CNA's passing meds

Nurses General Nursing

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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 diverse than in a state where they cannot.

I wish i had a list of the suspect states but i have no idea which, if any, actually let this happen.

Thanks for any input

NurseLeigh

Specializes in Vents, Telemetry, Home Care, Home infusion.
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.

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???

Originally 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???

Unfortunantely, I have also seen this particular phenomenom. I believe that it is EXACTLY as ADON states it, the med-aide simply dosen't have the equal number of distractions that the nurse does.

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.:confused:

i 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?:bluecry1: :angryfire :nono: :chair:

Too 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 :o

I 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....

Sigh-----

leigh - 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 :-)

Solutions, solutions, solutions. Oh where are the solutions? If not med-aides, then what? If you're short 3 nurses, do you just continue to operate and HOPE that ALMOST everyone, gets ALMOST everything that they're supposed to get? Inclusive of meds?

Pay and working conditions are certainly issues, however, when you're fried from too many patients and not enough hands to enable you to give care at all in certain areas, much less QUALITY care, what are you supposed to do?

Sit back and let it continue, or use people that , while they don't have as much education as a nurse, ARE additionally trained, specifically in med. administration, enabling you, the nurse, to give as much quality care as is possible.

In our area there are simply NOT the nurses to meet the demands, regardless of the many nursing schools in the area, competitive pay and good working conditions.

You cannot hire and use people that do not exsist.:eek: :eek:

Come up with other solutions was the challenge. Well, heck. The ones I can think of aren't gonna get done. Like the excellent nurse who got burned out on staffing policies and got a job as a manager at a fast food joint making more money and less headaches, and doesn't kill anyone if she forgets the pickles. Would she come back to nursing? I doubt it.

A related problem IS the staffing shortages. If we had RNs lined up waiting to put in applications at LTC, and the pay was reasonable, would anyone use a CMT? If money wasn't THE issue, would CMTs be used at all? If there were plenty of RNs, would anyone use CMTs? I doubt it.

Mrs. Jones gets a new order for Lanoxin and goes into v-fib, dies, and no one notices and so I get sued. Will the BON say, "there, there, Nurse Betty. Don't worry about it. You did the best you could." No, the BON won't say that. They'll yank my license.

So, here's the problem, the cop-out if you prefer. I don't count beans. I don't get to wear a suit, and don't want to. I just take care of my patients. If I am so busy that I need a CMT to pass my pills, then it's time to find another job. Does that solve the problem? Nope. But, it keeps me safe and sometimes prudence is the better part of valor. At least the BON thinks so. How those problems get solved, is beyond my ability. I'm not a CEO, I don't set budgets, and I don't care if the investors on Wall Street are happy with their quarterly dividend check at all! So, all I can do is follow my conscience and refuse assignments that are unsafe. If you are comfortable with it, and you don't have a bit of doubt, and nary a pt. ever went without optimal care because of it, in your experience, then, Hey! Great! But, me? I pass my own meds, then I don't have to worry about doing an assessment AFTER a pill has taken effect. I can decide on the spot if it should be given at all.

Youda

Your posts on this subject express the concerns of many nurses. You get to the crux of the issue without being defensive. Thanks for speaking my mind so well.

Specializes in Corrections, Psych, Med-Surg.

Youda--exactly right.

With all due respect to those who want to blame these issues on administrators and money . . . these are only additional elements in a very complex situation. Many adminstrative staff including DNSs and administrators are nurses and a lot of research has shown that money really has very little to do with whether people get satisfaction from their work or is directly related to the quality of care.

We can all sit here on this bulletin board and find problems . . . thats easy. Surprisingly, so are solutions. A challenge is to find solutions and propose them here so that those who come here for help can take something away . . . not just get sucked into the whining and complaining. A difficulty is making the solutions work, e.g., in order to assure that medications are administered effectively it is necessary to monitor the administration practice for variance. This is to say . . . take the opportunity for poor practice out. Unfortunately this means that nurses have to monitor and report on other nurses practice (or on CMA practice). We are reluctant to do this because we know how difficult it is to do the work that we are monitoring (and we don't want others monitoring our work). So we complain that no one is doing anything when the people we are complaining about are ourselves.

We are a unique and funny group of people.

mboyce

Your point about oversight in the second paragraph of your last post is well taken and something I've seen problems with countless times. Could be topic for disc in it's own thread. But like you say, lots of problems presented, very few solutions. In a case or two (unrelated) I have seen solutions presented on the job where the response was almost insulting. I think these particular managers really want the status quo, that's why they promote it so strongly and beat down anybody who tries to make a positive difference. Just my on-the-job observations.

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