Survey: Which Med Administrations must be done by RN & which can be delegated?

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    From : 2001 Online Journal of Issues in Nursing
    Article published September 28, 2001
    Greer Glazer RN, CNP, PhD, FAAN
    Legislative Editor

    Summary: medication administration is one of the most highly contested tasks delegated by registered nurses to others. Readers are encouraged to complete this brief survey asking about which nursing interventions must be performed by an RN versus those that can be safely delegated.

    A myriad of potential legislative solutions to the nursing shortage have been proposed including increasing the number of new registered nurses by increasing funding for nursing education programs and nursing students, as well as increasing the numbers of employed registered nurses by addressing critical workplace issues such as mandatory overtime and registered nurse-client ratios. Whereas legislators, registered nurses and the public are interested in the long term solutions to the nursing shortage, their main concern is how to deal effectively with the nursing shortage NOW.

    One quick (though not recommended) way to remedy the situation would be to expand the practice of others to perform treatments currently performed by registered nurses.

    Medication administration is one of the most highly contested tasks delegated by registered nurses to others. However, there is no consensus within the nursing profession (or elsewhere) about which nursing interventions related to the administration of medication and blood products must be performed by an RN and which interventions can be safely delegated (see "What makes something a nursing activity or task" for related information).

    Please be part of an exciting effort to bring some clarity to this critical issue by filling out the Nursing Interventions Survey. It will take approximately 10 minutes. Results will be shared with readers in a subsequent issue of OJIN. Simply click on Nursing Interventions Survey to proceed.

    Greer Glazer, PhD, RN, FAAN
    Director, Parent Child Nursing
    College of Nursing
    Kent State University
    Kent, OH 44202
    Email Address:
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  3. by   P_RN
    VERY interesting. I have noticed that whenever a task is "removed" to another department that department tends to construe VERY narrowly what they are to do.

    For example, Xray and PT have transporters, where formerly some nurses/tech had to do the transport to the department.

    Well, the transporters did EXACTLY that, push stretchers and wheelchairs. They refused to lift, carry IV bags, push IV pumps. They would not help someone to the bathroom before they transported. Frankly sometimes I wanted to tear my hair (or theirs out.)

    I worry that med administration being delegated would become that same thing. I do not mean to disparage med techs.

    I know there are many dedicated ones, but I can just see "I can't answer the light, telephone,questions, I HAVE TO GIVE MY PILLS. And we all know work expands to the fill the time allocated.
  4. by   hoolahan
    Frankly, in my opinion, no one who cannot answer a pt's questions about meds actions, indications, side effects and adverse effects should be giving meds, and No one who cannot do instruction about meds or interpret their effects, like po coumadin for example, has any business touching them. Bubble pack or no, med tech do not have the knowledge base to distinguish which med is which or which one may be causing the adverse reaction.

    No No NO! I am going to fill out the survey right now...
  5. by   P_RN
    One more thought. WHERE IS THE LPN in this?

    It seems to leave the LPN totally out of the equation. There are many of those scenarios that can be performed quite well by the LPN.

    THAT is where the delegation should stop. I have written the author of the study for clarification.
  6. by   hoolahan
    If you are talking about the survey P_RN, it did only have "RN" in the question. I agree the LPN can give many of those meds, but for those I answered it was never necessary for only an RN to give the meds.

    I did stick with RN to always give a transfusion, but I would love to have LPN's do that, just b/c it's a PIA. I stayed with RN however, only b/c I don't think it is fair to have LPN's have to do things and not be compensated at the same rate, so the increased responsibility should fall to the RN, if only for that fairness of pay.
  7. by   nilepoc
    Man there are routes in that survey that I am not comfortable with using, let alone delegating them out to others. Nursing is fractionalized enough as it is. Locally nurses are loosing much of their practice and left being high payed techs. Examples include.......

    A local hospital has RT do CO numbers on all the swans in house.

    Baloon pumps in the same institution are run by RT.

    RT alone takes many aspects of nursing away, at least in the ICU.

    PT has removed many of the interventions nurses used to perform.

    Another thing to note, is that these professions while being highly trained specialties, make equal or better money, for assuming a fraction of the responsibility of a nurse.

    So would medication administration become another highly payed specialist area?

    I am definately not for any further fractionalization of the nurse role.

    Besides, I am tired of the skilled aspects of our jobs being taken away. Why not find ways to decrease the meanial tasks. Why is it we couldn't dictate our nurses notes. That alone would save so much time.

    I emphatically vote no to these and other changes occuring in nursing.
  8. by   frustratedRN
    thank you nrskearn for the link
  9. by   pts1st
    I must agreee with others that the nursing role is over-fractionalized. This type of thing is one of the reasons our profession lacks the proper respect due it!

    I had a group home aide tell me last week that her management was going to let them give meds. I tactfully suggested that it was important to know side effects, etc. She said, "I can look up side effects, no big deal! Why shouldn't we give meds?" I felt a chill; I guess all those years of nursing school weren't necessary?!!!

    Ditto to relieving us of tons of paperwork and other time-consuming tasks so that we can devote our time to true nursing. How many more nursing responsibilities are we going to allow others to take over for us? We've fought hard to be recognized as a profession; why are we throwing all of that away?
  10. by   P_RN
    I wrote the study coordinator about why only the RN was specified.

    She wrote back:

    the purpose of this survey was only the rn. another legitimate survey would include lpns too. thanks for your comment. greer glazer