wasnt everywhere. The only place I know that Med Aide's work is nursing homes though. They dont pass anything but daily po meds. It is not at all like a hospital setting. They are only giving them their prescriptions, not going off of an MAR and going to the med room and picking from a bajilion meds. They find the bottle with that pts name on it and follow directions. It is the same as if you were to go to you grandmas house every morning and make sure she gets her daily pills down. Also, I have to add that if they were medication that was dangerous they would probably be in the hospital, instead of at the home. Most meds being passed are antihypertensives, diuretics, alzheimers meds, etc. Also, LVNs oversee the medication aide. Honestly, in that kind of setting, I dont see the issue.

[JStyles1]

FIGHT AGAINST THIS AT ALL COSTS

Not only is it not safe but it is an excuse to devalue the jobs of a nurse. We go to school for this and this is part of our education, pharmacology. Having cna's do this is is a way to get a job done for cheaper pay.

Keep an eye out for legislation in your area where this comes up and write to your local legislators telling them it is unprofessional, dangerous, and a danger to the nursing profession.

[missjennmb]

unfortunately, I see a direct link between jobs that don't pay well and people that don't care about their jobs. For that alone, I would be against this... Just how much is riding on the med tech making the right choice? How much penalty is there if they ignore a med error?

If you go to a store or restaurant where the person taking care of you makes minimum wage and can go anywhere and get a replacement, you don't generally get near the service and care that you would if you went somewhere that valued their employees and the tips were the best in town. I think that goes across the board. I think its sad that CNAs get paid so little, considering how much care they give to our loved ones and how much help they are in the over all care model. But I don't think giving them MORE duties and leaving them at such a low pay/low responsibility level is going to make things any better. Plus it means one more thing out of the nurse's hands yet under the nurse's license... no thanks :)

[Daytonite, BSN, RN]

Think about this as well. . .where there is bad supervision and management there is also likely to be bad performance.

[chevyv, BSN, RN]

Here is WI we have medication aides in LTC facilities. They take a special course and cannot give narcs. They get paid a bit more on the days when they are med aids. I wonder what the LPNs have graduated to that med aides are being utilized.....