Letting CNA pass your meds, bad idea? - page 4

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   sister--*
    I always rely on MY assessment of the pt. BEFORE administering any medication! If you just hand 'em out to be given by others then where is your assessment? Where is the patient's safety considerations? What about the 5 rights?

    Also I'd never, ever, ever, ever give any medication that I did not set-up myself after check, check, and double check. How in heavens would you know that what someone else set-up is the actual medication indicated? PO liquids, stock bottled meds, syringe contents......

    What a frightening way to practice nursing!!
  2. by   lmaldo
    I was a CNA before being a Master's prepared nurse and even I knew then, without going to nursing school that it was ILLEGAL for me to pass meds. In fact, not only is it illegal, but completely irresponsible and and an incredible liability for any health organization to allow it, in California, anyway. Think about this. Let's say that, hypothetically speaking, it was NOT illegal. Okay, so you are a smart nurse and you know about all the interactions and contraindications for this medication about to be passed. So what. First. If you pass a med to patient, as an RN, you are responsible for watching the patient take the medication. That way, if the patient is dysphagic, you can use critical thinking skills to either crush the med, get orders for a different route, or chokes on the medication, you can be there to correct the situation, contact the doctor, take doctor's orders for treatment (which I might add is also illegal for any CNA to take orders directly from a doctor). If you gave this task to the CNA, (who is not required to be a critical thinker) who became distracted by the other patient in the room who suddenly had emesis and diarrhea and the patient took the meds left at the bedside by the CNA, choked... By the time the CNA got back to the patient, there was a code situation... Ooops, the patient just died. Although the CNA can be held liable, you, the RN, who had the patient under your care, is completely responsible for the entire affair, even though you were not in the room. Next, a complaint is filed with the board of nursing, you lose your license and you are convicted of a felony charge of negligent homicide and all the work you put in to school is gone and perhaps you will never be able to go into healthcare period. Except, I understand as a trustee you can work in the prison infirmary.

    This is just food for thought and not meant as an inflammatory response to a ridiculous question
  3. by   Marie_LPN, RN
    Quote from walla189
    Wow great response, to save some face, I'm a student doing this for a essay so don't string me up just yet...
    You should have specified this in your OP, so people weren't answering to false pretences.
    Last edit by Marie_LPN, RN on Oct 18, '06
  4. by   pagandeva2000
    Quote from walla189
    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?

    I think that it can be a bad idea, but can comprehend why an overwhelmed nurse would be tempted to do so. If you work in a nursing home, and are overwhelmed, it is hard to keep up, but I would be too afraid to do it. The aide has nothing to lose by making a mistake, and with you signing for it, you are ultimately responsible for the outcome.

    When I was a nursing assistant at a nursing home, an LPN asked me to give meds to a patient in a certain room that housed 2 clients; one was oriented x3 and the other was spacy. Being naive, and proud that I was assigned a nursing responsibility, I went in there to give it. Come to find out that I offered it to the lucid one, and she told me that it was NOT hers. I checked her ID band, then, went and told the LPN that I was not giving it. What if it was a drug like Lopressor, and I gave it to a person who already had low blood pressure, and they passed out. Do you think that I would have admitted to that...and it was not my job to begin with? Of course not. What explaination would the aide give? What guarentee would you have to know that it was administered? NONE!!

    I had another situation where the nursing assistant came to me in the clinic I work in and told me that the blood pressure was high. I told her to take a manual, and she told me that it was 200/100. I told the provider, and he told me to give clonidine 0.1 mg. I came to the patient and retook the pressure before I administered it; (got the same reading), and the aide was furious with me, because she felt that I didn't trust her. I administered the medication, because then, I deemed it to be safe to do so. I then explained to the aide, who happened to also be a friend of mine that it would be MY license on the line if I just took her word.

    You really place your license on the line when you give it to someone else, especially a person who does not comprehend what medications are, the risks, and responsibility. Only you can account for yourself.
  5. by   TINKERBELL83
    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.
  6. by   lmaldo
    Sorry, I just thought of another good example why it is a bad idea. It again goes to critical thinking. Let's say you, the RN, have to give atenolol. You know you need to first take a blood pressure. Okay, the CNA could take that for you. Let's say the blood pressure is 85/55. A CNA does not have the responsibility of ASSESSING this patient and making the appropriate decision to hold the med and to continue ASSESSING the patient's blood pressure and other vital signs. If the CNA just went ahead and gave the med, tha patient would be in a hypotensive crisis and end up in ICU, or worse yet, dead. It would still be the RN's responsibility for the outcome and the Nurse Practice Act would not be able to overcome the error committed.

    Food for thought
  7. by   lmaldo
    Well, Tinkerbell, you obviously don't work in California. I hope the meds you pass don't include cardiac medications or narcotics :/
  8. by   angel5
    First of all, the correct term is "personnel" not personal.
  9. by   25(2)+2
    i am a certified med aide and one day i was giving a prn to a resident and a cna took it upon herself to give a resident a scheduled med. i came back and told her i was going to give the gentlemen his midnight med and she said she took care of it. i lost it. told her she is not suppose to be giving meds. she replied that the nurse has had her do it numerous times. i explained that puts our licenses in jeopardy. the other problem with this what if the resident would happen to choke or not swallow the pill. never a good thing to allow anyone to give pills that are your responsibility to pass.
  10. by   pagandeva2000
    Quote from walla189
    Wow great response, to save some face, I'm a student doing this for a essay so don't string me up just yet...
    That changes things, but it would have been better that we knew that in the original post.
  11. by   jthomas47
    In North Carolina, anyone off the street can take an 8 hour course at the Community College, which includes clinical work, pass a state test and give meds to Assisted Living residents, and Nov.1, they can give meds to Skilled residents. They can give Insulin and controlled drugs, but not IM injections or IV meds. HOW IS THAT FOR SCARRY ????
  12. by   hptogram
    To add to this topic I'll share with you what happened to me.

    I work at a ALF and took a med tech class that was provided by the facility. I have pulled and passed pills on the weekends when the CNA who usually does this is off. It was a Thursday morning and I went into my residents room to give her her pills (they were pulled by the CNA). The next day the resident got very angry with me because I gave her the wrong ones. For that reason, I will not pass any med that I did not pull myself. I triple check the MAR and everything just to be sure I'm doing it right. I've also found other mistakes that the CNA has made (for instance, she's signing for pills that I know she isn't passing). In any event, its a bad idea to pass pills that you didn't pull yourself. And always triple check yourself.
  13. by   FutureNurse2005
    well, at my previous job, I took a 3 day training course and was able to pass meds to residents. I never gave an injection though. This was a private facility and this is totally legal. I was considered to be under the supervision of an RN during my shifts. Any mistakes that were made fall onto the RN. We had a 3 strikes and your out policy though...once we got written up 3 times for med errors we could no longer give meds.

    It is not a bad idea, as long as it is done correctly and is a well supervised program. I learned alot from that job and I appreciated the RN's confidence in me.