CNA's passing meds

NannaNurse · Sep 25, 2002

I have worked in 2 different states ( Oklahoma and Missouri) where CMT's are used. I have nothing bad to say. The 'Med Techs' I worked with were professional and knew their meds. They let me know when a patient c/o pain and waited for my assessment before administering any medication.

They took BP's and Pulses prior to administering any medication, as indicated.

I dare say they knew more about the meds than the pharmacists did. They carried Med books with them at all times. I appreciated the hard work they did and it help lighten my load at work. They didn't do Accuchecks or administer any injections tho'.

The courses they took were tough and the test was not an easy one. Had a nurse that decided to be a CMT, thought she could 'breese' her way through because she was a 'nurse'??? Took her 3 tries to pass the test.

Shoot, who says only nurses can administer medication?? I've worked with some really 'scary' nurses who didn't know what they were giving or what to watch for!

NannaNurse · Sep 25, 2002

Certified Nurses Aids are NOT passing meds.

Certified Medication Aids/Techs are. They must attend 6 months of very intense courses and pass 'one hell of a test'.

My license in not the one 'on the line' for these people....the D.O.N is the one holding the 'torch' so-to-speak.

Why all the bickering here?? I just in on the 'tail-end' and boy oh boy........

azgirl · Sep 25, 2002

St Judes in Southern CA is having robots do meds according to the article on their website. Now that is a new idea.

MarcusKspn · Sep 25, 2002

In oklahoma we have Certified Medication Aides. Thats what I am currently doing. They pass meds under the supervision of a nurse. I know some really good CMA's and some really bad ones.

It's one way the state has tryied to fix the nursing crisis

mboyce · Sep 26, 2002

Youda, you're getting emotionally defensive about this topic.

Ignorance is only an absence of knowledge, not a judgement unless you meant or take it that way.

I'm not arguing, trying to prove a position (you wouldn't have changed yours no matter what data I put up) or trying to change your mind . . . I don't care what you think. I just want to be sure that anyone else who drops in here has more than just your point of view to choose from because yours is not well thought out.

I'll be looking for your point of view, it's different.

jamistlc · Sep 26, 2002

Greetings,

Here in Ohio about 14 years ago Ohio State Univesity triwed a pilot prgram using Pharmacy Tech to pass meds it was dissolved and LPNs assumed that position ( I was on staff as a "LPN Pharm Tech) we were considered annicillary staff and not NURSES, which really made me mad! But as far as I know it is illegal here in Ohio for anyone to pass medications except NURSES, the exception is when they designate it as a medication training program for the client in a care plan the it is not passing medications but assisting a client to meet a need and a goal. So there are ways round it and ADM. will try anything to reduce costs even if means reducing quality of care!

MarcusKspn · Sep 26, 2002

Working in Rural Oklahoma, The LPN are often to busy filling out papers to go out and give all their med by themselfes. Us CMA are trained to know why we give the meds, what they are for, what the normal situations are, more than that we are trained that if we see ANY situation that is not normal, we bring it to the nurse's attention imideatly.

PS: Many times the LPN's and RN's come to us CMA's to consult meds. We actually spend every minute of our shift with the meds. We handle them, know them, understand them. We know more about what meds the patients are on than most of the licensed personnel.

PPS: about the nurses being responsible for any mistakes the CMA's make. They are also responsible for any mistakes the CNA's make. Are the nurses gonna go around and do all their baths themselfes? I don't think so.

Mattigan, RN · Sep 26, 2002

I work in rural Oklahoma. The LPN's don't have all the paperwork here- the RN's do. Big difference in taking responsibility for someone giving bed baths over someone giving meds. Bed baths are not as high a risk potential.

Oh, I've taught those CMA classes on meds at the vo-tech. It is standardized cirriculum from the state and it goes over diddly squat.

mboyce · Sep 26, 2002

There is a difference between being responsible for giving a bed bath and giving medications, unless there is a developing pressure ulcer that is missed or doesn't get reported, or there are new symptoms, or there are changes in a resident's response or personality that might mean compromise in the resident's well-being. In either case each of the two team members, the nurse and the CNA (or CMA) depend on each other to do their share of the resident care effectively and with compassion. Isn't that what teamwork means and isn't that what makes working in a nursing home worthwhile? The whole team, resident included can take satisfaction from effective teamwork.

MarcusKspn · Sep 26, 2002

If I could get the LPN's I work with on tape and play it here I would. My LPN, whine and ***** if they have to get up and spend 4 hours passing meds. They do not have time to do their charting, do their treatments, supervise the CNA's, and do everything else they are supposed to do. If the CMA's make mistakes their butt is on the line just as much as anybody elses. I had an LPN tell me I was an idiot because I insisted that Colace and Peri-Colace are two different medications, and she then went ahead and gave it to the patient (2 med errors, wrong drug, and wrong dose (if you are keeping track)) CMA have more time on the floor to spend with the patients, they know them better, they know if there is something unusual about someone asking for pain meds, instead of just giving them that Lortab. They have more time to focus on the med-pass. Yes there are bad and stupid CMA's out there. But I have also seen RN's that should be kicked out of the health field. I have seen RN's and LPN's give Meds that residents were allergic to, I have seen them give meds that were counterindicated together, and make many other mistakes. At the LTC facility where I work, LPN's make more mistakes in less time than the CMA's do ---- AND BEFORE ANYBODY SAYS ANYTHING ABOUT CMA"S NOT SELF REPORTING ---- Our DON goes through our charts periodically, so does the Pharmacy consult, AND the state board of health (they are here because of mistakes the LPN's made). LPN's practice under the supervision of an RN, RN's practice under the supervision of a Doctor, I don't know if many nurses still remember that little fact. And doctors can be held responsible for mistakes their nurses make --- Just look at Norman, Oklahoma and that was a very highly trained Master of Nursing Level person. So is the doctor gonna do all the nursing, is the RN gonna do the LPN's work, is the BSN RN do the ADN RN's work? So everybody that has anything to do in Healthcare, Doctors, RN's, LPN's, APN, CMA, CNA, MAT, etcccc........

QUIT TEARING OFF EACH OTHER'S ASSES!!!!!!!!!!

WE ARE HERE FOR ONE THING AND ONE THING ONLY, TO TAKE CARE OF OUR PATIENTS. SO FOR CRYING OUT LOUD WORK TOGETHER.

We have to much work to do to fight for our patients, we should not have time to fight with each other.

PS: one of my LPN's is currently in risk of losing her license because one of her CNA's!! dropped a patient. Maybe the LPN should have transfered her herself.

mboyce · Sep 26, 2002

MarcusKspn,

I appreciate your observations and your frustration. You are contributing to our work to bring CMAs into nursing homes in NM. I have used some of what you have said in your earlier remarks in a fact sheet we will be distributing in support of our legislative proposal.

Has your facility considered other alternatives, e.g., Lead CNAs (CNA supervisors)? We have found that these people, when they are effective, free the nurses from some of the supervisory tasks so they can focus on resident care.

MarcusKspn · Sep 26, 2002

I'm sorry if I lost my temper earlier. It just frustrates me when LPN get mad at RN saying "I don't want to be responsible for what my LPN does" and then say the same thing about CMAs.

At my facility the CMAs have somewhat of a supervisory position over the CNAs. We do our rounds every two hours and make sure the patients are dry, turned, ask them if they need anything. Check on things the LPN or RN wants us to check. And report anything unusual about the residents back to the nurse. And if we see the CNA hiding in a closet, taking a nap and not working we bring that to the attention of the nurse too.

As far as my experience goes, CMA's in Oklahoma are not here to replace "real Nurses" (you have some people say LPN's are not real nurses either). They are a very valuable resource for the nurse if proberly trained. We pass her meds (following the same Dr.'s orders and MAR as the licensed nurse would), evaluate the patients response to the meds and if anything happenes that is in the slightest remark unusual, report it to the nurse. CMA and CNA with years of experience and knowledge can be just as usefull as licensed nurses. Believe it or not, but being around you LPN's and RN's all the time, we do pick up a thing or two. I do not in any way consider myself a licensed nurse, I am very well aware of my scope of practice, and what I need to do if anything falls outside of that. I am however a person that is able to have more one on one contact with the resident, and by that I can pick up on any changes that might escape an LPN or RN who is racing down the hall trying to get the work done that she cannot delegate to anybody else. I hope that more states take the opportunity to use this resource to help the patient recieve better care.