Medication Nurse Assistants

vettesweet · Oct 23, 2005

I worked as a Certified Medication Assistant in a nursing home prior to becoming a Registered Nurse. What I know now is that I knew just enough about medications to make me dangerous. Granted, it was mandatory that a Licensed professional nurse was to give the first dose of any medicine. Then the big thing was to pass meds to masses of people at mealtime and at bedtime. The real kicker was that we were paid a whole quarter an hour more than the CNA's, and frequently had to do both jobs. I think back to the days of doing that and how we went about it, and it scares me to death. Needless to say, I work in a hospital now, and we do not employ CMA's, Thank god.

jtfreel · Oct 23, 2005

I personally find this topic disturbing and wonder where the state Boards of Nursing are or what they are thinking. In Virginia, an acute care medical center was allowed by the Board to use medication technicians to administer everything but IV push drugs. In some instances, these medication techs worked between floors administering medications on 2 separate units.

Though the practice has been stopped, it was extremely concerning that the Board of Nursign approved this practice for individuals with no license who had received minimal training. My husband was hospitalized and I recognized our bank teller as his 'medication nurse.'

DF-LPN · Oct 23, 2005

I've never heard of MNA's before.

When I was shift supervisor at a LTC facility we had an assisted living unit that was staffed with cenas with some training passing medication, the theroy was that these resident could give themselves their own meds but prefered to keep meds at nurses desk instead of in a locked drawer in their rooms. I knew the cenas were working under my license and did not have a problem with that. They received their med training at our facility by our DON, whom I had complete faith in. But assisted living operates under diff guide lines.

When I first started as a nurse there were a few nights (11-7) when I was the only nurse for 2 floors, 121 pts. I had several NA's (is this dating myself? :rolleyes: ) who could pass meds. They would give out any prns that pts asked for, that included T3's, Vic, and DCN (weren't locked up then

:nono: ) and I would do the scheduled med passes. Then it was changed

slightly to the NA's would give the prns but not sign them out, the nurse would have to and we all said NO!!!! We trusted our aides but were not willing to sign for something we didn't do.

Today, I have a hard time time seeing a facility put itself at that kind of risk by hiring these MNA's. I know that I have worked to hard and to long to allow some non licensed staff member to put my license at risk. It's one thing for me to do that, because we all know that the best person to protect our license is ourselfs. Bottom line is that I would refuse to allow a nonlicensed person to pass meds under me. Hell, the state of MI doesn't even issue temp licenses to new grads like they did when I was a new grad. I beleive most facilities won't even hire new grads until they are licensed, I could be wrong though :smackingf

spacy · Oct 23, 2005

I cannot believe that the MNA is practicing under the RN's license. I also live in the state of Illinois, so this will not affect me personally. It still is wrong though. We as nurses give up a lot of our lives to learn about medication reactions, checks and balances for medication distribution, and learn how to assess the patient's current condition. This is a sad day for nursing.

mstigerlily · Oct 24, 2005

Really? All through nursing school we passed meds without our instructors on the floors, in particular the last few semesters. She was in the hospital but not necessarily on the floor with us as sometimes we were split between floors (we would rotate - 3 students to cardiac, 3 students to med-surg, etc) This is done in all schools around here as far as I know.

Also, during our preceptorship we did 120 hrs (10 12 hr shifts) at the hospital. With 10 of it, it would be impossible for the instructor to be there whenever we were. She would have to be there 24 hrs a day, 7 days a week as we worked all days/shifts.

I'm pretty sure that would be against the state laws.

DusktilDawn · Oct 25, 2005

I've never heard of MNA's before.
When I was shift supervisor at a LTC facility we had an assisted living unit that was staffed with cenas with some training passing medication, the theroy was that these resident could give themselves their own meds but prefered to keep meds at nurses desk instead of in a locked drawer in their rooms. I knew the cenas were working under my license and did not have a problem with that. They received their med training at our facility by our DON, whom I had complete faith in. But assisted living operates under diff guide lines.
When I first started as a nurse there were a few nights (11-7) when I was the only nurse for 2 floors, 121 pts. I had several NA's (is this dating myself? ) who could pass meds. They would give out any prns that pts asked for, that included T3's, Vic, and DCN (weren't locked up then
) and I would do the scheduled med passes. Then it was changed
slightly to the NA's would give the prns but not sign them out, the nurse would have to and we all said NO!!!! We trusted our aides but were not willing to sign for something we didn't do.
Today, I have a hard time time seeing a facility put itself at that kind of risk by hiring these MNA's. I know that I have worked to hard and to long to allow some non licensed staff member to put my license at risk. It's one thing for me to do that, because we all know that the best person to protect our license is ourselfs. Bottom line is that I would refuse to allow a nonlicensed person to pass meds under me. Hell, the state of MI doesn't even issue temp licenses to new grads like they did when I was a new grad. I beleive most facilities won't even hire new grads until they are licensed, I could be wrong though :smackingf

Late 2003 (November/December) the state of MI stopped issueing temporary licenses, even to Canadian nurses (who were licensed in Canada). They will still hire new grads without a license, however if they fail their NCLEX they will be let go. I believe they are considered "Nurse Externs" and until they have their permanent license work with another RN.

What really bothers me about MNAs is that with all the standards of practice that RNs/LPNs have to adhere to in regards to all aspects of our job, a UAP can be "trained" so that certain tasks can be "delegated" to "ease our burden."

First off what say does any nurse have in regards to training at their facility concerning UAPs.

Second we are not actually delegating what they do since they have a job description that outlines what they do, however what they do falls under "delegation" in regards to nursing practice so therefore we are responsible. If your working with a UAP who is not doing their job or doing it correctly, as a nurse you are ultimately responsible.

Thirdly how does it ease my burden if I have to ensure that UAPs are doing their job? If I cannot count on the UAPs I work with to: report abnormal VS or chemsticks; label labs properly; record all I's & O's properly; turn, position, change/clean the patients that need to be every 2 hours; etc how does this "ease my burden," if anything it increases it and my frustration level.

It's wonderful when you have support staff that take pride in their work, do a wonderful job, are conscientious, and work with you as a team member. However it is not always the case, and when it isn't the stress and tension in the work environment is increased tenfold.

The majority of the UAPs on the unit I work on, I cannot count on or trust to do their job. The thought that any of these people could be trained to pass medications is frightening.

I do apologize to any CNAs who may find this post offensive, because yes I have worked with many (often floated to our unit) that are professional, conscientious, and a pleasure to work with. Bear in mind that my post is based on the experience I have encountered on the unit I'm on.

Marie_LPN, RN, LPN, RN · Oct 25, 2005

Thirdly how does it ease my burden if I have to ensure that UAPs are doing their job?

I know. That's why i'll refuse to work any place that employs them.

BobbieRN53 · Oct 26, 2005

question...do these MNA's work on your liscence? Our instructors told us that PCAs or CNA's are essentially working on your lisence and you are ultimately responsible if something were to happen to your pt. while they were providing care...I am wondering is it the same for these MNA's? If so, I definetly wouldn't be comfortable with that....

Yes anyone working under you works under your license if you are connected with the patient at all. Same way for us in the Operating Room, the techs and the surgical assistants work under our license and try to run the room.

moonstruk2000 · Oct 27, 2005

Hi everyone. I just found out that an MNA will be working on our 50 bed LTC unit:eek: ! Has anyone worked with an MNA? I'm a new LPN, just got used to passing meds to 25 pts, and am really on the fence about this. On one hand, I'm disgusted that I spent 13 G's obtaining my LPN, and struggled through a tough Pharmacology course :angryfire . On the other, maybe this will be a help. I really like working alone on my side. I keep people(LNAs, residents, visitors) around my cart at a mininum, cause I find it distracting. Am I going to be constantly bumping into the MNA? How does it work? BTW, there has been NO mention of an orientation for the nurses in regards to this. Oh, and the MNA will be earning 3 dollars an hour more than I do. Hmmm. any feedback will be welcome:) .

I did not know how common it is for unlicensed staff to administer medications until I read this discussion. At my place of employment here in Florida, you can give injections, assist with procedures, administer medications, remove staples, stiches, and catheters, the list goes on, had I known that I didn't even need to graduate high school to work as an LPN or even call myself a Nurse, I would have not went into debt with student loans to become a nurse, not to mention get paid the same amount. I will tell you one thing I will not have any medical procedures done at any facility here in Florida, I would rather drive somewhere that has stricter laws restricting uneducated staff doing a nurses' job.

michelle-reggie · Oct 28, 2005

question...do these MNA's work on your liscence? Our instructors told us that PCAs or CNA's are essentially working on your lisence and you are ultimately responsible if something were to happen to your pt. while they were providing care...I am wondering is it the same for these MNA's? If so, I definetly wouldn't be comfortable with that....

Hi!!! I am currently a LPN\LVN at a nursing home and I have certified medication aides working under me. I am on the other hand very pleased to have this person working with me. It takes a load of off my back on all the work I have to do. Our facility disciplines the medication aide if they cause a mistake though. Yes they do work under our liscence and we are responsible for them, but they too can lose their certification if a mistake is determined harmful to the patient. I am for it and pray to God they do not take them away from me!!!!!!

sbic56, BSN, RN · Oct 28, 2005

I see a bit of paranoia and a bit of elitism here about the med tech issue. Nurses are not losing their licenses because med techs make mistakes. Med techs have been used sucessfully for decades, so why all the uproar now? The sky is not falling, Chicken Little. How many of those who are so turned off by the thought have even really experienced bad situations? Not many, I am sure. And why is it that nurses think only they can do every aspect of their jobs? What if doctors felt that because of our two or four year degrees, they couldn't trust us to give competent care? (Well, some do think that way, but you catch my drift.)

Tweety, BSN, RN · Oct 28, 2005

I'm not elistist or paranoid, nor concerned about my license, and I realize that we are talking tasks here, not assessments. But I when I read things like "here in Florida, you can give injections, assist with procedures, administer medications, remove staples, stiches, and catheters, the list goes on........", I begin to think of the old song "times they are a-changing". :)