What would you do in this situation?

Nurses General Nursing

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I am a CNA/Medication aide at a small county jail. I have been here for 7 years. The company I work for recently hired a medical assistant to do the med passes and my DON has instructed me to train her. As far as my knowledge is concerned, at least in this state, in order to pass medications in a correctional facility, you have to be a nurse (LPN, RN) or a CNA/M like I am. I have never heard of a medical assistant (associates degree level) being able to run a med pass. I talked to my boss about this and she assured me that this person's training as a medical assistant also allowed her to get a CNA/M certification, which, to me, doesn't seem possible. I know in order to get my certification, I had to be a CNA for 2 years, then take the CNA/M class (140 hours) My question is, is there any way that I can be held liable for actually training this person, or is my boss and the company I work for going to be left holding the bag? I know she was hired the same day as her interview and she started working the very next day, which seems to me like the company did not check into her credentials. I feel like I should report this to a higher authority, but I don't know if I have a right to.

Specializes in PICU, Sedation/Radiology, PACU.

If you raised the concern about her training/degree, and were told that she had acceptable credentials (CNA/M, in this case), I would leave it at that. It's not your right as her co-worker to see a copy of her license or application, and it's not your job as an employee to verify her credentials before performing one of your expected job functions (training a new employee). It's possible that her training was done out of state where requirements to take the CNA/M are different. Your boss has told you that this employee is legally qualified to do this job, and that's sufficient.

If the new employee later discloses to you that she actually doesn't hold an appropriate license then you could escalate the situation.

I agree with the above post. Leave it be. It is the DONs job to check her credentials.

but it is on all of us to keep our patients safe. is this new employee safe, or not.

I would leave it be. If your boss told you that she has credentials, then that's that. You would not be held liable because you believed your boss. Unless you are her direct supervisor (from your description it just sounds like you are training her) it's not your job to verify credentials.

Just be sure to monitor her and maybe keep notes on her progress during training. If you still feel like she hasn't had training or is clueless or a threat to patient safety, then you can bring it to management.

If you were training a new employee who was an LPN or RN, then it would be against your scope of practice in some states. Much like in most states, an LPN training an RN it is against their state practice act/scope of practice.

The language is vague at best, however, the consistency is usually those with "lower licenses" can't train those with "higher licenses". This has nothing to do with UAP's training other UAP's.

Unlicensed assistive personnel training other unlicensed assistive personnel under the direction/delegation of an RN or LPN is on the RN/LPN and not your certification, OP. It is up to the licensed nurse to supervise/oversee the medication administration process. Uder the policy and procedures of the facility.

And the new person may have an associate's degree, but much like your CNA with a medication administration certificate, a medical assistant certificate is not a license or degree.

I am an LPN who is certified as an EMT. I don't have 2 separate licenses, I have a license and a certificate. An LPN is a vocational diploma, an EMT is a state/national vocational certification. This person may have an associates in whatever, but it is the vocational certificate, under the direction and delegation of the licensed nurse, that allows for medication administration IN SOME SETTINGS--not all. (correctional facilities, nursing homes, skilled care....not usually acute care settings, more chronic care settings).

If anyone is to "get in trouble" for any of this, it is the licensed nurse who hires/delegates to a UAP who is "not qualified". Medical assistants are used in an MD office setting and have a large scope of practice. For some, a great deal more than a CNA in any other setting.

Make sure you have a checklist of how you are to orient the new employee. Report off to the nurse how the person is doing with what you are teaching her. Otherwise, it is not on you to determine credentials.

Does your state dept of health have a CNA registry? Check if she has medication credentials on the registry, if her certifcation is on a registry, it's public information, not a secret between the DON and CNA. Also, are you qualified to delegate medication administration, is it a part of your skill set?

Specializes in Med/Surg, Ortho, ASC.

All of this leaves me queasy. Med administration by unlicensed personnel, whether CNA or MA, does not compute with me.

All of this leaves me queasy. Med administration by unlicensed personnel, whether CNA or MA, does not compute with me.

Me too, I'm not comfortable with it either.

First I as a registered nurse did not know non license personnel could pass medications. Only RN and LPN. CNA's should NEVER pass meds. It sounds like someone is bending the law. Calling the state board will not help. They only get involved if you get in trouble. I would love to see where a CNA could ever pass medications.

I have never known CNA or medical assistants to ever to be able to pass medications. I have several nursing licenses from different states and have never heard of a CNA passing even an aspirin?

Specializes in Pediatrics, Emergency, Trauma.
I have never known CNA or medical assistants to ever to be able to pass medications. I have several nursing licenses from different states and have never heard of a CNA passing even an aspirin?

In certain settings CNAs can become certified medication aides; in my area most are in assisted living settings that pass meds.

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