What is your opinion on CNA's being med certified?

[nursedora]

I just read a post by a new Nurse who admitted to making a medication error, and as I was replying to her post I was wondering about something and I'd like to get opinions from others.

In my area, there are several state run facilities for the mentally and physically retarded, either as a large institution or as an ICF house in the community. In thees places, CNA's are medication certified, they go threw a 3 or 4 week crash course on administering medications. I'm not saying CNA's can't do a great job, they can. What I'm concerned with, we as LPN's or RN's have spent a year or longer learning dosage formula's, different names, side effects, differing nursing interventions etc. of medication administration. In addition to this, we have to take continuing education courses. As far as I know, all a CNA has to do is once a year show proficientcy in administering one medication in front of a staff nurse. They are only allowed to administer PO medications, so a licensed Nurse has to be available for IM, SQ, and for feeding tube care, med administration, and so on.

Do other states, counties or area's allow CNA's to administer medications. And what is your opinion on this?

[Dixiedi]

I think it is a very sticky situation.

There have been a few times when I have pulled out a med, or drew up something and stopped myself in my tracks...like wait a minute this cant be right, or hmm his/her stats were this or that let me recheck that BP, or call the Dr. I really don't think CNA's have this. I am not saying they don't have the capability, but not the education. I was a CNA before getting my nursing degree, and there is NO way I could have done this. Looking back, I might have been 100% sure I could handle passing meds and think to myself "im not stupid, I can do that" But it is not about that. It is not the CNA's fault either. They would miss things and not even knew they did.

That's exactlly what I just said. Did I miss something?

[mscsrjhm]

The Department of Mental Health in our state has various ways that they provide for MRDD (mental retardation and developemental disabilities) clients. (1) State owned/run institutions-only nurses give medications

(2) POS (purchase of Service) facilities-contracted to private owners.

POS facilities include: (ISL Independent Supervised Living) or Group Homes.

Basically, Any Party A would buy a large home, equip it for disabilities, contract with the state, hire a consulting Physician, RN, and "Q" (qualified mental retardation specialist), hire staff (CNAs and CMTs), and, after receiving my clients and a 60 day waiting period, begin to make alot of $$$$$.

If any of the clients have gastrostomy tubes, the medication/nutrition administration training is "passed on" from house manager to new employee. Or.... from one CMT to another CMT.

As the homes are to be kept as "homey" as possible, nurses do not stay and administer meds, unless it is a very large facility, or state owned facility.

The rules are different for private providers as compared to state facilities.

Basically, what I am attempting to relay, is that there are millions of persons in the United States being given medication by CMTs with only a few days training.

Having worked MRDD, it is scary. Due to staff not shaking liquid Dilantin, I have witnessed Dilantin levels in the upper 40s, going to 52 at one time.

Another time, the ballon (on the foley used as a g-tube) was filled with 35cc of medications. (Being administered into the wrong port).

Scary.....

[Dixiedi]

The Department of Mental Health in our state has various ways that they provide for MRDD (mental retardation and developemental disabilities) clients. (1) State owned/run institutions-only nurses give medications

(2) POS (purchase of Service) facilities-contracted to private owners.

POS facilities include: (ISL Independent Supervised Living) or Group Homes.

Basically, Any Party A would buy a large home, equip it for disabilities, contract with the state, hire a consulting Physician, RN, and "Q" (qualified mental retardation specialist), hire staff (CNAs and CMTs), and, after receiving my clients and a 60 day waiting period, begin to make alot of $$$$$.

If any of the clients have gastrostomy tubes, the medication/nutrition administration training is "passed on" from house manager to new employee. Or.... from one CMT to another CMT.

As the homes are to be kept as "homey" as possible, nurses do not stay and administer meds, unless it is a very large facility, or state owned facility.

The rules are different for private providers as compared to state facilities.

Basically, what I am attempting to relay, is that there are millions of persons in the United States being given medication by CMTs with only a few days training.

Having worked MRDD, it is scary. Due to staff not shaking liquid Dilantin, I have witnessed Dilantin levels in the upper 40s, going to 52 at one time.

Another time, the ballon (on the foley used as a g-tube) was filled with 35cc of medications. (Being administered into the wrong port).

Scary.....

You just HAD to mention MRDD and you did it on this fine Sunday morning!! :angryfire

[fairyprincess2003]

Hey Didexi

I was in agreeing with you:) For some reason, I always reply with the previous post in my response not even realizing it.

[kidluvinRN]

You just HAD to mention MRDD and you did it on this fine Sunday morning!! :angryfire

And mentioning MRDD is a problem why? We should be most concerned about this population as they are so vulnerable. This is a great discussion and I think that the MRDD population is at risk here; I've seen it too.

[Dixiedi]

Should have figured that one out. lol... i very often do the same thing.

[obeyacts2]

And mentioning MRDD is a problem why? We should be most concerned about this population as they are so vulnerable. This is a great discussion and I think that the MRDD population is at risk here; I've seen it too.

This is exactly the population that is most in danger from improper meds handling and administration. These places are (in CA, ICF facilities) money makers for private businesses that have every incentive to cut corners. These patients havent hte family to advocate (usually) that LTC residents have, so if a mistake is made, who is going to complain? Not the MRDD patient with an IQ of 25!!

Laura

[Dixiedi]

And mentioning MRDD is a problem why? We should be most concerned about this population as they are so vulnerable. This is a great discussion and I think that the MRDD population is at risk here; I've seen it too.

MRDD is part of the problem! They want to do everything the cheapest way possible! Not the most ecoomical way, the cheapest way!

We're not talking about them wanting CNAs to distribute meds where at least there is a nurse available to "fix" an error we are talking about them wanting to send CNAs into home care where kids need skilled nursing!

We are talking about MRDD leaving vent dependant kids on auto pilot for 8 - 12 hours a day becasue the parents are home. Yea, they are sleeping, something all humans must do.

We are talking MRDD refusing to supply nursing care enough hours a week to allow parents an evening "off."

We are takling about MRDD wharehousing kids in classroom (loosely described) during school hours so that the board of education is responsible for them for a while.

Don't get me going about these people. One of my parents and I are in heated discussions with them on a regular basis and with senators, govenors and more.

MRDD is unwilling to offer a premium dollar to the agencies so they might attract and maintain only the best nurses. Because of this we are forced to keep breathing bodies with a license just to maintain coverage and those kids are left without the dedicated home care nursing staff they require for optimal recovery/maintanance.

[kidluvinRN]

In my mind MRDD, is just an abbreviation for Mentally Retarded, Developmentally Disabled. I use it to describe a population of people, not an agency or program of the state.

I agree that corners are cut with this population due to lack of self or other advocacy. Broadening the scope of ULP is a way to extend staff dollars for a routine task.

[Dixiedi]

In my mind MRDD, is just an abbreviation for Mentally Retarded, Developmentally Disabled. I use it to describe a population of people, not an agency or program of the state.

I agree that corners are cut with this population due to lack of self or other advocacy. Broadening the scope of ULP is a way to extend staff dollars for a routine task.

It's also the abbreviation for the agency that is guilty of all of the above. ULP I am unaware of (or just not used to that abrieviation, but in any case, I do not recognize what you mean.

[mscsrjhm]

Dearest Dixie:

Greatly enjoying the well-placed outrage at MRDD. And, in this state, Missouri, the head of the human services for the state, including MRDD, is the highest paid state employee.!!!!!

I feel, appreciate, and join you in the MRDD outrage.

Mschrisco

[Betty_SPN_KS, LPN]

There are TWO difference workers who are called CMAs.

This thread is about Certified Medication Aides, who work under nurses' licenses, not Certified Medical Assistants, who don't.

Yes, I've lived and worked in both Kansas and Indiana. What is called a CMA, Certified Medication Assistant in Kansas, is called a QMA, Qualified Medication Assistant, in Indiana, and CMA means Certified Medical Assistant. I guess Medication Technician is used in some places also.