Unlicensed personnel administering medications

  1. I recently moved to a new state that has very different scope of practice laws than the state where I come from. I was trained as an RN to take my responsibility of administering medications extremely seriously. The five (seven) rights of medication administration and all that; making sure I was aware of indications, contraindications, potential side effects and complications of every single med I ever gave. We learn this stuff in school and I for one have always taken it very seriously.

    My new state allows unlicensed personnel like medical assistants to dispense meds, including injections. I am so uncomfortable with this practice and was wondering if it's common. I know medical assistants go through training and I have to assume that the training is adequate. But I can't believe that the training is truly equivalent to what we go through as nurses to enable us to safely administer medications. It seems like a huge liability issue, not to mention potentially unsafe if the MA is unaware of some medication contraindication or something.

    Thoughts?
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  2. Visit boquiabierta profile page

    About boquiabierta, BSN, RN

    Joined: Apr '16; Posts: 54; Likes: 148

    28 Comments

  3. by   Elfriede
    Hhhmmm ...
    It´s - may be - your assignment to get "civilized rules" in your new state.
    Get organized and take influence on the legislative.
  4. by   VivaLasViejas
    It's very common in LTC and assisted living/memory care to use unlicensed personnel for medication administration. To nobody's surprise, they cost much less than a nurse, but their training is usually very good and I've found most of them to be competent. Of course, the nurse is always responsible for patient/resident care, so it's like a double-edged sword.
  5. by   CharleeFoxtrot
    It's also common in doctor's offices now as they employ more MAs than LPN/RNs due to cost.
  6. by   caliotter3
    If it bothers you that much and relocating is not an option, the only way I see to deal with it "easily", is to insure that you only work in venues that does not employ unlicensed assistive personnel in this role. It may be difficult to find places where the nurse is "it", but I imagine they exist somewhere.
  7. by   boquiabierta
    Quote from caliotter3
    If it bothers you that much and relocating is not an option, the only way I see to deal with it "easily", is to insure that you only work in venues that does not employ unlicensed assistive personnel in this role. It may be difficult to find places where the nurse is "it", but I imagine they exist somewhere.
    I mean, it bothers me right now because I'm so used to something different. But I'm really looking for opinions from other nurses on what they've encountered and if this is something common in different states. I feel like I can probably learn to live with it over time if I can trust that the system is set up to ensure safety.
  8. by   nursel56
    I think you'll find it to be very common in different states, especially in the office or outpatient clinic setting. The regulation of unlicensed assistive personnel is left to each state, so you'll find quite a variety of programs and requirements and associated acronyms to describe them. The common denominator is usually "under direct supervision" by an MD or RN.
  9. by   MunoRN
    While it's not unusual for MA's to be allowed to give medications, I don't know of any states where they are allowed to administer medications, it's important to note those are two very different things.

    The scope of an MA is generally limited to assisting with self administration or assisting with administration by personnel licensed to administer.
  10. by   Pixie.RN
    Paramedics aren't licensed - it's a "only" a certification, and we give a wide variety of meds via a wide variety of routes in the prehospital setting. It is possible to be competent in medication administration without being an RN or LPN, it just takes proper training and competency verification.
  11. by   quiltynurse56
    I the three states I have worked in, there were Certified Medication Aids who administered meds. Depending on facilities and states depended on what they could and could not do. IV meds and injects usually were not allowed.

    I have worked with and without med aids. The busy facilities I welcomed them. The nurses still had a fair number of medications they had to do and it worked out well.
  12. by   GeminiNurse29
    Where I've worked, CMAs can give injections/vaccines but can't do certain ones like depo. I know LTCs also use med techs for meds. They're still under the nurse's license though. And neither are allowed to do IVs.
  13. by   Wuzzie
    Quote from boquiabierta
    I know medical assistants go through training and I have to assume that the training is adequate. But I can't believe that the training is truly equivalent to what we go through as nurses to enable us to safely administer medications. It seems like a huge liability issue, not to mention potentially unsafe if the MA is unaware of some medication contraindication or something.Thoughts?
    But it's more than training than the hundreds of thousands of patients and family members who administer these same meds to themselves and their loved ones every single day.

    I think the big bugaboo is that we feel we are ultimately responsible for what the ancillary staff does, and sometimes we are, so it makes us nervous. I'm sure this new concept is making you understandably anxious. However, in a long term care situation medication assistants seem to be working out rather well and leave the nurses time to do the other 5 million things required of them.
  14. by   boquiabierta
    Quote from MunoRN
    While it's not unusual for MA's to be allowed to give medications, I don't know of any states where they are allowed to administer medications, it's important to note those are two very different things.

    The scope of an MA is generally limited to assisting with self administration or assisting with administration by personnel licensed to administer.
    Can you clarify what you mean by the difference between give and administer? In my state the MAs both give meds (i.e. hand pts oral medications) and administer them (injections).

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