CNA's passing meds - page 6
I have heard tales that in some states the CNA's are the ones who pass meds. I was just wondering if any of you live in any of these states that supposedly do this and if the CNA courses are more... Read More
Sep 5, '02Occupation: R.N.,STAFF DEVELOPER Joined: Aug '02; Posts: 13I WORK IN RHODE ISLAND WHERE THE MAJORITY OF LTC'S USE MED TECHS TO PASS MEDS. THE POSITION REQUIRES A 3 MONTH COURSE FOR WHICH THE PERSON BECOMES QUALIFIED TO TAKE AN EXAM AND DO THE "MED THING"! DO i LIKE IT???? NO, BUT THERE ARE A LOT OF NURSES, STRESSED TO THE MAX WHO ARE ALWAYS GLAD TO SEE THE TECH ARRIVE. NURSES STILL DO NARCS, GT'S, ETC. I DO NOT KNOW MUCH MORE ABOUT THE COURSE. MASSACHUSETTS, DOES NOT ALLOW TECHS.
Sep 5, '02Joined: Nov '01; Posts: 765; Likes: 14Wow! That makes me feel safe they can pass meds except narcotics.
Sep 5, '02Occupation: charge nurse Joined: Sep '02; Posts: 8What's even scarier is: some of these QMA's are smarter than some RN's and LPN's. Have more common sense!!!!!
Sep 5, '02Occupation: nursing student Joined: Dec '01; Posts: 181; Likes: 29In the facility I work the CMT's not only pass meds but do all patient care and laundry. How much time do you think they have to think about the meds. It's a nuisance to them as they have other things to do but sure helps on the payroll.
Sep 5, '02Occupation: RN, PI Coordinator at NM State Veteran's Home Joined: Sep '02; Posts: 20I don't think that proponents of CMAs are using the nurse shortage as an excuse to justify the use of CMAs. The nurse shortage is a reality that forces us to deal with unmet patient and resident needs by looking for alternative solutions. To ignore reality is to weaken the profession by allowing others to create alternative solutions that are then forced on nursing.
To suggest that nurses should re-engage in supporting the profession is a good idea but it ain't working; look at the membership numbers for your state associations. In the mean time, while nurses pass pills patients wait for care.
That CMAs cannot do assessments is a fundamental arguing point for CMAs; CMAs free nurses to do the assessments that are not now being done. Look at the entries from the nurses who work with them.
The role of the nurse needs to both evolve and expand. With the support of CMAs, nurses are free to focus on assessment of response to medications not just wait for emergence of adverse reactons or symptoms of medication ineffectiveness. High risk patients and issues can be scheduled for attention instead of "fit in" and while medication rounds are a good time for viewing patient status they are not a good time for patient intervention.
In Long Term Care, the resident population is relatively stable . . . and so are their medications. In our facility (census 135-140) we administer over 1000 individual doses of medications each day within very limited time frames. The CMS threshold of concern for residents is 9 or more medications, our average is 5-6. While there are PRNs and these involve assessment we do not anticipate that CMAs will either conduct the assessment or administer the PRN. What could the nurse be doing that they cannot now do because they are passing medications?
It may be that CMAs are not for every setting and perhaps those differences generate some of the heat in these discussions; we should be careful to stay on issue and the issue is really very simple. Nursing either responds to environmental forces . . . no matter how turbulent the currents . . . by deciding what nursing is and is not or nursing ceases to be.
Sep 5, '02Joined: Mar '01; Posts: 542; Likes: 44Originally posted by sunnygirl272
what's a Medicaid nurse aid?
Hi Sunny Girl,
Hi Don't really know, but you best believe I intend to find out. I know that the community college I attend requires that all nursing students complete and pass this course prior to the first semester of schooling. I didn't have to go through it since I am a LPN. I am NOT belittling them or anyone else....I guess I was just unnerved in HOW she said what she did.
Sep 5, '02Joined: Sep '02; Posts: 11Perhaps some of us accept CMAs as easily as we do, because we have worked with them and around them for such a long time. I can remember, years and years ago, as a GVN, the facility where I got my first job used a med-aide, and every place I've worked since then has used at least one.
In all honesty, I have, over the years seen a fewer number of nurses, passing a fewer number of meds, be responsible for a larger percentage of med errors than any of the med aides.
Perhaps this is because the CMAs have to pass meds. Period. Their attention isn't divided between multiple numbers of tasks.
Whatever resolution is brought about in the end, something has got to be done universally, to relieve some of the care issues that have come about due to the shortage that we have faced, and will continue to face.
Mboyce is right. We need to come up with a viable solution, or someone else will.
Sep 5, '02Occupation: Utilization Review, prior Intake Mgr Home Care Specialty: 40 year(s) of experience in Home Care, Vents, Telemetry, Home infusion ; From: PA, US ; Joined: Oct '00; Posts: 27,548; Likes: 13,755In all honesty, I have, over the years seen a fewer number of nurses, passing a fewer number of meds, be responsible for a larger percentage of med errors than any of the med aides.
Sep 6, '02Joined: Sep '02; Posts: 9Originally posted by NRSKarenRN
OR, is it because the Certified med tech doesn't feel the need/OBLIGATION to report an error, understand what an error is or the need to do root cause analysis re system breakdown to head off another error???
Aspersions upon these people's character's as to their sense of obligation or knowledge base only serves to insult others and get the conversation off the issue at hand, which is if med-aides are such a horrendous choice to alleviate the care issues confronting us, then perhaps some of us could put forward some ideas.
I have seen a lot of pretty harsh critisisim of the proponents of using med-aides, particularly one of them, but as of yet, I've not seen anyone come forward with a better solution.
Instead of pulling apart just one person's comments on the subject, and maligning people that we don't know, we would help ourselves more by coming up with alternate solutions.
I apologize ahead of time if this plain-speaking offends anyone, it certainly isn't intended to. I simply don't know how to put what I'am seeing on this particular thread any other way.Last edit by NrseK on Sep 6, '02
Sep 6, '02Occupation: RN Joined: Aug '02; Posts: 218; Likes: 7i always learn something new on this allnurses board!!!
i must say, however, that this topic is totally freaking me out!!!
i've not had experience with ltc nursing as my love is the nicu where nearly everyone is a rn. the concept of nursing assistants passing meds just never occurred to me!!! i thought only lpn/lvns and rns were able to do that!!!
it always boils down to money !!!
i personally feel that the nursing homes/ltc facilities need to not be open if they can't afford to have a licensed rn or lpn pass the meds!!!
for heaven's sake.... where will it all end? :angryfire
Sep 6, '02Occupation: caregivers, ushers to the portal of heaven Joined: Dec '01; Posts: 164; Likes: 1Too many nursing issues have been parceled and determined via the bottom line instead of concern for the pt's health and well-being.
ioho, only an good, alert, compassionate RN has the broad education and awareness optimal to pass meds in a facility setting and know what to watch for and what to continually evaluate.
The trend is to delegate more and more responsibility further and further down the line. In Oregon it is to the point of ppl off the street with no experience or education being the preferred care providers because they are inexpensive and have no liability or governing authority.
If the focus came back to the patient's health, RNs would do the meds and all facilities would pay an specialized RN *well* for the exclusive duty of passing meds and monitoring effectiveness / reactions etc.
But what SHOULD BE is very different from WHAT IS.
Meanwhile, we all would do well to be supportive to those excellent caregivers who try their best in whatever capacity they are placed. It is all difficult. And it doesn't look like bean-counting "upper management" is putting a priority on patient care anytime soon
Sep 6, '02Occupation: RN Joined: Aug '02; Posts: 218; Likes: 7I would love to see all those "bean-counting upper management" types end up on the receiving end of one of their "money saving" tactics some day... and the result be uncomfortable for them to the extent that they made life uncomfortable for others while they were in their managment roles....
Sep 6, '02Joined: Jan '02; Posts: 1,614; Likes: 2leigh - i ain't never seen no mention of meds in my recent cna capacity at a hospital. At the cna school, i remember there being seperate classes for folks who wanted to pass meds. There is some three letter acrynim for it in Oregon.
I have never had any opportunity to see meds except the ones PT's sometimes leave behing on the little white cups :-)