Letting CNA pass your meds, bad idea?

Nurses General Nursing

Published

I fill the cups and check for all interactions and whatnot, but anyone have any negative experiences or can think of any possible neg exp with this?

Thanks

Specializes in nursing homes, home health..
First let me address this junk about documentation. I made the comment that you seemed like you were all for it if you were behind . Now, I see by re-reading your post that you think it is just as simple as reading the MAR and that you would not be concerned with the training of the CNA but that you just dont want to be reported. You have admitted to not taking BP's with meds and doing assessments before you give meds. In other words you are not concerned about the patient just covering your orifice and getting by anyway you can , doing the min.
icon11.gif Well if I documented it then don't be concerned because I always document what I am supposed to do. And you are sortof--kindof right about your last concern. Although I never do the bare min. I always try to cover my behind.;)
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Specializes in ICU, PICC Nurse, Nursing Supervisor.

I understand the extra time it takes to take the BP but it is a part of the job. You cannot tell by looking at someone if you need to hold their BP meds( on a normal basis). There is also something else here. If you are not taking the blood pressures when giving the BP meds then are you leaving the MAR blank when it ask for the BP measurement or are you just making the stuff up as you go. Either way you are cutting corners on your behalf and your patients will suffer in the end.

:uhoh3: My goodness where on earth do I say I couldn't handel a Blood Pressure cuff? I plainly stated that the equipment in the nursing home is no good. Geez. And yes I meant what I said about doing assessments and all of that. Never had any problem tho. Maybe I was just lucky or maybe I have learned how to look at residents and know if anything is wrong. Sorry got to give the meds out whether they require BP or not.
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Specializes in nursing homes, home health..
I understand the extra time it takes to take the BP but it is a part of the job. You cannot tell by looking at someone if you need to hold their BP meds( on a normal basis). There is also something else here. If you are not taking the blood pressures when giving the BP meds then are you leaving the MAR blank when it ask for the BP measurement or are you just making the stuff up as you go. Either way you are cutting corners on your behalf and your patients will suffer in the end.
:idea: Correct delioso. In the twelve yrs. I have yet to have a problem. A lot of the times residents[not pt.] don't really need all of that junk. But, since the family or the resident themselves seem to think there is a pill for just about any ailment they accomadate. I know and the doctor knows taking antibiotics for a sniffle decreases their effectiveness and helps the ABT. to build a resistance to the infection they still give them since the family or resident insists they are the answer to everything.icon6.gif
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Specializes in community health, LTC, SNF, Tele-Health.

I can't believe that this thread has gone on as long as it has. It shouldn't even be a question. Nurses are held accountable for all our actions, and the actions of those we supervise. Why in hell would you put your patients and yourself at risk? Do the job you were hired to do, that means all of it. Yes nursing is busy. Yes LTC's are understaffed. Yes there are people who divert narcs. Yes med passes are long and tedious and sometimes stupid, we have patients on meds they don't need to be on but the bottom line is,

this is what nurses do. And delegation does not mean handing out meds to CNA's to pass. It means having a CNA put balmex on a patients rear, not giving a potentially dangerous med. I have worked LTC on a unit with 42 patients and two aides. Somehow they all got their meds and the CNA's had nothing to do with it and it certainly wasn't the medication fairy. Its called busting your hump every night. If you can't find the time to pass meds and do treatments and everything else we're supposed to do then take up forensic nursing. Those patients don't need meds!

Sorry if I ranted, I am just irritated at some of the things people have said.

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I can't believe that this thread has gone on as long as it has. It shouldn't even be a question. Nurses are held accountable for all our actions, and the actions of those we supervise. Why in hell would you put your patients and yourself at risk? Do the job you were hired to do, that means all of it. Yes nursing is busy. Yes LTC's are understaffed. Yes there are people who divert narcs. Yes med passes are long and tedious and sometimes stupid, we have patients on meds they don't need to be on but the bottom line is,

this is what nurses do. And delegation does not mean handing out meds to CNA's to pass. It means having a CNA put balmex on a patients rear, not giving a potentially dangerous med. I have worked LTC on a unit with 42 patients and two aides. Somehow they all got their meds and the CNA's had nothing to do with it and it certainly wasn't the medication fairy. Its called busting your hump every night. If you can't find the time to pass meds and do treatments and everything else we're supposed to do then take up forensic nursing. Those patients don't need meds!

Sorry if I ranted, I am just irritated at some of the things people have said.

amen, sister nurse!
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Specializes in ICU, PICC Nurse, Nursing Supervisor.

LAWD, this is the kind of post that makes me wonder what the Texas BON was thinking when they passed out nursing licenses. Sure about 70% of the meds in LTC could be cut out ... but unless you have MD or DO behind your name , you dont decide what the resident takes. We are not speaking of ABT's here either, so I dont even know where that came from. Just because you havent had a problem in past does not mean your practice is safe ..it means your lucky. I guarentee that if you do have a problem because of your incompetent practices the Texas BON will not accept that the residents dont need all that junk anyway or I have to get the pills out and dont have time to take the BP's. I cant believe you have made it this far without a problem either...This is the kind of stuff that gives LVN's a bad rap....:banghead:

:idea: Correct delioso. In the twelve yrs. I have yet to have a problem. A lot of the times residents[not pt.] don't really need all of that junk. But, since the family or the resident themselves seem to think there is a pill for just about any ailment they accomadate. I know and the doctor knows taking antibiotics for a sniffle decreases their effectiveness and helps the ABT. to build a resistance to the infection they still give them since the family or resident insists they are the answer to everything.icon6.gif
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I don't think it is a bad idea. I'm a CNA going to school for nursing and I work in a CBRF facility and I pass meds out everyday that I'm at work. Most places require you to take a class on med passing. Then you have the option of taking a state license test depending on the facility you are working in. In my opinion at my facility the nurse would be over worked with passing out meds due to we have over 1000 residents in our facility and thats all they would be doing all day. We of course don't do injections that is the nurses responsibility unless you are in school for nursing and a nurse is there while you are doing the injection. I guess it all depends on the training on what you are doing. I can understand that if someone has no clue what they are doing or giving then yes I would have to say no they shouldn't.:monkeydance:

I am bothered by this......

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I don't understand why some of you are talking about giving narcotics as if that is soooooooooo different from the other meds. I have worked mostly nursing homes for the 12yrs. I have been doing this. Not once have I seen anyone go beyond looking at the mar and giving what is on there. You simply don't have time to assess a resident everytime you give meds. While I would never ask a CNA to give my meds it is not because of any training but the fact that I just don't want to take the chance of getting reported. There are residents that refuse meds and have for God only knows how many yrs. Still getting around fine. Then there are others who take so many I get sick just from pulling them all up. The truth is if you can read then technically you can give any med. But of course we don't do things that way. Complaints are reported to state constantly for all kinds of things. It is always the same senario. They come in and tell the nursing home they have been bad boys. They supposedly correct the problem and life goes on. By that I mean of course they were cleared. What I am getting at is someone can have a bad reaction to anything at anytime. You can assess till the cows come home and still have a problem. I do think it is just dumb and plain mean to report a nurse for example letting a CNA hand MOM to a resident. But just for that very reason with me the resident will just have to wait until I can get to them. I do know of a RN that did the previous example and someone told. Everyone knows whatever their reason was---it defintely was not because they are concerned about the residents safety.

How can you not have time for an assessment? That's the core of what we do. It goes beyond simply the MAR and the med.

:o

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:uhoh3: Yes, I am in the nursing profession, but, I think you missed the point. You should be glad I am in the nursing profession because I seem to be the only one mentioning the patient as the point of concern. In the hospital I work in and teach in, I see so many new nurses that forget about what the patient is in the hospital for and are too caught up in worrying about their career, and judging from the replies to the email wondering about having the keys to the med drawer, or making sure the MAR is signed for, or that a CNA might take the medication for herself/himself instead of the patient still implies that the best interest of a patient is the last thing considered. And, by the way, I was positing an opinion, not slamming anyone who "disagrees" with me. You do make a very valid point - nursing homes do have a high patient-to-nurse ratio, and you can get absolutely slammed. I know I couldn't work in a nursing home because the loads placed on nurses is beyond safe measures. I applaud you. But, it still concerns me that the first statement you make is that you don't want to get in trouble, not "the patient is in trouble therefore..." It sounds as though the DON may not managing the facility very well. It is still unacceptable that assessments are not made, especially when meds are given. Are you telling me you don't always take a blood pressure before you give a blood pressure medication or having an aide get the blood pressure for you? These are simply reasons that it is not a good idea to let CNA's pass meds. The really neat stuff we use in a hospital is our critical thinking skills that helps us the most. I especially like the stethescope. It is really cool and very helpful.

Well, besides the fact that I've seen the pt comes first on this thread, let's just say for instance, that the whole picture of putting the pt 1st is being able to also be responsible and think of all these 'minor ' things like keys, and the MAR and all of the legalities we tend to to prove that we, ourselves, have done our very best in the interest of the pt. I'd say that from the concerns of most of these repliers, that they are in tune with their priorities. (Save a few worrisome ones.) And as far as our critical thinking skills, they are awfully good to have to evaluate what all the neat-o equip has to tell us about our pts, doncha think?

;) :rolleyes:

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Specializes in nursing homes, home health..

I see what you guys mean about the posts be attributed to the wrong person. I am being quoted as saying something Imaldo quoted. I am so sorry some of you think I am just the wrost thing to come to nursing since the cap but I am only being honest. Please consider this. Nursing home residents are not as fragile or critical as hospital pt. as a rule. I have had to learn what is really important and what isn't if I want to survive in a nursing home.:smiley_ab :smiley_ab

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Specializes in nursing homes, home health..
LAWD, this is the kind of post that makes me wonder what the Texas BON was thinking when they passed out nursing licenses. Sure about 70% of the meds in LTC could be cut out ... but unless you have MD or DO behind your name , you dont decide what the resident takes. We are not speaking of ABT's here either, so I dont even know where that came from. Just because you havent had a problem in past does not mean your practice is safe ..it means your lucky. I guarentee that if you do have a problem because of your incompetent practices the Texas BON will not accept that the residents dont need all that junk anyway or I have to get the pills out and dont have time to take the BP's. I cant believe you have made it this far without a problem either...This is the kind of stuff that gives LVN's a bad rap....:banghead:[/ ABT is a pill and we are talking about pills so that is where that came from. For the record I understand your concern. And for the record I have no intention of ever telling the BON or anyone else what I sometimes have to do in the name of time and making sure the nursing home makes lots of money. I am being fesicious here since I of course couldn't care less if I make the nursing home owners richer.
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Specializes in community health, LTC, SNF, Tele-Health.

I'm at a loss. I work so hard to make sure that the needs of ALL my patients are met every shift I work. You don't get to pick and choose what is the most important. If you have a problem with certain meds or assessments or whatever then get on the horn and get it changed or d/c'd. You can't just not do it. I can't believe that I even have to say that. And by the way Goingnuts, I do think you are the worst thing to come into nursing since caps, but you said it I didn't. And just for your information, some nursing home patients can be very acute. Maybe some nursing home patients are of a hardier stock, they've been through alot, but does that mean that they should get half-assed care? I'd hate to have you standing over my bed with 100 of atenolol and you debating whether or not to check my pulse and BP. You're asking for a lawsuit.

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