CNA's passing meds in ALF. What's your opinion?

Specialties Geriatric

Published

I have a big problem. I have been observing CNA techs passing meds in ALF's this year with huge med errors. Like not knowing the doses, side effects, checking with Doctor's for old orders.meds not in the drawers and pts. not get their meds for 10 days.What about a pt getting 17 PO meds at 8am!!!! Not one single nurse in the ALFs.

We as nurses go years to school to learn meds and general nursing tasks.

What is your opinion on this?

Thanks.

Hi, I am new here.

I came across this post about CNA's passing out medications. So, it's CNA's, not CMA's passing out med's?? What a scary thought.

What if a patient is on Digoxin (and other meds similar), does that CNA know what to assess before giving that med, and what to watch for after she has given it?? These are questions I have.. This is putting the patients in danger.

Just my opinion

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WOW! I didn't realize this happened in ALFs. So who becomes responsible in the event of a medication error, since these people are not licensed. If an error occurs that results in injury, who is held ultimately responsible? (Please tell me it's not the nurse).

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Specializes in ICU, PICC Nurse, Nursing Supervisor.

what the h*ll is going on with this. this has got to be a hugh liability.

2000 hours of nursing school and i could have moved to wisconsin and done it in 8.

i work at an assisted living facility in wi im not even a cna and all i had to do was take a medication training course(course was 8 hours) and i pass meds. we have narcotics(although the residents dont ever take them) that we have to count at the end of every night. i havent had a problem with it. we dont pass out that many meds really, but i am very careful with what i do.i learned alot in that class about side effects, dosages, dr. orders and the such. ive had to do telephone doctor orders before to discontinue a med and whatnot. i admit its alot of work, making sure everyone gets there med on time, keeping a close eye out for possible side effects and calling the doctor when there is a problem but i love the work i do and i would do anything to make these residents' lifes' better,which is why i feel comfortable passing meds because i have confidence in what i know and have learned.
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Specializes in Oncology/Haemetology/HIV.
WOW! I didn't realize this happened in ALFs. So who becomes responsible in the event of a medication error, since these people are not licensed. If an error occurs that results in injury, who is held ultimately responsible? (Please tell me it's not the nurse).

As it is the Nurse that has the license, who do you think will get the shaft for not "properly supervising" the aide????

Of course it will be the Nurse.

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Specializes in Utilization Management.
Originally Posted by Nurse2B73

We had a resident pass away because they were only giving her antibiotics during the day. None in her system at night. I had it scheduled to be in her system at the right times and amount a day and they switched it after my shift. I told the DON about it and she did nothing.

Because you seem to be distressed over this and because you are going to nursing school, I'll address it.

While you are trained to read the patient's MAR, the fact remains that what you don't know now will probably really scare you later when you've had the proper training. ;)

The truth is: there is leeway in the timing of dosages of some medications. This is why I doubt that the timing of the antibiotic caused this patient's demise. In fact, I'll bet my shorts that this particular patient had a lot more going on than just a simple infection.

Our hospital med dosage policy has people getting meds at what might be considered odd hours--for instance, our t.i.d. schedule means that we automatically time those meds for 0900, 1300, and 1700--per the doctor's instructions. With some meds, we'll ask the doc to change it to every 8 hours, so there's more even distribution of the medicine in the patient's system, but if that patient doesn't wish to be woken up at midnight to take the first dose, we keep it to daytime hours. No medication is going to do a bit of good if the patient refuses to take it.

So you were correct to report what you perceived as an error to your DON first. But to say that "nothing was done" may be incorrect.

The DON would then have called the patient's doctor and asked him about it. Timing might not have been the big factor that you thought it was, and the doc might not have wanted the dosing schedule changed. In other words, your job ended when you reported, and then the DON took over. She was under no obligation whatsoever to report back to you about her findings or her actions. If it was me, I would have, seeing how upset you were. Even a simple "It's OK, I called the doc, and he's OK with it," would've gone a long way to assuaging your anxiety over this situation.

Actually, you might still express your concerns to the DON about this patient. You've been upset worrying that an improper dosing schedule caused a patient's death, and you really need to get the facts. So go ask her why the patient died and if the antibiotic dosing schedule had anything to do with it.

In conclusion:

No, I don't think unlicensed staff should be allowed to pass out pills. As we've seen, it puts too much responsibility into the hands of staff who've had too little education.

Would I put my license on the line to supervise unlicensed staff? No way, Jose.

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Specializes in Utilization Management.

Oops. Double post.:imbar

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Specializes in Home care, assisted living.

I have seen something happen in the ALF where I work that scares me. As a med-tech, I've seen other med-techs hand a cup of pills to a NON med-tech and tell them to give them to a resident. I've also noticed the med door is being left unlocked (but closed) with residents' pills lined up on an open tray. I mean, yeah, we're short-staffed, but this scares me. Just seems like our facility has gotten too lenient. :uhoh21: :eek:

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Wo was I ever shocked to read some of your posts. I have worked as a CNA and CMT for over 15 years in assisted living as well as nursing homes and hospitals. We have never claimed to be perfect but I can see that some of you think you are. Funny that the RN caused the death of a patient due to overdose, wonder how that happened with your precious for years of school. I am not sure if any of you are in touch with reality or not but when we have 60 or more patients to care for I hardly think even an RN could do a med pass buy the book much less perfectly. I think you all would do good to respect those that are apparently BENEATH you. Remember were it not for us you would have to wipe well you know...of course with your allmighty degrees I am assuming that wouldnt be proper. I am now after reading all this crap thrilled to see the docs treating u all like crap after all he does have more EDUCATION so obviously he is better at doing the job!:angryfire

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Wo was I ever shocked to read some of your posts. I have worked as a CNA and CMT for over 15 years in assisted living as well as nursing homes and hospitals. We have never claimed to be perfect but I can see that some of you think you are. Funny that the RN caused the death of a patient due to overdose, wonder how that happened with your precious for years of school. I am not sure if any of you are in touch with reality or not but when we have 60 or more patients to care for I hardly think even an RN could do a med pass buy the book much less perfectly. I think you all would do good to respect those that are apparently BENEATH you. Remember were it not for us you would have to wipe well you know...of course with your allmighty degrees I am assuming that wouldnt be proper. I am now after reading all this crap thrilled to see the docs treating u all like crap after all he does have more EDUCATION so obviously he is better at doing the job!:angryfire

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Wo was I ever shocked to read some of your posts. I have worked as a CNA and CMT for over 15 years in assisted living as well as nursing homes and hospitals. We have never claimed to be perfect but I can see that some of you think you are. Funny that the RN caused the death of a patient due to overdose, wonder how that happened with your precious for years of school. I am not sure if any of you are in touch with reality or not but when we have 60 or more patients to care for I hardly think even an RN could do a med pass buy the book much less perfectly. I think you all would do good to respect those that are apparently BENEATH you. Remember were it not for us you would have to wipe well you know...of course with your allmighty degrees I am assuming that wouldnt be proper. I am now after reading all this crap thrilled to see the docs treating u all like crap after all he does have more EDUCATION so obviously he is better at doing the job!:angryfire

My goodness, what an attitude.

It's attitudes like this that cause animosity to develope between caregivers of all levels in nursing.

I do not think of anyone being above me or beneath me.

I have not read one post in here, where it seemed that anyone put forth the message that they were perfect. It seems to me that we all are genuinely concerned for our patients well being and welfare.

NEVER once have I refused to wipe an A$$.....I will anyday, but where I work my primary job is passing meds, treatments, emergencies for our residents, and assisting the doctor. It's what I WAS TRAINED FOR. It's what I get PAID to do. If my facility should so choose to start hiring unlicensed personnel to do my job, so be it. THEY can have the responsibility, but my license has MY Name on it, and no one else's.

That doesn't mean I don't respect CNAs and the work they do.

I also respect RNs...if for nothing else for the fact they have more education than I do. If I have a problem or question I can't solve on my own, my RN supervisor is the first one I head for. That's one reason why she's there, as LPNs traditionally work under the supervision of an RN or a doctor, but if I make a mistake it's my butt, my license, not hers.

Your profile says you are a nursing student...is that RN or LPN?

I think when you do get it, and you've been a nurse for 30 years, you might see what some of us have been trying to say.

There's more to taking care of someone than just putting pills in their mouth.

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Wo was I ever shocked to read some of your posts. I have worked as a CNA and CMT for over 15 years in assisted living as well as nursing homes and hospitals. We have never claimed to be perfect but I can see that some of you think you are. Funny that the RN caused the death of a patient due to overdose, wonder how that happened with your precious for years of school. I am not sure if any of you are in touch with reality or not but when we have 60 or more patients to care for I hardly think even an RN could do a med pass buy the book much less perfectly. I think you all would do good to respect those that are apparently BENEATH you. Remember were it not for us you would have to wipe well you know...of course with your allmighty degrees I am assuming that wouldnt be proper. I am now after reading all this crap thrilled to see the docs treating u all like crap after all he does have more EDUCATION so obviously he is better at doing the job!:angryfire

My goodness, what an attitude.

It's attitudes like this that cause animosity to develope between caregivers of all levels in nursing.

I do not think of anyone being above me or beneath me.

I have not read one post in here, where it seemed that anyone put forth the message that they were perfect. It seems to me that we all are genuinely concerned for our patients well being and welfare.

NEVER once have I refused to wipe an A$$.....I will anyday, but where I work my primary job is passing meds, treatments, emergencies for our residents, and assisting the doctor. It's what I WAS TRAINED FOR. It's what I get PAID to do. If my facility should so choose to start hiring unlicensed personnel to do my job, so be it. THEY can have the responsibility, but my license has MY Name on it, and no one else's.

That doesn't mean I don't respect CNAs and the work they do.

I also respect RNs...if for nothing else for the fact they have more education than I do. If I have a problem or question I can't solve on my own, my RN supervisor is the first one I head for. That's one reason why she's there, as LPNs traditionally work under the supervision of an RN or a doctor, but if I make a mistake it's my butt, my license, not hers.

Your profile says you are a nursing student...is that RN or LPN?

I think when you do get it, and you've been a nurse for 30 years, you might see what some of us have been trying to say.

There's more to taking care of someone than just putting pills in their mouth.

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Yes I would agree that there is more to taking care of my people than putting pills in there mouth. Perhaps you were not aware that CNA's and CMT's can lose there certifications as well. My point was that we can do the job as well if not better that those with almight degrees. I am getting ready to go for my LPN but if I am going to have these opinions expressed here I will rethink that decision. I have worked a long time in nursing and have observed mistakes by all staff. I worked with an RN once who dumped a whole tube feeding in at once and the resident asperated and died. So I am curious whether her education mattered to her when she made that mistake and now is without her job and will never work again in any state. I know for a fact that if I make a major error on the job my boss isnt on the line I am....I lose my certification and could never work again in nursing. We are as acountable as you whether u believe it or not. My attitude comes from the fact that we are looked at as incapable at doing our job and I am here to tell you that those of us who truly care for our residents do it far better than most...

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