Letting CNA pass your meds, bad idea?

pagandeva2000, LPN · Nov 16, 2006

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.

I heard that if the issue is really pushed enough, it can happen, but usually it doesn't, and I have not heard of any board of CNAs, so to speak. The unfortunate thing about this is that the nurses are overworked, and are juggling to do all that they can, making this very tempting for any overwhelmed person to do. And, if a nurse that has been working at a facility for many years suddenly has to contend with certified aides, and being responsible for their errors is a sad thing, because she may have invested too much time to just leave.

dylla · Nov 17, 2006

First what kind of facility are we talking about here. Assisted living maybe LTC facilities NO!!!

I worked in a Nursing Home -- and they had TMA'S -- we were force to work 2 wings one with a nurse passing meds and one with a TMA under our license. I complained and they thought I was Just a pain in the 'butt" The TMA has 60 hours of training and worked under my license in the nursing home.

Loca · Nov 17, 2006

I am an RN working in a nursing home that utilizes Certified Medication Aides. They are to pass po meds to stable residents. PRN medication must be authorized by a nurse and Yes, they do operate under my license, a fact I am highly aware and mindful of. This is a practice that I am uncomfortable with but is a common practice in my state. I recently have been working with a DON consultant on coming up with guidelines for CMA's. Another facility was actually using them for "Charge" and putting them in charge over CNA's. YIKES!!!! This has been a thorn in my flesh where our facility is concerned. I recently had to battle with the DON about keeping CMA's from writing in the Nurses Notes...CAN YOU BELIEVE THAT?!!! I am careful to only delegate to the CMA duties I am comfortable with, I perform assessments at the beginning of each shift and do not delegate the CMA to give po meds to the residents who have a higher acuity. The Nurse Practice Act puts the RN in the very scary postion of having his/her license on the line every time we are at work. We are trained extensively (or at least I was) to delegate appropriately. The LPN's that work my shift are also operating under my license and are not, under the Nurse Practice Act, allowed to do "assessments", so if I was to get too wrapped around the axle ( and I have!) I would have to admit that I get nervous when I read the LPN who says she "assesses" before giving medication. Neither CMA's or LPN's are to "assess", they may report what they "observe". Our CMA's take a one semester course. Our LPN's take a one year program. It all boils down to the fact that as an RN it falls on me. The staff that work under me on my shift think I am too "nosey", and "controlling" and I even heard an LPN say "don't worry so much about what is going on at my station, I will handle my aides".....guess what?! LPN's, CMA's, Aides....it all falls under my license. I love my job--but due to the shortage of nurses we do what we can, my heart breaks at this dilemma.....

Tanningtulip · Nov 19, 2006

As a former DON and a Nurse of many years. Always pass your own meds. I am not sure if you are joking but that is a huge no no.

pagandeva2000, LPN · Nov 20, 2006

I am an RN working in a nursing home that utilizes Certified Medication Aides. They are to pass po meds to stable residents. PRN medication must be authorized by a nurse and Yes, they do operate under my license, a fact I am highly aware and mindful of. This is a practice that I am uncomfortable with but is a common practice in my state. I recently have been working with a DON consultant on coming up with guidelines for CMA's. Another facility was actually using them for "Charge" and putting them in charge over CNA's. YIKES!!!! This has been a thorn in my flesh where our facility is concerned. I recently had to battle with the DON about keeping CMA's from writing in the Nurses Notes...CAN YOU BELIEVE THAT?!!! I am careful to only delegate to the CMA duties I am comfortable with, I perform assessments at the beginning of each shift and do not delegate the CMA to give po meds to the residents who have a higher acuity. The Nurse Practice Act puts the RN in the very scary postion of having his/her license on the line every time we are at work. We are trained extensively (or at least I was) to delegate appropriately. The LPN's that work my shift are also operating under my license and are not, under the Nurse Practice Act, allowed to do "assessments", so if I was to get too wrapped around the axle ( and I have!) I would have to admit that I get nervous when I read the LPN who says she "assesses" before giving medication. Neither CMA's or LPN's are to "assess", they may report what they "observe". Our CMA's take a one semester course. Our LPN's take a one year program. It all boils down to the fact that as an RN it falls on me. The staff that work under me on my shift think I am too "nosey", and "controlling" and I even heard an LPN say "don't worry so much about what is going on at my station, I will handle my aides".....guess what?! LPN's, CMA's, Aides....it all falls under my license. I love my job--but due to the shortage of nurses we do what we can, my heart breaks at this dilemma.....

I am an LPN, and yes, we do not assess. But, I am curious...if the LPN has her own license, how can it ultimately be that she is working under your license...is it because she reports to you? I'm not asking this to be sarcastic, I'm just clarifying for myself. I was really under the impression that if the LPN makes a mistake, then, it is her license that will be left hanging in the wind. If you respond, that would be a great help to me for the future in regards to how I conduct myself. I don't want to be considered as a high risk employee to any supervisor. I do understand your dilemma, though...and would be "nosey and controlling" as well if they will be dragging me over the carpet and gaining rug burns all the way.

Tanningtulip · Nov 20, 2006

I would agree that you are working under your own license. I was an LVN for years;however if a task is delegated to you by the RN then it is under hers.

Tanningtulip · Nov 20, 2006

Being an LVN was very beneficial to me because I know my medications really well, and I can relate alot better to the LVN's that I work with. They are a very important part of the team and highly utilized here in CA.

txspadequeenRN, BSN, RN · Nov 20, 2006

Only if that task is out of the scope of the LVN.....

I would agree that you are working under your own license. I was an LVN for years;however if a task is delegated to you by the RN then it is under hers.

kelticwoman · Nov 21, 2006

I would not do this. As the nurse, I am responsible for for giving the correct medication with the correct dose per correct route of administration to the right patient at the right time.

ShimmyMeli · Nov 21, 2006

Are you freaking kidding???!!!! Im only a first year nursing student and I know this is a very VERY BAD idea..they teach us being responsible for everything from drawing up the meds the checks ,to checking that the PT. swallows it! etc...

MurseNeutron · Nov 22, 2006

cna's dont have the training for passing meds. i recall having to remember an ungodly amount of meds and study for a few years to pass meds. how long does it take to get a cna license? thats your rear end on the line my man...

i have had cna's i wouldn't let pass a mv tab, much less considering colace.

i hoped to goodness your not letting them pass blood pressure medication thats down right scary.

figure this. you hand a cna 100mg of lopressor. he or she walks in the room. say they even take the bp it ends up 100/60 c a heart rate of 60. would he or she give it. hell yeah!

MurseNeutron · Nov 22, 2006

sorry i accidentally posted twice. i have to run and dont know how to cancel it so read this:) and feel time wasting away, sorry.