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.

I wonder if this...having CMTs....is some kind of trend to phase out LPNs?

I've heard talk years ago that LPNs would be phased out, but obviously, it hasn't happened yet.

I, myself, work in DD, and the facility I work in, state operated, actually used to allow the aides to pass out the medication. An LPN would prepare, place the med into envelopes with the people's names on it, then the aides actually passed them out. But they stopped that, and hired more LPNs to do the job. That was many years ago.

Today, as some of DD people are discharged into homelike settings, they are supposed to be able to set up their own medications. But these people, or most of them, can't read, so when changes come about, {dr changes the dosage} SOMEone has to instruct that person on his new medication order.

I'm sure that there is alot more than just "assisting" being done.

I have helped train some of these people in setting up their meds before they are discharged, and I KNOW for a fact they not all can do it. Very few would I consider competent. But EVEN if they are competent at it, and the dosage changes, then they have to be retrained.

Specializes in Med-Surg, Geriatric, Behavioral Health.

Oh My God...this is so dangerous. Call your Board of Pharmacy. Call your Board of Nursing. Contact your state senator/rep. Oh My God...Leave if you don't have the power to change something in there internally...in fact, don't let the flames from your heals slow you down as you exit the door. Regardless man, report this stuff. This is worse than the scariest nightmare.

Specializes in Education, Acute, Med/Surg, Tele, etc.

My board of nursing supports this for some reason in assisted living facilities, group homes, or in home CNA services. I guess they see it as at least they are getting meds on time, vs a patient unable to administer their own medications correctly or even get to a pharmacy doing it.

I guess it falls into that grey area again...assisted living is not considered any type of skilled nursing facility, and the only rules are that they must at least have an RN delegate this task and follow the protocol for deligation and be at least on call for probelms. Those that employ nurses on floor is a bonus, an many don't even have them 24/7 like mine does.

I guess it is the mindset of better someone do it following a set of rules, vs the patient who will most likely misjudge or forget like they would in their own home (I hear that all the time when I ask questions about it...'well, then what would they do if they were at their own home???'). If my facilty lost the ability to have CNA's pass meds...they would shut down leaving all of us out of a job, and them without a place to live, then back to square one all over again with them passing their own meds and not getting doctor appointments, or even nursing services etc.....catch 22 big time!

My facility has been open for 5 years, had CNA/caregivers passing meds for that long, and we have yet to have a medication error that lead to any sort of emergency or harm...KNOCK ON WOOD! A missing colace from time to time, but our CNA's get bi monthly inservices on the effects, side effects, and general pharamacology of meds in the facility, and a med pass test...this is NOT done at other facilites and is done only because us nurses threatened to walk off!

I have talked to my board, my facility, my docs, my patients, their families, other nursing groups...and so far this is allowed commonly in assisted living facilities and not due to change anytime soon, but actually grow in not just popularity...but for the financial benifits (as management would see it).

So watch out..these things are popping up everywhere now, for some reason people like the idea better than sending mom or dad "to the home". Assisted livings are more..ohhhhh posh?? Uhggggggg!!!!! Yeah, nice candy coating over something that isn't all that sweet!~

My mindset was...better I be in there assuring the safety of my patients to the best of my abilities and what my SBN or facility will allow then to quit, and just complain to the deaf ears of management or administration that assures me it is okay ad nauseum.

(one bonus for our facility is that my CNA's only deal with one service area (thats about 12 patients), and have been dealing with them and their meds daily for quite some time. They know when there is a change in meds, and us nurses talk to them per service area any time there is a change. I am also dilligent about writing down things on the mar to watch out for, and when to call the LN...oh boy is that lots of writing. We also get those printed out description papers from pharmacy which they must read and sign whenever a med is changed, and believe me..they read them because they are very FEARFUL of making mistakes! Having a nurse on 24/7 helps them too because if they have ANY question..they call us and they DO! Each med cart has an update med handbook for questions, which I use contantly! Us nurses also will be known for passing a CNA and asking them..."what is the side effects to watch for for [insert med here], and what is this med supose to do???"...that has been very helpful!!! (and great reminder for nurses to whom aren't passing meds and may loose the info due to not using that skill) ). We do what we can..but the thing is...we are very rare, most facilities don't even bother, but us nurses insisted on these rules so much that the facility finally accepted the rules we drafted!

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

I think it all just comes down to this for me: I'm not willing to stick my neck out on the block and rely on other people to pass the meds, knowing if THEY screw up, that it's MY license.

I live in NC, and the ALFs here don't even employ nurses! There is no such thing as a DON of an ALF! There are administrators, and shift supervisors. That's it. The highest rank of any employee is CNA, and you don't even have to be that to give medication. When I finished nursing school I thought I would like working in an ALF, everyone told me "We don't hire nurses". That sux. I don't understand. Those people are on just as many meds as those in LTC. :angryfire

I'm a CNA and just quit an ALF who demanded that I give Morphine injections. At this facility we all were required to pass meds some as young as 17. When I asked the RN about my apprehension in doing this I was treated as if I attacked the ethics of the facility administrator. Ï've done things this way for 7 yrs and state never said a word...'she said. As CNa's we are not trained to pass meds and sitting and watching a video for half an hour is not training. The state tells us we are not to pass meds but there is no backing for us if we object.

:nono:I'm a CNA and just quit an ALF who demanded that I give Morphine injections. At this facility we all were required to pass meds some as young as 17. When I asked the RN about my apprehension in doing this I was treated as if I attacked the ethics of the facility administrator. Ï've done things this way for 7 yrs and state never said a word...'she said. As CNa's we are not trained to pass meds and sitting and watching a video for half an hour is not training. The state tells us we are not to pass meds but there is no backing for us if we object.:madface:

Specializes in Psychiatric, Detox/Rehab, Geriatrics.

When I was a CNA I worked in a personal care/dementia unit and I passed medications as a CNA and did some basic treatments as well. There were only 2 CNA's on 3-11, I passed the meds to 30 or so residents and the other CNA helped them with their care that they needed help with. I never had any problems with any medications side effects and I did that for about a year and a half while I was in RN school, which really helped me alot for when I became an RN as I was familiar with passing meds to alot of people and doing basic treatments. That experience for me was a good one and I actually miss working in a personal care/dementia unit.. I wonder if they would hire an RN, probably would but would only pay them LPN wages.

SCARY and dangerous, but they can get away with it because of the way they are liscensed, just another way for unscrupulous healthcare corporations to swindle money from unsuspecting families. This LTC industry is very, rich, powerful and DIRTY, I speak from personal experience.

Specializes in Geriatrics.

Why pay an LPN $15/hr when you can pay a CNA $9/hr. It's all about saving money. As an LPN I find my self feeling more like a highly trained CNA. One place I went to wanted me to do patient care (getting them ready for bed), treatments and pass meds. And still expected me to stay within the time limits alotted. I was so proud & happy when I got my licence, now I wonder if I made a mistake.:o

I live and work in IA in a LTC facility. Here we are required to take a course on passing meds. I have completed my CNA training and I have also taken the CMA (Certified Medication Aide) course. The law requires that you have both certificates to legally administer medications to patients. I do not agree with anyone passing medications that has not received proper training in this area. Even as a CMA there is alot I do not know about the meds and I am constantly looking up information or talking to my nurses on duty. That is really scary thinking that this is going on. :chair:

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