Help me understand Med Aides

[LovebugLPN]

I am applying to a personal care home where they used medication aides to pass the meds. I actually worked there about 2 years ago but left after 3 days. I was so nervous watching these girls all pass meds off the same cart and not know what they were giving or why. I need to work and have "burned too many bridges" with a few of the area nursing homes by leaving and not giving notice (don't ask, it is a long story). My point is I can't be too picky anymore. My question is, as a LPN, if one of these med aides is passing meds and makes a med error who is going to be on the chopping block? I would be alone overnight with them and would only be responsible for narcs and insulins. Is my license being put at risk or not? Someone has got to take the fall and it looks like it would be me.

I made a mistake. They are PCA, not med aides. What is the difference anyway?

[TrudyRN]

I think you need to check with your state Board of Nursing and with some attorneys for a true, definitive answer.

Personally, I don't see how you can be held responsible if someone else makes an error. But I really don't understand the whole issue, probably, if I think it is clear cut. Let us know, will you, after you check with those who should really know the answer to these things.

One good thing - how many meds are there on nights? Very few, I'd think, aside from narcotics and insulins, which you will be doing.

Another thing you can do - do it anonymously from other than your home phone - check with whoever licenses this facility and find out what that body has to say about PCA's passing meds and who they think would be liable in the event of an error.

Have these aides passed a certifying course of some sort? It is really a very common practice to have aides passing meds after instruction/certifying.

[banditrn]

OK, I'll weigh in on the med aide thing - my son was a med aide in Iowa for 3 - 4 years - he had to take a course and pass a competency. My son is a very smart man, and even though he's been out of the field for a couple of years - he STILL knows more about most meds - and understands the rationale for giving them or not - than a lot of nurses I've worked with in LTC.

You have to get to know and trust the med aides - just as you do the other nurses!

Might I share that at our facility, a certain LPN was medicating people without a doctors order!! She said it should be a 'nursing judgement'!!:uhoh21:

[pat8585]

I would like to know the answer to this one too. If a med aide makes a mistake, does the lpn take the fall?

[AimeeJo RN]

I was a med aide for a little while, I just became an LPN. There is a big difference in the amount of training. I agree there are some nurses who may not be very responsible with meds.

Recently I spent time in a facility where the med techs would pre pour meds for like 20 patients into paper cups and carry a stack of unlabeled cups to dispense the meds to her patients. They would say that they knew who's pills they were based on the appearance of the pills. I would just cringe. I think that there should not be a med aide in a big facility where there are alot of patients to medicate. Especially since many assisted living facilities are starting to resemble nursing homes. I don't think that the LPN would be held responsible for actions of the med aide though.

[nursebrandie28, BSN, RN]

Hello!!! Does anybody see the danger in a med aide, vs LPN!!! Does the med aide know what the drug is for, standard dosage, etc?

I KNOW THERE IS A NURSING SHORTAGE, however, THIS IS NOT SAFE!!1

WHERE DID STANDARDS OF PRACTICE GO?

[RedCell]

Hello!!! Does anybody see the danger in a med aide, vs LPN!!! Does the med aide know what the drug is for, standard dosage, etc?

I KNOW THERE IS A NURSING SHORTAGE, however, THIS IS NOT SAFE!!1

WHERE DID STANDARDS OF PRACTICE GO?

It seems that this new job title is a hastily thought out solution to a problem that I believe will only be made worse by these unlicensed personnel.

[dorianna]

It all depends on the med aide. I work with a lot of LPNs. They may have more nursing education than I do, but, let me tell you, many of them are not particularly educated or smart. I have close to a BS in psychology and sociology and I am smart. I catch a lot of errors and find that I have to explain stuff to them that they should know. Some of the LPNs I work with are scary! A title isn't everything. And don't get me started on QA and charge nurses that have no clue how to supervise staff adequately.

[Batman24]

Your concern is valid. I would check with your BON and an attorney in this case ASAP. I wouldn't let anyone else pass meds under my license.

[dorianna]

I don't pass meds under your nursing license. That is a myth.

[island40]

As the LPN you are supervising the med aids. They are responsible for their actions and working within their scope of practice. You are responsible for ensuring that their assignment is within their scope of practice and that they perform their jobs competently to the standard that has been set in your area. This usually means that you have to make sure that they are not doing anything grossly negligent. The same as supervising a CNA. My suggestion is that you talk with the person who will orient you to the position, talk with the med aids you will be working with and take some time during your orientation to learn what their role is. Med aids are the wave of the future if you want to make a professional wage.

[jnrsmommy]

For me, a good med aide is worth their weight in gold, just like a CNA. I too cringed when I first worked at a facility that employed them. All kinds of "what ifs" went through my head, but I guess it goes w/ any co-worker you have. You learn really fast who you can absolutely depend on and who needs to be watched over.