Letting CNA pass your meds, bad idea? - page 16
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... Read More
Nov 12, '06[QUOTE=lmaldo]Quote from goingnutsworked acute care - not what i went in for- i wish to get to know my residents and families and acute care does not afford the closeness with the stays being so short for the most part. i enjoy my LTC and will cont to do it - being needed not only by my residents but by the docs and everyone else who isnt there to assess my residents - aqnd leave the acute care to others.,
You are so right! We are very fortunate to have the equipment in the hospitals, as well as the access to doctors and specialists. That is actually one of the main reasons I chose hospital care, as opposed to Nursing Homes. I have to admit that under your situation, your environment forces you to defend your license to the point it does come first.
With the shortage of nurses today, it might be worth it for you to perhaps explore acute care - that way you can be a nurse for the original reason you probably became one. It is well worth it!
Nov 12, '06I would never let someone give meds that I was responsible for. Doesnt matter if they ar Rn, CNA or the Janitor. Your name is on that order. If anything goes down you will go with it.
Nov 12, '06Quote from txspadequeen921sorry but any LTC facility has policies on this - it is not required as in a hospital to be doing full assessemnts on everyone every day - in my opinon makes LTC nurses needing experience so much more important than in hopsital because we need to be able to "see" things noone else may notice on our residents and in experience i also mean long term employment ( i personally belive as does my facility that no agency belongs in LTC because they dont KNOW the residnets) we dont have docs and RT and labtechs etc to call up if in doubt -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 arse and getting by anyway you can , doing the min.
i will tell you there are some nurses who dont give a rats arse about the residents but the meajority that have remained in LTC do very much CARE about thier residents and thats why they are still there protecting thier residents from the wonders that do come in.................we dont do the minimum we can and most of all we are often doing much more than required of us -
Nov 12, '06Quote from goingnutshey - i think the hat shoud be brought back :spin: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
Nov 12, '06Quote from txspadequeen921[/QUOTE]Big Mouth.... LOL so what??? You know there is post after post on here about LVN's and how they are not qualified to do this job or that job... So much talk about replacing us with RN's because we are not competent in practice and our patients are at risk cause we dont have the level of training needed to be safe.... I have been arguing and fighting this ever since I have been a member of all-nurses... then here you come a LVN , just out right and upfront about doing wrong and being incompetent..... Who cares if the nursing home makes money.. you should be more concerned with doing justice to your patients. I cant believe you still have a job . Everybody knows ABT's are over RX'd nobody is disputing that .. we are talking about BP meds and the fact you dont find it important enough to take a simple BP.. did you ever think you may have to hold that med. But you never answered my question .Do you lie and just write down a fake BP or do you just leave that little space blank....hummmm
[/:spin: 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 didn't know LVN's had a bad rap. They must also have a big mouth.
there is no space left blank - as i said nursing home policy is once month after the initial 3 days q shift then q week so many times - unless otheriwse specified by an MD - if we did b/ps on every resident that had b/p meds wed be doing nothing but b/ps as 80% if not more have b/p pills. gotta be realistic and have approriate policies to cover your butt - that doesnt mean that we dont notice s/s of a low b/p so check first and then doicument it if needed. gads- id love to see any of the ones saying everyone needs b/ps and assessemnts for everything come work at a LTC facility - they wouldnt go a week without changing thier point of view or leaving if they couldnt...
Nov 12, '06i dont think i responded inappropriatley to any posts but if anyone took offense i do apologize - i meant no direction at anyone personally.
Quote from rn/writerThis thread is about a half a centimeter from being closed because of personal attacks, bad manners, offensive language, and a general lack of respect.
I apologize to those of you who have not participated in the vitriolic exchanges. Unfortunately, there have been so many out-of line posts during my absence (due to computer problems) that I hardly know where to start addressing cautionary comments.
The hostility and rancor need to stop immediately. This is a message board, not a battlefield. Strong feelings are no excuse for insulting other members or belittling their personalities or practices. Disagree all you want, but stay on point. Focus on the subjects being discussed, not the other posters. Ultimately, each of us has to decide how we will conduct ourselves and what we are willing to be accountable for. No amount of cyber-brawling can change that.
I am so proud of many threads on this board. We've had members patiently teach each other about nursing practice and procedure. Some posters started here even before they entered school and stayed with us through trying times as students and new nurses. Now many of them delight in passing their knowledge and encouragement to those behind them on the path.
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That sense of connection is one of the things that makes this board shine.
Because this board is open to the public, anyone who can find the website can drop in and wander around. I hope the threads that show our solidarity (even in disagreement), resilience, wisdom and humor are the one they see first.
I do understand how a controversial subject can get out of hand. Emotion rises, tempers flare, and all of a sudden, otherwise decent people are at each other's throats. An online forum provides the same kind of anonymity that allows normally nice drivers to erupt in road rage. Sometimes with great regret.
I'd like to think there may be some regret floating around right now, or, at the very least, upon rereading the back end of this thread.
I'm going to confer with the other moderators to see what action(s) should take place regarding this thread and violations of the Terms of Service. In the meantime, if any of you feel you may have spoken rashly or with undue intensity, now might be a very good time to consider how best to set things right.
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Nov 12, '06Quote from pagandeva2000i so totally agree - dont recall there being a board for cnas ( then that ws 24 yrs ago i was one haha) but i agree thier shoudl be somewhere they are held accountable- i have seen nurses fired for not assessing a resident approriately after a fall even though the cnas had already PICKED that resident UP and sat them in a chjair!!!! unbelieveable- cna by the way still working there- tsk tsk - we really dont get paid for the responsinbility we have - at lest in our area.What practice do you think that they have had? I agree with some of the other posters...if the CNA/CMA are totally held liable, accountable and responsible for any possible error, then, fine, but, as another poster mentioned, the nurse working at Burger King was not present when this occured, yet, she lost all that she worked really hard for, and that is plain WRONG.
I always felt that the CNA should bear more responsibility with their certification than they actually are. If a CNA lifts a patient the wrong way, and breaks a limb, they are counseled, the nurse may have a real problem. I think that the CNA should have to face their 'board of CNA" (if there is any) the same way that a nurse should have to. This way, they may think twice about glossing over any mistakes in care. I was a certified AMAP, and I made mistakes during that time (over 20 years ago), and, I was not responsible enough to care what happened, either...because I wasn't licensed. Now, I see that this is a mistake. Unless the CNA, whether they are trained to pour meds or not is to take the full brunt of the error, then, they really shouldn't.
Nov 12, '06I got in trouble several times as an aide because I refused to pas a med for a nurse. Nurses would crush a med and if I was feeding a pt she would mix it on the tray with the dessert. I was taught as an aide that if that happened I was not to touch that tray anymore because medications was on it. But the nurses would get upset because they "didnt have time for this." As a nurse now I will put applesauce or something in the med cup and then give it to the pt myself this way the CNA can carry on with their duties without me interfering or causing legal issues.
Nov 15, '06Quote from twotrees2I heard that if the issue is really pushed enough, it can happen, but usually it doesn't, and I have not heard of any board of CNAs, so to speak. The unfortunate thing about this is that the nurses are overworked, and are juggling to do all that they can, making this very tempting for any overwhelmed person to do. And, if a nurse that has been working at a facility for many years suddenly has to contend with certified aides, and being responsible for their errors is a sad thing, because she may have invested too much time to just leave.i so totally agree - dont recall there being a board for cnas ( then that ws 24 yrs ago i was one haha) but i agree thier shoudl be somewhere they are held accountable- i have seen nurses fired for not assessing a resident approriately after a fall even though the cnas had already PICKED that resident UP and sat them in a chjair!!!! unbelieveable- cna by the way still working there- tsk tsk - we really dont get paid for the responsinbility we have - at lest in our area.
Nov 17, '06Quote from txspadequeen921I worked in a Nursing Home -- and they had TMA'S -- we were force to work 2 wings one with a nurse passing meds and one with a TMA under our license. I complained and they thought I was Just a pain in the 'butt" The TMA has 60 hours of training and worked under my license in the nursing home.First what kind of facility are we talking about here. Assisted living maybe LTC facilities NO!!!
Nov 17, '06I am an RN working in a nursing home that utilizes Certified Medication Aides. They are to pass po meds to stable residents. PRN medication must be authorized by a nurse and Yes, they do operate under my license, a fact I am highly aware and mindful of. This is a practice that I am uncomfortable with but is a common practice in my state. I recently have been working with a DON consultant on coming up with guidelines for CMA's. Another facility was actually using them for "Charge" and putting them in charge over CNA's. YIKES!!!! This has been a thorn in my flesh where our facility is concerned. I recently had to battle with the DON about keeping CMA's from writing in the Nurses Notes...CAN YOU BELIEVE THAT?!!! I am careful to only delegate to the CMA duties I am comfortable with, I perform assessments at the beginning of each shift and do not delegate the CMA to give po meds to the residents who have a higher acuity. The Nurse Practice Act puts the RN in the very scary postion of having his/her license on the line every time we are at work. We are trained extensively (or at least I was) to delegate appropriately. The LPN's that work my shift are also operating under my license and are not, under the Nurse Practice Act, allowed to do "assessments", so if I was to get too wrapped around the axle ( and I have!) I would have to admit that I get nervous when I read the LPN who says she "assesses" before giving medication. Neither CMA's or LPN's are to "assess", they may report what they "observe". Our CMA's take a one semester course. Our LPN's take a one year program. It all boils down to the fact that as an RN it falls on me. The staff that work under me on my shift think I am too "nosey", and "controlling" and I even heard an LPN say "don't worry so much about what is going on at my station, I will handle my aides".....guess what?! LPN's, CMA's, Aides....it all falls under my license. I love my job--but due to the shortage of nurses we do what we can, my heart breaks at this dilemma.....
Nov 19, '06As a former DON and a Nurse of many years. Always pass your own meds. I am not sure if you are joking but that is a huge no no.