Is it illegal for a private duty caregiver hired by a family to administer insulin ?

caliotter3 · May 19, 2011

You can do anything your employer and you agree to. However, you run the risks when exceeding your scope of practice. If you trust your employer not to turn on you, you decide whether that is a risk you want to take.

fuzzywuzzy, CNA · May 19, 2011

You are working as a caregiver, not a CNA, so I think it's fine.

txspadequeenRN, BSN, RN · May 19, 2011

if i were you i would stay as far away from that as possible... if you don't understand the patho and how the medications work you can cause that patient some real issues then be responsible. one issue is your a paid caregiver and acting well out of your scope. leave the medications to the family (and let them be responsible for messing up ) or a licensed nurse.

BabyLady, BSN, RN · May 19, 2011

if i were you i would stay as far away from that as possible... if you don't understand the patho and how the medications work you can cause that patient some real issues then be responsible. one issue is your a paid caregiver and acting well out of your scope. leave the medications to the family (and let them be responsible for messing up ) or a licensed nurse.

i disagree that you have to understand the patho in order to administer insulin...because children as young as 6 and 7 can be taught to manage their own insulin...they sure as heck don't understand the patho. if you get the dosage right and administer it correctly, the patho doesn't matter. lord knows i don't know the patho of some of my meds that i take myself.

however, since she is a licensed cna and not an lpn and is getting paid, not volunteering...she has to act within her scope of practice as a cna. cna's cannot give medications without the supervision of a nurse or physician.

Trauma Columnist · May 19, 2011

I think this is a question for either your board of nursing or health dept - whoever regulates CNAs in your state.

As you can see, there are differing opinions.

JasmineMarie · May 19, 2011

But they didn't hire me as a CNA. I was hired as a private caregiver. The family already sorts out his medications for me and organizes it in the pill boxes for the week(I just crush them). They also tell me what dose of insulin to give him if his blood sugar is a certain number. Thank you for your replies!

MurrR · May 19, 2011

I think this is a question for either your board of nursing or health dept - whoever regulates CNAs in your state.
As you can see, there are differing opinions.

I was about to say this. I could tell you, roughly, how nurse delegation works in Oregon that allows me to work as a caregiver and perform certain tasks for my clients - like giving insulin, epi-pen, etc. etc. - but you don't live in Oregon and the administrative rules might be very different in your state.

Also, I have a CNA license but work as a caregiver and unless I have special dispensation I cannot do things as a caregiver that I would do as a CNA - i.e. I cannot give suppositories without going through a nurse delegation training as a caregiver, even though I'm familiar with them from my CNA education.

Working in an unlicensed position while holding a license is very, very tricky as I have found every day at my job.

yousoldtheworld · May 19, 2011

Since they did not hire you as a CNA, then the "scope" of a CNA doesn't apply here. They could hire any old person off of the street to give insulin, as they are a private employer (not any part of an agency or facility governed by the state) and that is their choice.

I would only worry if they hired you as a CNA or if it were a facility or something like that. An This is really no different than a parent hiring a babysitter, and having the babysitter give the kid their medications. I'm sure the family are not licensed nurses, either. There's a big difference between med administration in a health care setting, and at home. The state has nothing to do with how you take your meds at home.

txspadequeenRN, BSN, RN · May 19, 2011

okie dokie so what we are saying here is that joe blow off the street can give insulin as long as they can read instructions and know what angle to hold a syringe. we are not talking about a 6 year old child; we are talking about a elderly man with dementia . this man i can assure you has numerous issues going on and other medications that make insulin administration a little more complicated. patho does matter and it surprises me that a registered nurse would make such a re-mark. i also recommend if you don't know the medications you take you probably should pull out a drug book and do some research.

i disagree that you have to understand the patho in order to administer insulin...because children as young as 6 and 7 can be taught to manage their own insulin...they sure as heck don't understand the patho. if you get the dosage right and administer it correctly, the patho doesn't matter. lord knows i don't know the patho of some of my meds that i take myself.
however, since she is a licensed cna and not an lpn and is getting paid, not volunteering...she has to act within her scope of practice as a cna. cna's cannot give medications without the supervision of a nurse or physician.

Jessicias85 · May 19, 2011

I would have a legal agreement drawn up between you and the PT/ Medical POA (and a lawyer) stating that they wish for you to administer meds as per the following agreement : Med A at A time, Med B at B time, so on and so forth. IF the person is on home health/ hospice, they should have an in home nurse that checks in. I would speak to her/ him about this as well.

I agree with other posters that you should speak to your board administration about the matter. you are opening your self up to a HUGE lawsuit if the family tells you the wrong dosage, puts the wrong pills in the wrong box Ect.

Even though you are not working as a CNA, that is probably a contributing factor to that fact that you got the job and they are looking to you in that capacity. Just because your job title is not as such does not change that fact that you are licensed.

JDZ344 · May 19, 2011

Not knowing the specific laws of that state, IF anything where to go wrong, the family could bring a civil (not criminal) suit against you. I would make VERY sure that you have a written agreement in place with this family. Why can't the family deal with the meds, or hire a home health nurse to come in daily? Honestly, I think IF anything were to go wrong, a lawyer would have a field day.

I'm not saying you are not capable- but even seasoned RNs make med mistakes, and believe me, some people will milk anything for a few dollars.