CNA's passing meds in Long Term Care

[DanChicagoRN]

For many years the long term care industry has been trying to allow CNA's to pass medications in long term care facilities. Often these have been led through legislative efforts.

Now, they've created a website to back up their efforts.

http://www.medaidesillinois.org

I find it hilarious that they highlight Florence Nightengale, and use the idea of her being for delegation in an attempt to bolster the argument.

If we continue to outsource nursing care to non nurses-whether it be unlicensed assistive personnel, nursing assistants, etc, where is nursing knowlege and judgement needed. Where is our value as the RN?

The argument becomes that passing out medications is a task only, not a process that requires skill, knowledge, judgment and clinical decision making.

Oh yea and on a side note, the page "benefits- nurse", I really love the gender stereotyped language.

"In other words, performing all the roles for which she went to nursing school to begin with, such as assessing, collaborating, managing, supervising, role modeling, documenting, educating, and functioning as an agent of change. Let's look at a day in the life of a staff nurse freed from the task of passing routine oral medications:

Thoughts?

[Joybelle517]

For many years the long term care industry has been trying to allow CNA's to pass medications in long term care facilities. Often these have been led through legislative efforts.

Now, they've created a website to back up their efforts.

http://www.medaidesillinois.org

I find it hilarious that they highlight Florence Nightengale, and use the idea of her being for delegation in an attempt to bolster the argument.

If we continue to outsource nursing care to non nurses-whether it be unlicensed assistive personnel, nursing assistants, etc, where is nursing knowlege and judgement needed. Where is our value as the RN?

The argument becomes that passing out medications is a task only, not a process that requires skill, knowledge, judgment and clinical decision making.

Oh yea and on a side note, the page "benefits- nurse", I really love the gender stereotyped language.

"In other words, performing all the roles for which she went to nursing school to begin with, such as assessing, collaborating, managing, supervising, role modeling, documenting, educating, and functioning as an agent of change. Let's look at a day in the life of a staff nurse freed from the task of passing routine oral medications:

Thoughts?

After working in a CBRF in an attempt to clean it up after several violations (this in Wisconsin), and coming across a med error where a PCW (personal care worker, NOT even a CNA) gave a resident 20cc of Morphine instead of Carafate....well, I'm totally against non-licenced personnel doing med passes, yet this is totally legal in WI.

In addition, the long term facility I worked at (before recently moving back to IL) allowed first semester nursing students to work as nurses, passing meds, doing assessments, and wound care. What the he** did I go to nursing school for???

BTW, as a RN, there is NO WAY I would allow a facility to permit a nursing student to work unsupervised under my license!

[SASSI 0608]

as a cna that is my biggest fear about starting the courses to become a nurse. im soooooooo afraid of being in charge of medications......... i dont want to screw up on a pt's meds and something go totally wrong. is this a fear u eventually get over or does it stay in the back of ur mind at all times? just curious

ive worked in the same nursing home since i was just out of classes. i have stood and watched as the nurses gave the meds, put them together, and yet helped encourge those res. to take their meds i feel as long as u are properly trained and have the ability to do it it should be allowed.

[gericare2009]

i personally think that cna's do not know enough about the medications to pass them. in nursing school we take pharmacology and other courses to prepare us for the knowledge needed to pass a med. the ramifications are huge for errors. you can't just say "here is your digoxin" and not know what you are looking for prior or after. i worked as a cna for many years and i often had nurses asking me to give medications. i refused because i knew i did not know what i should as a cna to give medications.

[TBANKS71]

I am a CNA student and there is no way that I would want to give a resident or patient any meds! That job is for the nurses and the doctors, not for me, thanks!

I don't think that CNA's should be passing out meds, we have enough work to do as it is and an over-worked, tired, or stressed out CNA is more likely to make an error.

JMHO and 2 pennies worth

[VivaLasViejas, ASN, RN]

Are we talking about regular CNAs or CNA IIs, or specially trained CMAs who have taken and passed state exams to be able to pass meds?

As a LTC charge nurse, I work with several CMAs who are every bit as competent as I am to pass medications safely. They also ask me about ANYTHING they are unsure of and never give medications that they haven't either looked up or asked a nurse to explain. Of course, I'm the ultimate authority on the floor when there's a question of when to hold a scheduled medication or give a PRN, but I appreciate the help of these excellent workers.

That said---I wouldn't want CMAs to take the place of nurses completely when it comes to passing meds. For one thing, we have the education and the ability to utilize the nursing process, and the knowledge base for assessing the outcomes of our interventions; for another, I'm sure management would find something else for us to do if we weren't passing meds!

[caliotter3]

Discussed at length in other threads on topic. Remember hearing about the nurse who was fired when a family member complained that one of the CNAs was giving her father his meds. I agree with the action to fire that nurse. It will be a sad day when CNAs are doing the nurse's job in my state.

[sharpeimom]

Is AARRRGGGUUUHHHH a word? Or how about AACCCKKK? Or Yikes!

I've worked with some really good CNAs but none I'd be comfortable having pass "my" meds or those of my companion or subordinate nurse.

sharpeimom:paw::paw:

[atla]

In a certain ALF where I work(ed) in IL, they have a position called "Med Care Manager" which is a CNA that they've given a short class on giving medication "reminders." Since the he meds come individually packaged for each resident, they're saying that even though the CNA is gathering the meds and handing them to the resident, they're only reminding them to take it rather than "passing" meds. I think it's a loophole put in place to save money on nurses.