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

JDZ344 · 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!

Honestly I think if they go to THAT amount of trouble, they may as well just admin. the medication themselves, unless one of them is not always there?

yousoldtheworld · May 20, 2011

I will agree that a written agreement would be a good thing...but in my opinion, that is the case in ANY sort of private caregiver position, meds or not.

caliotter3 · May 20, 2011

Should the client decide to pull the rug on this caregiver and use their CNA certificate against them, (probably a safe assumption that the client was told of the CNA qualification at the initial interview), the caregiver would find out soon enough that a CNA is held to their scope of practice just like any licensed nurse. A caregiver off the street has a better leg to stand on than a CNA, when it comes to doing things that are above and beyond. CNAs can lose their certification for wrongdoing. Best to have a little chat, preferably in writing, with the certifying authority. There is a reason that HHAs and CNAs doing home care for home health agencies are not allowed to administer medications, only to give reminders, to clients in the home setting. And just because one is being paid as a caregiver and not as a CNA, does not make the CNA certificate go away.

BabyLady, BSN, RN · May 20, 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!

...I agree that you need to call your BON, because here is what they are going to tell you:

It doesn't matter what they hired you to do, it is the fact you are getting paid as a caregiver and CNA's cannot give medications, even with the permission of the family. The problem is that you are licensed.

Here is an example:

Let's say a home health agency needed an LPN but I took the job as an RN for LPN pay. If something goes wrong, I am going to be held by the BON to the RN standard...not the LPN standard, because it is a paid position and that is my highest level of training.

That is why many "caregivers" choose not to be licensed--at all.

BabyLady, BSN, RN · May 20, 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.

An agreement between the family and the caregiver, written or not, cannot be used to circumvent the scope of practice set by the Board of Nursing.

ashleyisawesome, BSN, RN · Aug 31, 2011

okay, bringing up a thread from a few months ago because im in a similar situation.. sort of...

im in nursing school, working per diem as a PCA at an assisted living facility (I have no CNA certification), where I took a one day medication administration class and am allowed to pass meds at that facility-- including administering insulin.

Ive been looking for some part time caregiver jobs, involving children in particular because im interested in peds, and i could use some extra cash because im a poor student.

I found a family online that is looking for some occasional respite care for their teenage son with down syndrome. It seems like a pretty good gig and im interested, they just want someone to kinda hang out with him, make sure he doesnt get into trouble/hurt himself, and do some activities with him. however, they also state that the caregiver must be comfortable/learn to give fingersticks and check blood glucose and admin insulin as needed (kid is diabetic).

i am comfortable with checking b.s. and giving insulin, i do it often at work and clinical... but im worried about it being legal for me to do in this persons home.. i read in the previous posts that on eof the big problems was that she had a CNA cert. and that the BON would hold her to that scope of practice.

Since I am not technically certified/licensed in anything (except cpr), would it not be a problem for me to give him his meds? I'm thinking of typing up some kind of agreement like another poster said that says something along the lines of "the family knows that i do not have any kind of medical license/certs and i am administering the meds as per their request and i wont be held accountable for any errors" (not sure how to word it and make it not sound scary to the family)...

i also think it would be a good idea for them to have a written instructions for all meds to be given (dose, time, route etc) that we both sign and i keep a copy of for my records..

yeah im getting a little ahead of myself, havent even applied yet. any additional advice anyone wants to add?

CabanaDay · Sep 3, 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!

But you are a CNA. You can't conveniently turn your CNA status on and off like a switch whenever it suits you. You are subject to your nursing scope of practice 24/7.

The answer is to voluntarily relinquish your CNA license if private caregiver is the career path you want. You can of course get your CNA back when this client's condition, or the family's whim, changes.

MissMcCoy · Sep 3, 2011

hummmm....

You know in my area this is what legislation is:

Giving insulin is a restricted activity.

You CAN give insulin IF

The patient is stable

The out come is predictable

You have to be taught the procedure

You have to be supervised to know that you are competent

You have to be directly or indirectly monitored. (Being able to reach an on call nurse is enough)

If my memory serves me right I do believe that it also has to be pre-drawn insulin.

Becareful if anything happens it will be your butt! You know we have the right to refuse unsafe work.

jb2u, ASN, RN · Sep 4, 2011

Closing thread as "seeking legal advice." Please see the BON guidelines for your state. No one here is allowed to give legal advice, which this falls into the category of. Also, remember to create your own thread for your question, even if it is similar.