Letting CNA pass your meds, bad idea? - page 17

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

  1. by   pagandeva2000
    Quote from Loca
    I 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.....
    I am an LPN, and yes, we do not assess. But, I am curious...if the LPN has her own license, how can it ultimately be that she is working under your license...is it because she reports to you? I'm not asking this to be sarcastic, I'm just clarifying for myself. I was really under the impression that if the LPN makes a mistake, then, it is her license that will be left hanging in the wind. If you respond, that would be a great help to me for the future in regards to how I conduct myself. I don't want to be considered as a high risk employee to any supervisor. I do understand your dilemma, though...and would be "nosey and controlling" as well if they will be dragging me over the carpet and gaining rug burns all the way.
  2. by   Tanningtulip
    I would agree that you are working under your own license. I was an LVN for years;however if a task is delegated to you by the RN then it is under hers.
  3. by   Tanningtulip
    Being an LVN was very beneficial to me because I know my medications really well, and I can relate alot better to the LVN's that I work with. They are a very important part of the team and highly utilized here in CA.
  4. by   txspadequeenRN
    Only if that task is out of the scope of the LVN.....

    Quote from Tanningtulip
    I would agree that you are working under your own license. I was an LVN for years;however if a task is delegated to you by the RN then it is under hers.
  5. by   kelticwoman
    I would not do this. As the nurse, I am responsible for for giving the correct medication with the correct dose per correct route of administration to the right patient at the right time.
  6. by   ShimmyMeli
    Are you freaking kidding???!!!! Im only a first year nursing student and I know this is a very VERY BAD idea..they teach us being responsible for everything from drawing up the meds the checks ,to checking that the PT. swallows it! etc...
  7. by   MurseNeutron
    cna's dont have the training for passing meds. i recall having to remember an ungodly amount of meds and study for a few years to pass meds. how long does it take to get a cna license? thats your rear end on the line my man...

    i have had cna's i wouldn't let pass a mv tab, much less considering colace.
    i hoped to goodness your not letting them pass blood pressure medication thats down right scary. <---- ludacris

    figure this. you hand a cna 100mg of lopressor. he or she walks in the room. say they even take the bp it ends up 100/60 c a heart rate of 60. would he or she give it. hell yeah!
    Last edit by MurseNeutron on Nov 21, '06
  8. by   MurseNeutron
    sorry i accidentally posted twice. i have to run and dont know how to cancel it so read this and feel time wasting away, sorry.
    Last edit by MurseNeutron on Nov 21, '06
  9. by   RschNurse
    Helllllllloooooooo?! Have you taken out anybody's appendix yet? Just wondering how far this job-swap idea has taken you.
    Are you lending the CNA your license and name tag too when she passes out the meds?
  10. by   rlk146787
    No, I would not administer medications drawn up by someone else!
  11. by   pagandeva2000
    Quote from Tanningtulip
    I would agree that you are working under your own license. I was an LVN for years;however if a task is delegated to you by the RN then it is under hers.
    Just curious...how so? I mean, the RN is delegating a task that another licensed person can do under state law and facility protocol. It may be a lesser license, however, I would think that if the task is delegated, and the LPN does not follow protocol, then, it is HER/HIS license in jeopardy, I would think...I thought that it would fall under the RN if she didn't respond appropiately. I know that we work under the direction of the RN, that is clear to me, but somehow I was under the impression that we take our own weight if the chips fell down, since there are some things that are just common 'nurse-sense'.
  12. by   pagandeva2000
    Quote from txspadequeen921
    Only if that task is out of the scope of the LVN.....
    That was my impression...and then, the LPN would still be held liable, because we are taught in school NOT to act out of our scope of practice.
  13. by   RschNurse
    To Walla, 189...didn't realize this was a test....that is, hypothetical.
    However, to address your essay - "the first and foremost problem" is a patient safety issue, not a liability issue. Someone may have already mentioned this. It is always first and foremost a patient safety issue. And just 'cause I'm cranky about being blindsided - how did you come up with such a lame question with such an obvious answer for an essay?