Letting CNA pass your meds, bad idea?

Nurses General Nursing

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I fill the cups and check for all interactions and whatnot, but anyone have any negative experiences or can think of any possible neg exp with this?

Thanks

twotrees2, the link you posted clearly states:

"As stated in N6.03(3) an RN shall (a) Delegate tasks commensurate with educational preparation and demonstrated abilities of the person supervised. Although the administration of a healthcare facility or organization may suggest which nursing acts should be delegated and/or to whom the delegation may be made, it is the RN who makes, and is ultimately responsible for making, the decision whether and under what circumstances, the delegation occurs. If an RN knows or should have known that the person supervised is not prepared by education, training or experience to safely perform a delegated nursing act, the RN may not delegate the task."

An aide is NOT prepared by education, training or experience to safely administer medications, therefore this task cannot be delegated.

i guess we will have to agree to disagree then as i have asked my facility if its legal and have been told it is. at all facilities ive worked at - it is common practice with dementia residents on occassion to have to do this delegation in order to get the resident to take thier meds, and i have been told at all of them this is ok to do ive even had bossses come help when noone else is around give my dementia residents the meds ive gotten ready - and in my interpretaion of this - i see it differently allowing my aides to assist me in getting my dementia residents to take thier meds as long as i am right there and they have been trained by me to give the med ( which it doesnt take a wizard to learn to give meds via mouth in applesauce) and they are taught by me what the med is and why they are giving it - ultimately i am seting it up - monitoring/ watching the giving and outcome of the giving so i feel confident it is allowable. it is not like they are going to the med cart getting the med out , crushing it and giving it without me there - as a med tech would - which brings me to my next point.............

what i have a problem with by the statement in that website there - is with utilizing a med tech - i am not at all confident a few month course or however long it takes makes them able to give meds( anymore than you feel my training my aides is not educating or training or giving them expeience even though it does not say they must have formal training at school - it says training or experience or education ) when i am not right there with them when they give it - and i will be bringing this to the attention of my facility as unless i can be right there to make sure they are giving the right med etc - i wont be comfortable having them a wing or 2 away and giving god only knows what. we have only had 2 med techs so far - both gone now - but they wish to look for others - and after listening to those 2 talk about thier "education" and meds, my aides know far more about the meds i give then the techs i met do around here so far lol.

not to mention our "med techs" can only give meds ( no treatments or even accuchecks) so really they are not much use as we still have to find a nurse to go do their wings treatments , accuchecks , etc so we may as well just take the pills with us as between treatments and accuchecks, trachs, tube feedings and anything else they cant do- that usually encompasses just about the whole wing anyhow. lol.

but thank you for your opinoon. it is appreciated and noted. :)

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Specializes in Critical Care, Cardiothoracics, VADs.

I don't think your telling them what it is equates to "training or experience" required to administer medications... but hey, it's your license so good luck to you :)

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by no means do i or expect to say that i know all about meds. i do study and read about all meds. i would never give a cna pills to pass for me and i am a med aide. as for treatments i do treatments, i don't do open and invasive treatments but we as med aide can do eyedrops, creams topical, there is alot we can do to help the nurse out. i don't know where you are at but texas we do. now some med aide don't, but in school we are taught what we can do and what we can't. but it could free up some time for the nurse. i just wished nurses could trust more. i understand you lic is on the line, but my cert. is too. i have to sign off everything i do. maybe the med aide you have just don't want to do no more, i want to. someday when my husband is better i would like to go back to nursing school, but i couldn't make it trying to take care of him and try to work. but while i was in school i learned alot. the math is a b----ch. i wished i could figure the drop system. i didn't mean to change the subject, i just want nurses to know that there are good cna's and medication aides out there that really look upto nurses to teach all they can, when they can. i learned alot from nurses and i keep my eyes and ears open all the time to learn more. thanks and take care.

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by no means do i or expect to say that i know all about meds. i do study and read about all meds. i would never give a cna pills to pass for me and i am a med aide. as for treatments i do treatments, i don't do open and invasive treatments but we as med aide can do eyedrops, creams topical, there is alot we can do to help the nurse out. i don't know where you are at but texas we do. now some med aide don't, but in school we are taught what we can do and what we can't. but it could free up some time for the nurse. i just wished nurses could trust more. i understand you lic is on the line, but my cert. is too. i have to sign off everything i do. maybe the med aide you have just don't want to do no more, i want to. someday when my husband is better i would like to go back to nursing school, but i couldn't make it trying to take care of him and try to work. but while i was in school i learned alot. the math is a b----ch. i wished i could figure the drop system. i didn't mean to change the subject, i just want nurses to know that there are good cna's and medication aides out there that really look upto nurses to teach all they can, when they can. i learned alot from nurses and i keep my eyes and ears open all the time to learn more. thanks and take care.

actually our cnas once checked out on paper that they have done it ( documented they were trained ) can do more then the med techs - its not the techs - its the stupidity of the facility. the cnas work hard and want to be checked off for treatments and such but the facility is slow to go with the training and its unfortunate - especially that they WANT to do more to help. the med techs - i have no clue why the only thing they can do in our facility is pass meds - if they are trained for more seems a waste to not let them do it!!! i will have to ask the next tech we get what they are trained to do in class. now im curious as to why they arent allowed more if taught how to do it. seems like just a way to add more work on the nurses yet "staff" according to numbers of residents? and a way to save money by not paying for more nursing staff cause i am sure techs are not paid very good either. ??

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Specializes in Brain injury,vent,peds ,geriatrics,home.
NO NO NO

The CNAs are not licenced to give meds. Even if is only tylenol.

I agree! tylenol can be nephrototoxic if given in large doses!

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Specializes in Brain injury,vent,peds ,geriatrics,home.
actually our cnas once checked out on paper that they have done it ( documented they were trained ) can do more then the med techs - its not the techs - its the stupidity of the facility. the cnas work hard and want to be checked off for treatments and such but the facility is slow to go with the training and its unfortunate - especially that they WANT to do more to help. the med techs - i have no clue why the only thing they can do in our facility is pass meds - if they are trained for more seems a waste to not let them do it!!! i will have to ask the next tech we get what they are trained to do in class. now im curious as to why they arent allowed more if taught how to do it. seems like just a way to add more work on the nurses yet "staff" according to numbers of residents? and a way to save money by not paying for more nursing staff cause i am sure techs are not paid very good either. ??

Ya know back in the day(I was a nurses Aid in the early 80s)they didnt require you to be a certified na.And back then it seems that the ones that were certified were the worst.I earned a promotion to do treatments.I was very conciencious and learned a lot .I used to do wound care,document on it,foley catheter insertions,irrigations,IPPD treatments ,Enemas,ect.I thought I was very knowledgable until I was in nursing school.For example,you know you usually cant drain more than 750ccs of urine at once,it could cause dangerous hypovolemia.Or to give albuteral, could increase the pulse,but the nurses always did the Med pass and we always reported to her.the little LPN team leader.then the rules changed where you had to be at least an LPN to do the treatments!Times are always changing.!!Its crazy

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Specializes in Brain injury,vent,peds ,geriatrics,home.

And PS.It seems like nowadays you need aRN with wound care certification to do the wound care job I did as a(treatment aid)before I was a Nurse!Go figure.

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Specializes in Critical Care, Cardiothoracics, VADs.
I agree! tylenol can be nephrototoxic if given in large doses!

... and hepatotoxic to the point of irreparable damage.

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I fill the cups and check for all interactions and whatnot, but anyone have any negative experiences or can think of any possible neg exp with this?

Thanks

I think this is a bad idea. As LPN could not just take the test to become an RN. CNA did not take the same classes as nurses did.

Takotako

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It's a bad idea to let the CNA pass med. They did not take pharmacology like LPN and RN did.

Takotako

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I heard that they are proposing in the state of Nevada that "CNA should be able to pass med...."I don't think that they should pass this policy because I believe that this concerns patient safety. With regards to "letting CNA pass your med, bad idea?", passing med is not in the CNAs scope of practice and are not license to do so. I wouldn't let anybody else pass my patient's med even if i pour it myself...

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Specializes in jack of all trades.

I'll tell you all a little story in which I learned the hard way. Sixteen years ago I was working in a Burn ICU on nights as the only RN with no less than 4 pts. I did have a Burn Tech assigned on those shifts but otherwise had no other help. Now considering this meant debridment, dressing changes, vents, traches the whole shabang. Burns do take a great deal of attention more than I ever had to really give when I was working in ICU/CCU/CVICU. Answering a call bed needed to be done almost immediately etc. Anyway to the point. One night I had one patient who was suffering some heartburn. He had Maalox/Mylanta ordered. As I was in the room to give the little cup of Mylanta my other in the next cubicle pulled out his trach and started crashing. As I ran to attend this patient I asked my Burn tech to ensure Mr. So-So took his mylanta for me. I had significant trust in this tech as she was also a 4th year nursing student who had just graduated and was awaiting taking her state boards. Didnt think nothing of the request. Anyway when I gave report that morning my relief happened to be my NCM and I had forgotten in all the choas and asked the tech if Mr. So-So took his mylanta. Big mistake!!! This NCM turned me into the BON for "Misappropriation of Medication and for asking a non-licensed person to administer" I had to surrender my license for 4 months suspension, 2 years probation, $500.00 civil penalty, additional ceu's for medication errors and legal responsibilites, quarterly drug screens at my cost, and documented counseling for that entire 2 years also at my cost. I also was terminated!! Now please understand I had been a very experienced critical care nurse with my CCRN for over 12 years at this time. Had only been in this particular hospital 4 months. This NCM wasnt a friendly person and also I had questioned numerous protocol of the unit in particularly documentation as it was very poor!! They used mostly check list and the prior shift may not have a single nursing entry in the notes which I didnt feel comfortable with.

Anyway even something so simple you wouldnt take a second thought of came back to bite me in the royal orifice so to speak as retaliation. The BON's treat these things no differently then if you had been impaired or diverting medication. Funny thing is I had just recieved my 3 month evaluation and it was perfect from the previous NCM. The one who reported me was new. Keep this in mind when its something so simple you may not think of the consequences down the road or realize just how fragile a nursing license truely is!! It also leaves a permanent mark on your licensure for the rest of you professional life.

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