pct debate

Nurses General Nursing

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Has anyone heard of PCT *patient care technicians* ?

PCT 1 is a CNA

PCT 2 can do blood sugars, catheters, etc

PCT 3 can start iv's etc

I live near Chattanooga and I work as a PCT..in another thread this was a debate with everyone saying that I was lying and this was not the case. Asking why have LPN's..I understand this but we get paid less then LPN's and go to school a shorter amount of time but we are there *that's the point* Everyone may not agree with the fact that we can do so much but we have been trained to do this. Also if your trained you can pass out meds..I just want to know what everyone thinks and do you have pct's where you work.

Originally posted by MishlB

You know what...that isn't even the point. CNA's should not be passing meds.

Oh, I totally agree! But, at this point, I don't think anyone really knows what she is or what she does. However, we do all know where she works...:rolleyes:

Personally, I wouldn't want an unlicensed and obviously untrained (or poorly) person "helping" me out by passing drugs they have no clue about.

Well, at least you know where NOT to get a job....;)

WELL IF YOUR EVER IN THE CHATTANOOGA AREA AND YOU NEED MEDICAL ATTENTION THEN YOU WILL BE SURPRISED THAT THE LEADING HOSPITAL IN THAT AREA ALSO ALLOWS PCT'S TO DO ALL OF THIS. YOU MAY HAVE A HOSPITAL IN YOUR AREA THAT ALLOWS THIS.

Specializes in Everything except surgery.
Originally posted by caroladybelle

Thank You Brownie!!!!!!!

You're very welcome caroladybelle..:)!.

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.
Originally posted by Brownms46

First this was a discussion about unlicensed or PCT/CNAs.

Second here is an statement taken from the Florida Nurse Practice Act:

Now in my view if you made the decision to delegate a task to a PCT, and that PCT performed that task wrong, you're responsible for your decision to delegate that task to that PCT.

Also in one of the links I provided it said this:

Can the task be performed improperly without life-threatening consequences? No -> Do not delegate

Are the results of the task reasonably predictable? No -> Do not delegate

Now in order for the task to be reasonably predictable, you would have to know that there was no way for the resident to fall and break a hip...if you decided to leave the room.

Is appropriate supervision available? No -> Do not delegate

Can the task be performed improperly without life-threatening consequences? No -> Do not delegate

The above is from the Washington BON

The following is from Mass BON:

Generally, appropriate activities for consideration in delegation decision-making include those:

which frequently recur in the daily care of a patient or group of patients

which recognize that UAP do not have a knowledge base upon which to make nursing judgments;

which do not require complex or multi-dimensional application of the nursing process by a licensed nurse;

for which the results are predictable and the potential risk is minimal; and

which utilize a standard and unchanging procedure.

http://www.state.ma.us/reg/boards/rn/advrul/ruldelg.htm

The following is taken from MA. BON

Responsibilities and Functions - Registered Nurse

A registered nurse shall bear full and ultimate responsibility for the quality of nursing care she/he provides to individuals and groups. Included in such responsibility is health maintenance, teaching, counseling, collaborative planning and restoration of optimal functioning and comfort or for the dignified death of those they serve. A registered nurse, within the parameters of his/her generic and continuing education and experience, may delegate nursing activities to the registered nurses and/or health care personnel, provided, that the delegating registered nurse shall bear full and ultimate responsibility for:

(1) making an appropriate assignment;

(2) properly and adequately teaching, directing and supervising the delegatee; and

(3) the outcomes of that delegation.

the delegating licensed practical nurse shall bear full responsibility for:

(1) making an appropriate assignment,

(2) adequately teaching, directing and supervising the delegatee(s), and

(3) the outcome of that delegation:

Now I was attempting to answer the question posted. From what I read, it seemed to say that the licensed nurse is held accountable for the decision she/he makes. In other words, if you don't feel comfortable delegating a task to an unlicensed person..don't.

Brownie that is excellent information. (Sorry for getting off topic with the LPN thing, as RN the delegation question is the same LPN or PCT for myself.)

What if I do feel comfortable delagating the task. What if every answer to the questions is "yes" and I delegate the task (i.e. bedbath) to a patient of mine and there is a bad outcome. What then? Whose responsible, me? I guess with #3 it's clear, I am responsible for the accident.

When you think about there is a risk with just about every patient. Most all patients I work with are fall risks. What if I ask a PCT to walk a patient to the bathroom and the patient falls and breaks a hip? Am I liable because I knew the patient was a fall risk? Or am I not liable because part of the PCTs training and licensing by the state includes how to ambulate a patient? If in my assessment it was safe for one person to ambulate the patient (i.e. this has been done previously with no fall). Say, if it is reviewed by peers in a court and the delagation was deemed appropriate am I still liable just because the PCT had an accident?

Just babbling again. Thanks for the information.

It is my understanding that if the pt were to fall and break a hip in the presence of a PCT/CNA, they are responsible (if licensed). If not, it's the RN's butt. If a lawsuit were filed, the RN would most likely be named, I'm sure.

lpnga and I had a wonderful conversation via PM, and she said that they get certificates to pass meds. Now, a certificate isn't a license. I advised her to not do anything that could put her future in jeopardy.

Does anyone know of hospitals that allow this? We have a nursing home that does, but they are nursing students and Certified Med Techs. We don't have any at our hospital. I would be wary of someone with a "certificate" passing my meds for me.

Specializes in Everything except surgery.

Thank you an you're very welcome 3rdshiftGuy..:)! If you answer all the questions with a yes, than you are "supposed" to be able to delegate. But no matter what happens...you are still utimately responsible for that delegated task, and the outcome. Not a answer that sits very well with me, but that is what I have consistently read from all the boards I have looked at.

See the problem is that PCTs, CNA, and HHAs, although they are certified, they are still unlicensed personnel. I know doesn't make sense right. Being held responsible for someone else's mistakes or for a fluke.

The governing bodies of each state, decide on how much education/training is needed to say that this person should be able to safely perform the tasks described in their job description. But if you delegate a task to that person, and the same person performs the task incorrectly...you get the blame. Yes.... Yes I do beleive that same person would be disciplined by the board that has authority over them, but so would you.

I guess the only recourse anyone would have in this case, if the PCT/CNA performed the task in a manner inconsistent with their usual way of doing things.

Let's just say...that the CNA/PCT..was having a bad day...and this is an unusual thing for them to let this get in the way of how they perform their duties. But one day...they do something totally out of character for them. Well in that case I couldn't see how you could have known they were about to go off, and therefore couldn't have bought their unusual behavior into your decision making process. Did that make sense??

All in all I guess you really need to know who you're delegating to, what they're weakness/strengths are, what acutal training they have, and you really have to trust them.

Case in point. I had a CNA give me the results of a Blood sugar. Well before giving the insulin to that pt. I went back to check her "brains"(cheat sheet). I found out the blood sugar reading she gave me was written down for another pt in the same room!

Well on a fast paced tele unit, and working shorthanded I could understand how this could have happened. BUUUUT I no longer trusted her to do my blood sugars. Even though I always tell the pt. what the amount of their blood sugar reading is, and the amount of insulin I planning to give them, there is also going to be that pt. who couldn't remember or didn't bother to find out what their blood sugar was, and even be aware of what the dosage for the reading would be.

Yes I wrote up an incident report. This allowed me to have authority over who was assigned to do the blood sugars for my pts., without me as a traveler looking bad for making waves. Everyone understood the problem, and didn't blame me a bit. And the CNA also understood how this incident placed a shadow over my confidence in her. She never acted like she held a grudge about it. I just was very glad I tend to check and re-check things to be totally sure of what is what.

Specializes in Everything except surgery.
lpnga and I had a wonderful conversation via PM, and she said that they get certificates to pass meds. Now, a certificate isn't a license. I advised her to not do anything that could put her future in jeopardy.
by emily_mom

:D :cool:

Does anyone know of hospitals that allow this? We have a nursing home that does, but they are nursing students and Certified Med Techs. We don't have any at our hospital. I would be wary of someone with a "certificate" passing my meds for me.

They are certified to pass meds and you called them Certified Med Techs. Is it just me or isn't that the same thing I am doing? We just have a different name.

Theres some crazy crap out here in CA.

I have seen DD homes with warm bodies passing meds to pts without the ability to speak or move or otherwise stick up for themselves! (THE PTS,not the staff)! And the owners of this private enterprise making some fabulous dough! It didn't behoove them to put pt. care first.

We also have psychiatric technichians who are schooled for about a year in meds and other psych related phenom. This creature evolved from a need for skilled workers in the locked state run facilities, both psych and DD.

I have meet plenty of good techs but lots of doozies too.

As with any other discipline.

Techs are not taught to give IM's Can basicaly do everything else an LVN can do- They are licensed , but that license is not recognised in many states.

I feel some of the woes we have in nursing are due to lack of federal guidelines or standards.

Originally posted by lpnga

Does anyone know of hospitals that allow this? We have a nursing home that does, but they are nursing students and Certified Med Techs. We don't have any at our hospital. I would be wary of someone with a "certificate" passing my meds for me.

They are certified to pass meds and you called them Certified Med Techs. Is it just me or isn't that the same thing I am doing? We just have a different name.

While they attend a class (at our school anyway), I don't believe they are licensed (just a certificate). Just as you can be a Pharmacy Tech by taking a class via mail. So basically, you're right in that respect that they probably don't have a license either.

I pass meds as a Nurse Tech/Student Nurse Intern, and I work under my RN's license. However, I have been educated to a greater extent and am a senior student. I will graduate May 6.

You'll have all the time in the world when you're done with nursing school to pass drugs...:D Let someone else do it for now. As I said before, you don't want to put yourself in a dangerous situation that could compromise your future license or the RN's you are assigned to.

Kristy

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.
Originally posted by lpnga

Does anyone know of hospitals that allow this? We have a nursing home that does, but they are nursing students and Certified Med Techs. We don't have any at our hospital. I would be wary of someone with a "certificate" passing my meds for me.

They are certified to pass meds and you called them Certified Med Techs. Is it just me or isn't that the same thing I am doing? We just have a different name.

There are no hospitals here that use them either. But in group home settings, such as a group home for the mentally challenged there are med techs that are not licensed that pass meds.

I'm not sure how I feel about. For instance if a patient is sent home on meds, and her husband is giving the meds. You give him a teaching sheet, but he doesn't understand the pharmacokenetics (sp?) or even know what her vital signs are, yet gives the meds as prescribed. I can see how in a nonacute care setting, such as a group home (not a nursing home) that this might be allright.

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

Thanks again Brownms46, that really sux. Surely in every case the RN would be brought in. But I don't see how if the process of delagation was legally followed how a court would hold her/him liable. But I see what your saying.

Now off topic again. LPN makes a med error. Whose responsible? Are they for their own, or since in Florida all patients are under "RN level of care" (in hospital settings) is the RN in trouble too?

Makes me want to give up charge, give up using pcts and go back to total care nursing. Because there's always that vague part of the practice: "risk". If I'm going to hang myself, let it be me who does it. LOL

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