Insulin given by nursing assistant?

[LightsMyWay]

Hi everyone!

I work at a day program for adults with developmental disabilities. An RN is required to work at this program to administer medications and handle the nursing issues. I have a client I check blood sugars on and administer insulin to based on a sliding scale, each day at noon. He is a brittle diabetic and fluctuates between blood sugars of 40 to 450 any given day. I am going on vacation shortly. After giving almost 3 months notice for the vacation, I was told that there is an RN coming in to cover me, but she will leave before lunch time. The organization is apparently planning on having a supposed nursing assistant check the blood sugar and administer the insulin! Does this sound absolutely ridiculous to anyone else? The RN subbing for me is simply going in to package up the oral medications and have the unlicensed, probably non-MAP certified staff that are working with the clients give them their medications. And it is up to the nursing assistant to care for the diabetic in my absence? What is he going to sign in the medication charts? Make up his credentials? Craziness! Would you say anything or report this? Or just let it go because it will happen while I'm away and it is not my choice? Thanks!

[barnes2358]

Well now...as u have said ....u have been there almost a year...and u have "fixed" orders that u didnt take...known the "circumstance was against the law" and had blantant disregarde for ur patient's safety and their right to proper care...and ur solution to this is to apply for another RN liscense in Georgia...my thinking is just turn ur liscense in now and get a job at Wal Mart as a greeter b4 u kill someone...or u could do the right thing and report this to the appropriate governing agency as u should have already done...

[Neveranurseagain, RN]

Office staff and lay people at schools calculate and give insulin every day to CHILDREN with the blessing of the American Diabetes Assoc.! So this does not surprise me. ADA Launches Fight for Rights of Diabetic Children - Nursing for Nurses

[CiaMia, BSN, MSN, DNP, RN, APRN, NP]

Whoa. I manage a day habilitation program, and according to our regs (MassHealth, we're in MA) we absolutely cannot have anyone but an RN/LPN administer meds, regardless of MAP training. I can't transcribe or write in the med book. We have to have a policy and procedure around delegation of nursing activities (mixing thick-it, changing oxygen etc) that clearly defines what competency each staff member has to have documented and records of trainings for each specific task. If this came up at my program we would be cited/sanctioned for non-compliance.

[Larrythenurse]

Hi there.

I am an RN consultant for DD folks in group homes and day program settings. In Oregon we have a process of formal delegation described in our nurse practice act that defines how we can train unlicensed staff to do tasks of nursing care. The staff is trained to do the task only, not any of the nursing or support details.

In most of my facilities unlicensed staff, trained in this by other non-licensed staff, do a lot of traditional nursing duties. These include transcribing orders and administering medications. I don't like it, to be sure, but that is the reality of the situation.

[marsy]

I think you should find out what the regualtions are in your state first. I'm here in NY and we work under OPWDD. We have AMAP staff who can administer medications (PO, topical, eye/ear drops) but not Subq or IM...

[mentalhealthRN]

Can you not call your state board of health/dept of health?? This facility needs to be investigated and they need to be made aware of what's going on. I would do this to both protect those clients as well as your license. I would also pull up your states scope of practice for RNs and review it and show it to these morons running this place. Why can't they use an agaency or travel nurse to cover your vaca? there are some awesome nurses that work agency/travel and yes it would cost them a little more but less then a law suit or a fine by the state board of health!!!!

[classicdame, MSN, EdD]

I doubt that your license would be in question if you have not created the situation. Someone needs to talk to the State to see if this is appropriate. It may well be, in that environment. But I wonder why they need an RN at all if ANYONE can give meds. Especially a med that could cause sudden death if given inappropriately. At the least, you need to know what is the law in your state.

[Shamrock, BSN, RN]

May I ask what state you are in?