CNA's passing meds

CaliNurse · Sep 11, 2002

Originally posted by ADONDonnaRN

In response to the many negative views on the subject of "techs" or what ever your particular location refers to them as... I myself am an RN, that works as an ADON in a LTC facility. I also am a part time instructor for the local college. I teach the Certified Medication Aide class, along with the assistance of an RPh. This is a non-credit course, however, there are educational and vocational requirements that have to be met, in order for a person to participate in the course. I won't take up space deliniating these, however, suffice it to say that in speaking for our program only, it is NOT a walk in the park! Our cirriculum includes drugs, drug laws and body systems emphasizing the effects of drugs on each one, etc.

This makes me very curious.... what state do you teach this program in ADONDonnaRN?

How long is the program? I live in California and I haven't heard of this title. I have to admit it does scare me. I seen staff that have passed meds for years and the errors they make just cut me to the floor! I wonder what the med error rate is in the states that use these positions.

I hope that the staff that hold these positions don't stop there and continue on in nursing and get a license.

Cali

Susiesblues · Sep 11, 2002

Who ever thought of that? I have worked to long and hard to even see this! I would never let anyone unlicensed pass meds on my license. It is far to important to me. It is my livelihood and I would not let it be jeopardized. For all of you who are working in facilities that allow aides to pass meds, you might want to think twice about your license. I think that the aides have their place and thank heavens for them but pass meds....NO.

oldgirl, RN · Sep 11, 2002

Tshe-I agree completely. Only thing I was trying to point out was that the nutso pace of many floors these days is making bad habits easy to pick up. And yes, if I mess up, I answer to that-but meds under my license by someone else-no thank you.

Teshiee · Sep 11, 2002

Old girl I understand that is true the errors I see I just shake my head. Our license is ours alone why should we be held liable for someones' potential error? Crazy!!!!!!!

Youda · Sep 11, 2002

Originally posted by CaliNurse
I wonder what the med error rate is in the states that use these positions.

Cali

That would be an interesting thing to find out. I think. I doubt that any data would be reliable, though, since medication errors at a LTC would require "self-reporting" to an agency, study or group. There is, obviously, motivation not to report such things. LTCs are usually not "mandatory reporters" to the state BONs, so many errors, if dealt with at all, are done in employee "counseling" sessions and filed away in a personnel file (assuming there isn't any actual harm to the patient). Acute care settings are more strict with errors. But, yes, some hard data would be a good indicator. :cool:

Momto3RN, RN · Sep 11, 2002

I agree with venting our feelings/frustrations as a very human way of coping. I'd much rather do it here than in front of my patients!!!!

One of my main motivations for logging on to this site is to VENT!!

That said, I've seen many solutions so far that could help with this problem. As many of us have different circumstances, obviously just one solution will not do.

As for me, I do the best for my patients with the resources I have available. At my SNF, the nurses pass all meds and I prefer it that way. I'll be responsible for my own ADPIEs, thank you!

jtfreel · Sep 11, 2002

There is a major hospital (medical center) in Petersburg, VA who has trained individuals (not necessarily CNA's) to pass medications on acute inpatients. This includes IV piggy backs, changing IV's, adminsitering IM injections including controlled substances, administer insulin and all scheduled medications.

This hospital is JCAHO accredited, licensed by the state and the practice has been passed by the Board of Health Professions by the state of Virginia.

CaliNurse · Sep 12, 2002

I think we would all be better off with staff who could help us with all the different directions that we get pulled in. If they just simply put more CNA's on the floor it would help. They wouldn't even have to pass meds. Just do care. We are all part of the same team. We can't get by without each other. I know my hardest days are when I am being called to help reposition someone who I could do myself. After 12 hours of work the CNA's get to walk out the door. They can not help me with my charting. I can't come back the next day and chart. I can't take the charting home. If they put more staff on the floor then they could help each other and be on the call light patrol that also seems to distract me from how I have attempted to plan my shift.

And Yes, this is a great place to vent. When I speak to others they never really understand what it like to be out there.

I don't know why in nursing we seem to have this idea that we are all working as a team. We are the first to separate the day shift from the evening shift from the night shift. We are always blaming the other shift or claiming that we do more work then them. We will separate ourselves by title. I am the R.N., go find the LVN or CNA. I am the LVN, take that to the charge nurse or find the CNA. I am just the CNA, I don't do that, go get the charge nurse or the LVN.

We eat our young. New nurses .... oh what a joy! We complain that they "don't know" anything. We don't have the compassion to give them 2 extra minutes to reinforce their self esteem. When they make an error its the end of the earth... like we have never made an error.

I am lucky. The unit I am on now has a great director. She is extremely fair. We all know that we are in a stressful profession. The easiest part of our day is our drive to work. I believe in treating others all the way down to the housekeeping crew just as I would like to be treated.

I did get a little off the topic, I guess it was my time to vent.

I am with the majority with this one. CNA's or anyother non licensed person should not give meds. I don't believe that 3 months is long enough to learn the wisdom that you need to pass meds. My opinion.

Cali

jccarolina · Sep 17, 2002

I live in Wisconsin and a course must be passed to be certified in passing meds., the CNA are also taught by the RN and LPN staff to give insulin injections and accu. blood checks also. The med books are always kept up to date with sigs. and documentations at the facilities I have been at, so med errors are very rare that I have seen with our records

mboyce · Sep 17, 2002

I would like to ask a question or two of the nurses who are adverse to supervising CMAs because they don't want to be held accountable for the errors they might make.

Who is responsible for the errors of the staff you supervise now . . . no matter what their roles are?

Who is responsible for the errors of the people you work with that share in your care and service, i.e., conducting treatments that may need assessment and reporting that don't get done, writing orders that may be inaccurate or dangerous, forgetting to tell you something in report that you may need to know?

Youda · Sep 17, 2002

Originally posted by mboyce
I would like to ask a question or two of the nurses who are adverse to supervising CMAs because they don't want to be held accountable for the errors they might make.

Who is responsible for the errors of the staff you supervise now . . . no matter what their roles are?

Who is responsible for the errors of the people you work with that share in your care and service, i.e., conducting treatments that may need assessment and reporting that don't get done, writing orders that may be inaccurate or dangerous, forgetting to tell you something in report that you may need to know?

I understand the point you are making, that the RN is, ultimately, responsible for anything and everything that is delegated to LPNs or unlicensed personnel. Which tends to support the "against" argument more that the "for" argument.

mario_ragucci · Sep 17, 2002

The very first time I make decision to pass a med to a PT as a RN >Spring2004, it will be a holy event for me. From what I see, as a CNA on med/surg floors for 5 months, is the RN's are programmed what meds to pass via daily computer instructions. I see the RN's have a shift report, and they work with E-chart beyond my input/output scope. The meds all come from the mega-robot down in pharmacy. If med errors are made in these loops, it can only be human error not to deliver a med. Right? I'm a human. The stress, I imagine, would come from missing a delivery, or being distracted to the point of utter short-circuit.

I've seen that Pixis, cash-machine looking thing in all the med rooms. I guess thats where the nurses get their desicion-oriented meds to give to PT's like pain meds, insulin and such.

Then there are the IV's that come up the lift, or get dropped in by scut (shoot). They always make me flinch when they drop at the nurses station because of the abrupt slam. :-) And blood comes from the lab.

Thats alot to consider, and to me, I would manage it best I could.

When it comes to charting with echart, i am lucky to all ready have a decent backround with how a database thinks. To me, it's so cool to have echart on those wireless poles. Even though I make notes fo everything on my clipboard, I love to push it right into echart. It's like a space invaders game. The vitals and I/O's are always advancing to me, and when I enter one in, I haltthe advance. Granted, there is sufficent concern on my part to take care of my "wrist bones" when I am moving from room to room. If you jerk and pull that echart around improperly, the bones in your wrist will loosen and break :-( Other than that, echarting looks like a breeze for an RN. Iy'd always go for the mobile echart if I had anything to chart from a PT. It's a new trick for me to be able to work a computer and be moving/standing up at the same time.

The written charting you can do right at the PT room at the pull down drawer. The hassle would come from not having the chart, which would create distress on my part from not being able to let my work flow. Here is where I may experience discomfort of having to remember to chart something, and the chart is not with the PT.

I hope I didn't bore anyone with med talk from a non-med-passer :- I'm sorry