Is anyone else uncomfortable with this?

[jill48]

I know I should be thankful when a CMT is on my floor and passes my meds for me, but it makes me somewhat uncomfortable and I feel the need to pass the meds myself. I'm just not sure that a CMT will be looking for the same adverse reactions, etc. that I would be looking for. I'm not saying she/he would not do their job to the best of their ability, I just think that when passing meds I have a few minutes to observe the patient and possible give in a little medication information/education. Plus, I've ordered quite a few barium swallows after watching a patient try to choke down that water. Am I the only one who feels that the nurse should be passing the meds?:smackingf

[cmatobe]

If this happened, I would try to get the order. However, whoever did this would get educated on the proper way to deal with this.

1. Get the order.

2. Give the med after you do #1.

I'd report the whole mess to the higher-up's and pray no one (like a lawyer) ever noticed that the med was given before the order was obtained. Risk Management and the Administrator, as well as the DON, Ward Manager, and whoever all else would be made aware that I was not the one who made the mistake. I would expect them to take care that it never occurred again.

Who is teaching these people to do this? What if the doctor didn't want to give a Tylenol order - like maybe liver enzymes are up or whatever? :monkeydance:

No one is teaching us to do this. We are following procedure the same as the nurses do, in regard to passing meds. We have the same accountability as the nurses, the same rules and regulations. We are to never, NEVER give a med. without an order - actually, we have a whole list of "never"s, same as the nurses. And as long as we pass meds. according to the rules and regulations we have, all will be well.

[cmatobe]

I'm sorry, maybe I'm prejudiced. I just don't want ANYONE giving my patients medications except for myself. MY signature goes on the MARs every night, and my signature is on the flowsheet. I feel like I'm the one who will be held responsible if the patient has adverse effects. There are other things that would help me in the job far more than just being a pill-dropper.

We cannot work in hospitals, period, let alone in a step-down unit or ICU. We will be in nursing homes and assisted-living homes, where the patients have been on a lot of the same medications for months or years, and are stable on them, according to the labs and the objective/subjective data.

We do not give the first dose of any medication - the nurse will do that, and observe for adverse reactions.

We do, however, sign off the MAR`s, which makes US accountable in a court of law, not the nurses, for our actions re: the med. passes.

[Gromit]

Ok, I could see that. I do wonder though, does this position exist in Florida? Did a quickie search and didn't see it -and here is the first I've ever heard of it (of course, since I don't hang out at LTCs or ALFs that could well be the reason).

[dawn66]

Just for the record, upon further reading some of these things, some of what is being spoken about refers to a Certified Medication Aide, which is completely different than a Certified Medical Assistant which is what I am and the education I spoke of refers to that, not the Medication Aide. This is where my anger came from when I read that someone said CMA's have two weeks training. Also, my comments had nothing to do with the actual duty of passing meds. Certified Medical Assistants do not work in hospitals as a rule anyway unless it is in some other capacity. We do however give drugs, IV and orally in clinics, offices, etc. I mostly felt people were uninformed and making judjments about a vocation that they knew nothing about. I now realize they were speaking of the medication aides. Certified Medical Assistants are nationally recognized, trained and monitored. I don't think Certified Medication Aides should also be referred to as CMA's. This makes life quite confusing.

[Gromit]

that much is true. I've seen medical assistant classes (ads for them) all the time on TV, but I've never heard of or seen MEDICATION aids...

[KaroSnowQueen, RN]

I have preciously worked in areas where we had QMAs (Qualified Mediation Aides) to pass meds. Most of these girls were very smart, had went to a class to learn to pass meds and been checked off and passed a state test. They were able to pass routine meds in LTC without me standing over them. However, they were required to come ask my permission to give any PRNs. They also knew when and how to check b/p and pulse before certain meds.

I never had any problem with any of them. They made my life a lot easier.

[Ophelia78]

My knee-jerk reaction is to say there is no way I would want someone with such a small amount of training to pass my meds under my license. I would wish that more RN staffing and support would be a better solution to meeting the nursing needs of our patients. Perhaps using LPN's to pass meds in the hospital setting seems a better solution than an unlicensed assistive personnel.

Of course, to play devil's advocate, isn't this similar to the reaction many physicians have when it comes to advanced practice RN's having prescriptive authority and admitting privileges?

[sarajasmine]

See my post under non-nurses calling themselves a nurse.

I'm not saying she or he is calling themselves a nurse but, I think the patient's just assume the person who is passing meds are a nurse! Of course, occasionally nurses make mistakes but, hopefully you are aware of your CMT's training and hope they will ask for your advice before giving a med they have a question about. Then, the concern is am I liable for the CMT?

[oldstudent nurse]

I've been an Oral Medication Tech for 15 years, a CNA for 15 before that. Under the supervision of you, in my state, simply means that you have checked the meds and have faith in me. We are only used in long term care and the meds are sent by the pharm, are in cassetes or bubble packs. A lot of controls are in place to prevent errors, and I sign my own med errors. In order to be a med tech here, one has to work at a facility for at least a year an have a recomendation from the DON and the Administrator. I've oriented LPNs to my job that have never touched a res in their lives, let alone a med cart. So who is the better med nurse? By this time, I've known the res's for years, and am well aware when some thing is amiss with them. sorry so long

[scoobylover]

I am a cma in ohio in one of the pilot program facilities i have been passing meds for 3 mths and i am still not comfortable doing it i am constantly looking up drugs!! I do not give first time dosage, at our facility i do not give prns or coumadin,accuchecks g-tubes and if i make a med error i get wrote up the nurses do not. It took awhile for the nurses to get use to it but we are all ajusting pretty well. I pass for 4 halls so this does help the nurses with there charting and able to do proper treatments on people.

Hope this helps some of you email me if you have any questions about it.

Thanks

Crystal

[RN BSN 2009]

you get wrote up for a med error? thought it was just an incident report...

[BBBB]

I didn't even know it was legal in any state to pass meds without a license! Very scary. Also if it's "under direct supervision", why don't RN's do it themselves if legally they are supposed to stand there? Where do you work that has the $$ to pay TWO people to pass meds? I say fire CMT's and give you the difference on your paycheck.