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compromising quality of care

Specializes in sub acute, ALF. Currently in RN school. Has 5 years experience.

I am an LPN in NJ. We have CMA's (certified medication assistants) that are allowed to give medications to pts under the license of the RN.

My question is this: Does anyone feel that health care facilities are skimping on quality of care to save money? There are times at the ALF that I work at where there are two CMA's on and no nurse (the RN is "on call" at home in case of emergencies). The CMA's that I work with are good, but their schooling consists of a TOTAL of FOUR DAYS, two of them clinical. I just dont know that if it were my family member i would want their care on the hands of someone with schooling that limited. Just wondering if anyone else feels the same way...

do these cmas work in an acute hospital or ambulatory care center? makes a difference.

in state of ca, cmas may administer specific meds under the license of the md, not the rn.


Specializes in sub acute, ALF. Currently in RN school. Has 5 years experience.

It's in an assisted living facility. I just dont think that when I get my RN that I would take on that risk of having someone give meds under my license. The CMA's here also do dressing changes, ect.

Before I became an RN, I worked in an assistive living home as a AMAP, same as a CMA. I had to go through 40 Hours of class time and then take a state test to show that I was safe. I passed medications, took vitals when needed but that was about the most I was trained to do. I worked under the DON and reported only to her. One has to remember that in an assistive living facility the medications are basic maintance drugs that most would take at home themselves if able. In that enviroment I felt safe. I do not think that I would feel the same way if this was able to be done in a hospital or nursing home facility.

A few months ago, I accepted a position with a ALF that had an Alzheimer's unit as well, to be trained as a medication assistant. I have 7 years experience as a CHHA and have a certif for gerontoloty caregiving trained specialist, so that combine with being in nursing school, I thought the position would be a great experience. I left within a month.

The first day I was being trained by the CMA who was a really nice young man who had 4 months experience TOTAL as a caregiver, who was then trained by the facility to be the CMA. Prior to working at this place, he was a truck driver. My first red flag. Half way throught the a.m. meds the nursing supervisor (RN) informs me that she doesn't know why administration hired me as a medication assistant b/c they have too many of them already on staff... so I go into caregiving.

The next thing I see is the med assistants giving patients their medications crushed in a FULL glass of ensure, right after eating breakfast. Now most Alzheimer patients do not eat all that well and getting an individual to drink a full glass of ensure is near impossible. So most days the patients were noncomplient simply b/c of poor administration of meds. I kept telling the CMA about it, but "that's how it's done" was the only reply I kept getting. I went to the RN directly and made sure she knew about the situation.

The final straw happened with the State came in and sited this place for something like 50+/- violations. I walked into the administration and gave notice. Before I left at the end of shift, the RN comes over to me and says, did I hear what the night CMA did? She goes on to tell me..the patient wasn't able to sleep so the caregiver called the CMA and asked if there's something on order. CMA give Ambien; without putting the pt in bed. About 30 minutes later the patient is sitting in a chair falling asleep and the caregiver becomes concern b/c they can't wake this individual up. So they call the CMA. The CMA comes to the unit, and can't figure out what's wrong.... and .... are you ready....... calls 911! Paramedics come, assess, looks at the medication record and says... You just gave this pt Ambien 45 minutes ago.! Put them in bed!

My answer, based on my only experience, pt are being put in jeopardy b/c of costs.

Good thing they didn't need another CMA on site. LOL


Has 20 years experience.

LOTS of threads on the issue of CMA use in hospitals and dr offices. I do invite you to do a search and check out these threads......but make sure you have your kevlar suit on. These threads got quite HOT at times.

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