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

chayslip · Dec 17, 2004

Perhaps I have been a little harsh I apologize if I have offended anyone. I am just used to standing up for myself and my profession and have been attacked one two many times. I think we all know whether it is assisted living or LTC what it comes down to is money. I love the residents and will continue to try the best I can to do the best care for them. The reality is change will never come because the goverment doesnt support it. Furthermore most places in my area would never hire an LPN because sadly they are not willing to pay that much to have someone pass meds. I dont agree with some of these regulations or the way they do things but thats the way the system has been for at least 15 years here in my state. such as life I guess.

FocusRN · Dec 17, 2004

unlicensed people passing out meds? what a bad idea....

i don't really agree with this. i have always said that from what i have seen in the facilities that i have done any work in, that with a pharmacology class the cna's could easily do the work of the lpn's. i hope no one takes any offense. i a, just stating what i have seen. and as for passing meds specifically, i have seen many lpn's that need, notes to tell them how to give meds. something as simple as not crushing a time release or coated pill. so being licensed, doesn't mean you really know what you're doing, being educated and knowledgeable does.

FocusRN · Dec 17, 2004

unlicensed people passing out meds? what a bad idea....

i don't really agree with this. i have always said that from what i have seen in the facilities that i have done any work in, that with a pharmacology class the cna's could easily do the work of the lpn's. i hope no one takes any offense. i a, just stating what i have seen. and as for passing meds specifically, i have seen many lpn's that need, notes to tell them how to give meds. something as simple as not crushing a time release or coated pill. so being licensed, doesn't mean you really know what you're doing, being educated and knowledgeable does.

Marie_LPN, RN, LPN, RN · Dec 18, 2004

Without CNA'S and CMT'S you all would be jobless

Please keep in mind that some of the nurses here have worked as a CNA or CMA before they even became nurses. (I did that for 11 years)

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!

To be respected, one should be respectful, and so forth.

Snide and rude remarks accomplish nothing but alienation. :)

Antikigirl, ASN, RN · Dec 19, 2004

I work in assisted living and when I was hired I assumed there were nurses responsible for med pass...when I found out the job I just took had CNA's and unlicensed caregivers passing meds..you would have needed a fork lift to get my jaw off the floor!

I was scared to be honest..and I told them under NO terms would I ever EVER be held responsible for ANY med errors a caregiver or CNA does..that was facility policy and not mine!!!!!! I actually have that in my contract! Therefore I do not teach the med class (or that negates the contract).

After two years of seeing these people pass meds, I gained a respect for them. Here they are, nervous as I was my first med passes...with a current RN med handbook on their medcarts looking up meds and really looking at things they didn't know! I was curious and would ask about a certain med (say the dig/lasix/KCl triad and s/sx of Dig tox) and they COULD tell me! In fact, they would bring up things I had to look up! LOL! And believe me...I spend more time answering questions on medications and MAR mismatches from Pharmacy in a day than treating patients! If they don't know it..they call us..even if it seems stupid..they call us! WHEW!

I still will not take the med class role, we have an AWESOME nurse that teaches them for 3 weeks before they are even allowed to touch a Rx card! (she is great at it!). And every two weeks we have an inservice about a new med, and current topics to know about!

Heck...my caregivers forsaw Vioxx being d/c'd, and estimate it will be just a few months before Celebrex will (and that was at the time Vioxx went...smart cookies!).

Am I still okay with CNA's or unlicensed caregivers passing meds...honestly no, I still think RN's or Med aides should...but in this world of money money money ruling healthcare...it stands to reason why this has occured. Costs a heck of a lot less to have them do it vs an RN.

Also..if CNA's didn't pass meds in assisted living...oh I know management..then the patients would have to do it on their own...I don't know...most my patients can't remember if they ate lunch...I don't trust them to take meds..best someone does!

(my patients pay 3 thou for a room, extra 500 for med pass by CNA/Caregiver..doesn't that make you ill!?!?!?!?! UHGGGGG and RN doing your meds....well times that by 10! What has happened to healthcare???).

stbernardclub · Dec 19, 2004

I have the pleasure of going into a alf daily. The nurses aides pass the medication. From what I have seen and heard in conversation...ITS A DISASTER!!!!

caroladybelle, BSN, RN · Dec 19, 2004

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

As I rarely have an aide to work with, obviously my job survives without you quite well.

I have no problem with y'all passing meds (well, I do...but I check out the facilities that my friends/family stay in and ensure they will receive meds from a licensed caregiver, not merely a certified one). What I have a problem with is the RN or LPN being held responsible for the CNA/CMT's mistake.

And comparing the loss of your certification (a few weeks of school) for an error that you commited is not quite the same as the loss of our license (3-4 years of schooling) for an act commited by the CNA/CMT. It is not even remotely close.

So I will continue to work in facilities that do not use CMTs and on units that do not extend CNAs into inappropriate realms. I am more than happy to wipe the butts of my own patients, Thank You.

UM Review RN, ASN, RN · Dec 19, 2004

my patients pay 3 thou for a room, extra 500 for med pass by CNA/Caregiver..doesn't that make you ill!?!?!?!?! UHGGGGG and RN doing your meds....well times that by 10! What has happened to healthcare???).

I'm sure that the only ones who know that are the accounting firms. It definitely isn't the nurses who're getting that kind of salary for merely passing meds.

RN assessments make that "bargain" med pass not such a bargain. Patients are giving us clues about their health all the time, and we're educated, trained, and licensed to specifically pick up on those clues and follow through with their care.

Most people don't understand that when a nurse is passing meds, it involves so much more than just giving or not giving a pill.

And comparing the loss of your certification (a few weeks of school) for an error that you commited is not quite the same as the loss of our license (3-4 years of schooling) for an act commited by the CNA/CMT. It is not even remotely close.
So I will continue to work in facilities that do not use CMTs and on units that do not extend CNAs into inappropriate realms. I am more than happy to wipe the butts of my own patients, Thank You.

Well-said. I agree.

GLORIAmunchkin72 · Dec 19, 2004

I am a qualified medication aide and had to take the state test in order to pass meds. I learned a lot in school but I learned a lot more from our nurses who are mostly very kind and patient and by doing the job day by day. Our nurses are not afraid that I am going to steal their job because they know that I can't fill their shoes. QMAs and nurses work in harmony here, putting aside, of course, the little bickering now and then. There will be mistakes, but you can say that about anybody.

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.

UM Review RN, ASN, RN · Dec 19, 2004

Our nurses are not afraid that I am going to steal their job because they know that I can't fill their shoes.

Please understand, this is not about fear for our jobs; it's more about safe patient care.

TPTB invented the med tech position, and some of us have issues with that. It's nothing personal, it's just more like having a taxidriver make a run with an 18-wheeler. It really is better if the driver has the appropriate license.

That's just my opinion though.

Antikigirl, ASN, RN · Dec 19, 2004

"Most people don't understand that when a nurse is passing meds, it involves so much more than just giving or not giving a pill."

AMEN! They really don't...but they sure as heck assume as much when they are unsatisfied with the meds huh?!?!?!? LOL, It is like all the sudden we are fluent in all things pharmacological...LOL!!!!!! Oh brother..I am so glad I have my RN med handbooks, without those with so many newer meds comming out (for some reason I think geriatrics is the test ground for many new meds!)...I would be lost without it!

Marie_LPN, RN, LPN, RN · Dec 19, 2004

Trough, peak, half-life, therapeutic levels, classifications, conversions, etc.

Would anyone happen to know if CMAs are taught ANY of that?