Published Oct 31, 2015
BambiBelle07
54 Posts
I am a CMA. I realize this is a nursing board, but I have not come across a board for Medical Assistants. I just started a new job at a private practice about a month ago. For the first two weeks, my co-workers were nice enough and fairly helpful. This did not last long.
I am the youngest and by far the least experienced. I have no idea how I got in charge of what I feel is the most difficult/critical job: handling the narcotic medications by myself. I am responsible for dispensing medication and keeping up with the inventory in the system. On top of that I am responsible for making sure all paperwork is ready for the appointments/taking patients back and getting them ready for the doctor. I get really overwhelmed with all this work and don't have a minute to breath. My coworkers are lazy and spend a lot of time gossiping and looking at their phones and asking me to do things like take a patient back, call so and so when they can see I'm already swamped and stressed out. I told my boss this and she said I am overwhelmed because this is all new, but I will get the hang of it.
This week we were short a bottle of narcotics, or according to my co-workers we were. Right away, my co-workers accused me of stealing since I am the one who takes care of the meds. They were ready to tell on me and get me fired. I told them I would never steal anything and they continued to question me. Why are we short? What happened to the medication? I informed them I always triple check everything when I dispense meds, so I couldn't of dispensed it by mistake. I keep inventory. In the computer it said we had 0 on hand of the narcotics I was accused of stealing. So there was no way I could have stolen it since the computer proved it was all dispensed. I told them who I dispensed to.
When I did the inventory on 10/23, we had three bottles on hand. This week, I dispensed those three, so we were not short like my co-worker said we were.
When I did the inventory on 10/16, we five on hand. The week ending on 10/23, two were dispensed. So,when I did the inventory on 10/23, we would of had three. So in two weeks, I dispensed four of the bottles and my coworker said she dispensed one.
Somehow a miscount had to of occurr. For the week I counted five bottles of the narcotics on hand, another coworker said there should have been six. So she kept insisting one was missing even though it wasn't. Later that day I was talking to the doctor about a patient's medication, and when I got out of the room, my co-worker who insisted there should have been six bottles started questing me on what I was talking to the doctor about in a really snappy tone.
Then my co-workers continued to scold me on how I need to be extra careful and write everything down, which I do. I always triple check my work, which is why I was surprised this happened. Sometimes I even count twice to make sure my count is correct.
For the rest of the day, I felt like they were talking about me. I'd hear them whispering in the other room and whenever I walked by, they would get quiet and stare at me.
I just couldn't believe how they immediately accused me of stealing the meds and this incident kinda ruined the weekend for me. I feel like no one has eachothers back anymore, especially at this place. There is no teamwork. I feel like I am constantly covering my behind, defending myself, and walking on eggshells around these people. They constantly question what I'm doing like they can't wait to catch me doing something wrong so they could get me in trouble.
Has as anyone had similar experiences? And how do I handle working in this environment? I don't necessarily want to find another job because I like the doctor and the patients. Plus, I've only been there a month and that wouldn't sound good on a job app.
CVICU-Nurse1.5
129 Posts
Learn who you can and can't trust and act accordingly. Remember nobody else will put food on your table or pay your bills.
traumaRUs, MSN, APRN
88 Articles; 21,268 Posts
Moved to CNA/MA forum. Best wishes.
That's the truth. I obviously can't trust them. Gotta watch my back 24/7 when I'm around them.
CrunchRN, ADN, RN
4,549 Posts
Insist that 2 people sign off on all narcotic distribution.
hookyarnandblanket
318 Posts
^ This. Spin it this way: "Since the recent incident with the suggested missing narcs, maybe it would be a good idea if two of us count together to ensure the numbers are correct so we don't have another unfortunate mishap again and everyone is protected."
Good tips all! I made a chart last week with all the patients I am distributing meds to this week. Since I won't be distributing to all those patients myself, I am going to have my co-workers initial next to the patients they distribute to. I will initial next to the patients I distribute to. That way we know what patients got their meds and who gave it to them. Does this seem like a good idea or extra work. I'm new, so I don't want to seem like I'm overstepping my boundaries coming up with systems to make the office run smoother.
I will also suggest 2 people counting the narcs to ensure the count is 100% accurate.
achurley
2 Articles; 80 Posts
I had no idea that dispensing & inventory of narcotics was within the CMA scope of practice?¿?
I pack the meds for select patients. When they come in for their appointment I dispense (give) them to the patient and have them sign for it. Maybe I'm using the word dispense in the wrong context, but on the patients' intake is a list of the meds they get.
JustBeachyNurse, LPN
13,957 Posts
CMA's handing out medications other than administering a dose in the office is likely out of your scope and possibly a DEA issue. Only pharmacists can legally dispense medications. If an audit occurred and you were caught handing over a bottle of any medication without the training and scope to complete drug patient education you can be in a whole heap of trouble. Even samples of medications are technically only supposed to be handed over by the physician.
Tread very carefully here. You might want to check with your state board of medical examiners says about the scope for a CMA. You can be accused (rightfully) of practicing as an unlicensed pharmacist
For example in CA medical assistants are specifically prohibited from handing out narcotics to patients. They may hand over a prelabeled prescription under specific circumstances as verified by the licensed prescribing professional:
Are medical assistants allowed to hand patients prescription drugs?Yes, medical assistants may hand patients properly-labeled and pre-packaged prescriptions drugs (excluding controlled substances) that have been ordered by a licensed physician, podiatrist, physician assistant, nurse practitioner, or nurse midwife. The properly-labeled and pre-packaged prescription drug must have the patient's name affixed to the package, and the physician, podiatrist, physician assistant, nurse practitioner, or nurse midwife must verify it is the correct medication and dosage for that specific patient and provide the appropriate patient consultation regarding use of the drug prior to the medical assistant handing medication to a patient.
Yes, medical assistants may hand patients properly-labeled and pre-packaged prescriptions drugs (excluding controlled substances) that have been ordered by a licensed physician, podiatrist, physician assistant, nurse practitioner, or nurse midwife. The properly-labeled and pre-packaged prescription drug must have the patient's name affixed to the package, and the physician, podiatrist, physician assistant, nurse practitioner, or nurse midwife must verify it is the correct medication and dosage for that specific patient and provide the appropriate patient consultation regarding use of the drug prior to the medical assistant handing medication to a patient.
This is verified by the doctor. The doctor is the one who prescribes the meds. I am not dispensing anything without the doctors permission. The doctor sees the patients/talks to them about their meds before they leave with them.