Letting CNA pass your meds, bad idea?

twotrees2 · Nov 12, 2006

I wouldn't even let a certified med tech pass my meds. Not worth my license. If the tech messes up, then I'm on the line, too. I'd rather spend the extra time it takes to pass my own.
Anyone can be taught to give meds in a real short course--unfortunately, there's a lot more to passing meds than knowing how to put them in a cup.
Your essay topic is a pretty good one :-).

unfortuantley one may not have a choice but to have your license on the line for med techs - even if you arent giving them YOUR meds to pass - if the facility ( which ours is getting into ) hires them they run under whoever is in charge so that means when i am in charge my license is at risk because they choose to use this type of employee - personally - it is only a money saver on thier side and a headache on our side- though they may get to do meds- that is ALL they can do leaving the rest of the nurses responsible for getting treatments and dressings and tube feedings and traches etc - done. making the nurses responsibility even higher. sigh - nothing againts med techs - they have thier place - like maybe in assissted living and such but i am finding in LTC it just isnt a good thing.

twotrees2 · Nov 12, 2006

Oh this is a wonderrrrfull Idea(not), hell why dont we go ahead and let them (CNA's) go ahead and start are IV's and give are IM's to. Hell why dont we even have them intubate and defibrillate pts. to. Bad ideas I wouldnt risk my license this way.
Rod RN

good luck as its coming you know- at our facility there is already talk of training cnas to do treatments and such ( they have only had one med tech that is still on orientaion and think its WONDERFUL)- next will be trachs and theyll save tons of money hiring the crossed trained cnas and put it all on the shoulder of one nurse- youwatch - it will get there.

twotrees2 · Nov 12, 2006

Yes, I am in the nursing profession, but, I think you missed the point. You should be glad I am in the nursing profession because I seem to be the only one mentioning the patient as the point of concern. In the hospital I work in and teach in, I see so many new nurses that forget about what the patient is in the hospital for and are too caught up in worrying about their career, and judging from the replies to the email wondering about having the keys to the med drawer, or making sure the MAR is signed for, or that a CNA might take the medication for herself/himself instead of the patient still implies that the best interest of a patient is the last thing considered. And, by the way, I was positing an opinion, not slamming anyone who "disagrees" with me. You do make a very valid point - nursing homes do have a high patient-to-nurse ratio, and you can get absolutely slammed. I know I couldn't work in a nursing home because the loads placed on nurses is beyond safe measures. I applaud you. But, it still concerns me that the first statement you make is that you don't want to get in trouble, not "the patient is in trouble therefore..." It sounds as though the DON may not managing the facility very well. It is still unacceptable that assessments are not made, especially when meds are given. Are you telling me you don't always take a blood pressure before you give a blood pressure medication or having an aide get the blood pressure for you? These are simply reasons that it is not a good idea to let CNA's pass meds. The really neat stuff we use in a hospital is our critical thinking skills that helps us the most. I especially like the stethescope. It is really cool and very helpful.
no there is not a b/p taken for every blood pressure pill every time its given - they are on a schedule - ie daily for the first 3 dasy there and then weekly for a while then monthly unless otherwise ordered by the doc for whatever reason. yes- dig gets a AP every time but that is about the extent - any assessments are done are done due to suspected problems ( breathing seems labored, urine output is darka nd oderous , etc) and done for 3 days or longer if suspected trouble is verified - if we had to do full assesments on all our residents wed never hae time for anything like pill passes or dressings or helpoing the aides ( yes we have to do that too cause they often are short staffed too) and let alone chart everything. further more- one must remember that for the most part our patients are not critical as in a hospital cause if we find they are we send em to you-

twotrees2 · Nov 12, 2006

You are so right! We are very fortunate to have the equipment in the hospitals, as well as the access to doctors and specialists. That is actually one of the main reasons I chose hospital care, as opposed to Nursing Homes. I have to admit that under your situation, your environment forces you to defend your license to the point it does come first.
With the shortage of nurses today, it might be worth it for you to perhaps explore acute care - that way you can be a nurse for the original reason you probably became one. It is well worth it!
worked acute care - not what i went in for- i wish to get to know my residents and families and acute care does not afford the closeness with the stays being so short for the most part. i enjoy my LTC and will cont to do it - being needed not only by my residents but by the docs and everyone else who isnt there to assess my residents - aqnd leave the acute care to others.,

kiki2 · Nov 12, 2006

I would never let someone give meds that I was responsible for. Doesnt matter if they ar Rn, CNA or the Janitor. Your name is on that order. If anything goes down you will go with it. :)

twotrees2 · Nov 12, 2006

You have admitted to not taking BP's with meds and doing assessments before you give meds. In other words you are not concerned about the patient just covering your orifice and getting by anyway you can , doing the min.

sorry but any LTC facility has policies on this - it is not required as in a hospital to be doing full assessemnts on everyone every day - in my opinon makes LTC nurses needing experience so much more important than in hopsital because we need to be able to "see" things noone else may notice on our residents and in experience i also mean long term employment ( i personally belive as does my facility that no agency belongs in LTC because they dont KNOW the residnets) we dont have docs and RT and labtechs etc to call up if in doubt -

i will tell you there are some nurses who dont give a rats orifice about the residents but the meajority that have remained in LTC do very much CARE about thier residents and thats why they are still there protecting thier residents from the wonders that do come in.................we dont do the minimum we can and most of all we are often doing much more than required of us -

twotrees2 · Nov 12, 2006

I see what you guys mean about the posts be attributed to the wrong person. I am being quoted as saying something Imaldo quoted. I am so sorry some of you think I am just the wrost thing to come to nursing since the cap but I am only being honest. Please consider this. Nursing home residents are not as fragile or critical as hospital pt. as a rule. I have had to learn what is really important and what isn't if I want to survive in a nursing home.:smiley_ab :smiley_ab

hey - i think the hat shoud be brought back

Hellllllo Nurse, BSN, RN · Nov 12, 2006

CNAs should never pass meds.

Never- under any circumstances.

twotrees2 · Nov 12, 2006

Big Mouth.... LOL so what??? You know there is post after post on here about LVN's and how they are not qualified to do this job or that job... So much talk about replacing us with RN's because we are not competent in practice and our patients are at risk cause we dont have the level of training needed to be safe.... I have been arguing and fighting this ever since I have been a member of all-nurses... then here you come a LVN , just out right and upfront about doing wrong and being incompetent..... Who cares if the nursing home makes money.. you should be more concerned with doing justice to your patients. I cant believe you still have a job . Everybody knows ABT's are over RX'd nobody is disputing that .. we are talking about BP meds and the fact you dont find it important enough to take a simple BP.. did you ever think you may have to hold that med. But you never answered my question .Do you lie and just write down a fake BP or do you just leave that little space blank....hummmm
[/ ABT is a pill and we are talking about pills so that is where that came from. For the record I understand your concern. And for the record I have no intention of ever telling the BON or anyone else what I sometimes have to do in the name of time and making sure the nursing home makes lots of money. I didn't know LVN's had a bad rap. They must also have a big mouth.

there is no space left blank - as i said nursing home policy is once month after the initial 3 days q shift then q week so many times - unless otheriwse specified by an MD - if we did b/ps on every resident that had b/p meds wed be doing nothing but b/ps as 80% if not more have b/p pills. gotta be realistic and have approriate policies to cover your butt - that doesnt mean that we dont notice s/s of a low b/p so check first and then doicument it if needed. gads- id love to see any of the ones saying everyone needs b/ps and assessemnts for everything come work at a LTC facility - they wouldnt go a week without changing thier point of view or leaving if they couldnt...

twotrees2 · Nov 12, 2006

i dont think i responded inappropriatley to any posts but if anyone took offense i do apologize - i meant no direction at anyone personally.

]

This thread is about a half a centimeter from being closed because of personal attacks, bad manners, offensive language, and a general lack of respect.
I apologize to those of you who have not participated in the vitriolic exchanges. Unfortunately, there have been so many out-of line posts during my absence (due to computer problems) that I hardly know where to start addressing cautionary comments.
The hostility and rancor need to stop immediately. This is a message board, not a battlefield. Strong feelings are no excuse for insulting other members or belittling their personalities or practices. Disagree all you want, but stay on point. Focus on the subjects being discussed, not the other posters. Ultimately, each of us has to decide how we will conduct ourselves and what we are willing to be accountable for. No amount of cyber-brawling can change that.
I am so proud of many threads on this board. We've had members patiently teach each other about nursing practice and procedure. Some posters started here even before they entered school and stayed with us through trying times as students and new nurses. Now many of them delight in passing their knowledge and encouragement to those behind them on the path.
We've had people share the joy of various achievements--getting into school, graduating, passing NCLEX, weddings, pregnancy, babies and just about every other milestone you can think of.
We've also rallied around folks dealing with school setbacks, bad jobs, domestic violence, substance abuse, kids in trouble, family illnesses and deaths, and many other situations involving fear and loss.
That sense of connection is one of the things that makes this board shine.
Because this board is open to the public, anyone who can find the website can drop in and wander around. I hope the threads that show our solidarity (even in disagreement), resilience, wisdom and humor are the one they see first.
I do understand how a controversial subject can get out of hand. Emotion rises, tempers flare, and all of a sudden, otherwise decent people are at each other's throats. An online forum provides the same kind of anonymity that allows normally nice drivers to erupt in road rage. Sometimes with great regret.
I'd like to think there may be some regret floating around right now, or, at the very least, upon rereading the back end of this thread.
I'm going to confer with the other moderators to see what action(s) should take place regarding this thread and violations of the Terms of Service. In the meantime, if any of you feel you may have spoken rashly or with undue intensity, now might be a very good time to consider how best to set things right.

Terms of Service - All Users Please Read and Follow

twotrees2 · Nov 12, 2006

What practice do you think that they have had? I agree with some of the other posters...if the CNA/CMA are totally held liable, accountable and responsible for any possible error, then, fine, but, as another poster mentioned, the nurse working at Burger King was not present when this occured, yet, she lost all that she worked really hard for, and that is plain WRONG.
I always felt that the CNA should bear more responsibility with their certification than they actually are. If a CNA lifts a patient the wrong way, and breaks a limb, they are counseled, the nurse may have a real problem. I think that the CNA should have to face their 'board of CNA" (if there is any) the same way that a nurse should have to. This way, they may think twice about glossing over any mistakes in care. I was a certified AMAP, and I made mistakes during that time (over 20 years ago), and, I was not responsible enough to care what happened, either...because I wasn't licensed. Now, I see that this is a mistake. Unless the CNA, whether they are trained to pour meds or not is to take the full brunt of the error, then, they really shouldn't.

i so totally agree - dont recall there being a board for cnas ( then that ws 24 yrs ago i was one haha) but i agree thier shoudl be somewhere they are held accountable- i have seen nurses fired for not assessing a resident approriately after a fall even though the cnas had already PICKED that resident UP and sat them in a chjair!!!! unbelieveable- cna by the way still working there- tsk tsk - we really dont get paid for the responsinbility we have - at lest in our area.

Laught3r · Nov 12, 2006

I got in trouble several times as an aide because I refused to pas a med for a nurse. Nurses would crush a med and if I was feeding a pt she would mix it on the tray with the dessert. I was taught as an aide that if that happened I was not to touch that tray anymore because medications was on it. But the nurses would get upset because they "didnt have time for this." As a nurse now I will put applesauce or something in the med cup and then give it to the pt myself this way the CNA can carry on with their duties without me interfering or causing legal issues.