who's license do med techs work under?

FlyingScot, RN · Feb 24, 2009

the reason why i ask is that a friend of mine is an new CNA by a 8 week training course who took a two week med-tech class and now is referred to as a "med nurse" in a nursing home. she gives coumadin, nitro, darvocet, digoxin, morphine, etc, etc, etc......... the other CNA's report the vitals to her and she makes a judgement on them. she doesn't know to check a PT/INR, or a BP before nitro, etc... she said it is just her and one other LPN in the building and that she cannot give injections for IM's or insulins, etc but she does everything else including PEG meds....
i think that in itself is dangerous and i dunno how intense two weeks of med-tech training really is. my pharm course was one whole semester plus all the supervised two yrs of clinicals in nursing school. she was kinda just let loose and i know the nursing homes i did my clinicals at also had med-techs with similar duties.

Dang, now that IS scary. Still if the facility says this is okay then THEY are taking the responsibility. I'm not so worried about not checking the INR with Coumadin as under normal circumstances that isn't checked with every administration anyway,but she absolutely shouldn't be giving Nitro and a CNA shouldn't be making the judgement on whether to give meds or not. But again, it's the facility taking the responsibility although they seem to be playing it rather fast and loose. I think if I were her I'd run from that place. I wonder what other short-cuts they are taking. Still I think the RN's license is safe as long as she follows company policy.

TheCommuter, BSN, RN · Feb 24, 2009

I live in Texas, where medication aides are regulated by the Department of Aging and Disability, must complete a 4 to 6 month course in medication administration, and are mandated to administer medications during clinical rotations before they're permitted to receive certification.

Medication aides are widely utilized in the nursing homes and assisted living facilities in my area. Most of these facilities place their own limits on what a med aide may give. For example, many of the nursing homes in my city do not permit med aides to give "high risk" drugs such as Coumadin. One facility disallowed med aides to give pain medications because analgesics technically require pain assessments from a licensed nurse.

Medication aides in my area are held responsible for their own med errors, but the nurse is responsible for monitoring for any adverse reactions that might arise as a result of the med error.

Jewl · Feb 24, 2009

Thanks for the feedback!

I was just on the Official Internet Site of the Florida Legislature and it makes it very clear that an "informed concent" is given to the resident, or the resident's surrogate, guardian, or attorney in fact, that an assisted living facility is not required to have a licensed nurse on staff, that the resident may be receiving assistance with self-administration of medication from an unlicensed person, and that such assistance, if provided by an unlicensed person, will or will not be overseen by a licensed nurse.

Thanks again.

Jessica

sasha2lady · Feb 26, 2009

I personally do not favor med techs in any institution and I am glad my facility doesnt use them....although they did talk about it at one time but all the nurses were so against it that it quickly got dropped...in my nursing school I was taught that if you are the nurse in the bldg and a med tech messes up..med error or whatever that you are the responsible one...it goes up the chain...the nurse in charge/or in the bldg...then the nsg mgmt..don etc....not to mention policies. I think that 2 wks of training is a JOKE and I would not ever trust a med tech to give ANY med whether that pt was mine or not. I told my DON that if she started using a med tech that I would not be held accountable for them in any manner and that I would not assign them to anything...she would have to...I think they are unsafe. They dont know when not to give a med or what its for...they dont have the knowledge or the assessment skills it takes to make proper judgement calls....esp with bp meds, cardiac meds, coumadins, narcs, diabetics..etc...I think that places hire them and use them b/c its cheap labor. Plus...a med tech cannot assess jack....they cant take or write orders from a doctor much less know when they should even contact one....that is all put on the nurses plate which is a crock. I would never go for a med tech giving a member of my family any type of med..not even mylanta! I would want a real nurse. I guess it all boils down to how a place can save a buck and cut corners any way they can. Ive had cnas ask me if they could give some of my meds....and ive always said no. They have asked other nurses and those idiots let them give some meds so they automatically think its ok and kosher. The way I see it is its their license...not mine. Also....alot of assisted living places do use med techs b/c the state licensing requirements are totally different and allow it.

Atheos · Feb 26, 2009

I would never go for a med tech giving a member of my family any type of med..not even mylanta! I would want a real nurse. I guess it all boils down to how a place can save a buck and cut corners any way they can.

Assisted Livings are meant to be a 'home' environment. At home nurses DON'T give your meds. In fact, if you need so much monitoring that you need a bp before a med or this or that then the proper place for you is a nursing home NOT an assisted living.

In fact, despite the fact that our nurses/med techs give meds here the regulations state that the resident must be able to self administer AND in our facility they have to do it for the first week properly to stay.

If they can self administer then a med tech can administer.

Also, we have had nurses as family members that insist no med techs pass their meds. We kindly inform them that the ONLY choice they have is the nasty nursing home down the street that employs only real nurses. They usually stay here.

Kinda funny, in the few years I have been a med tech I have yet to make a med error. Can't say the same as some of the nurses I have worked with.

Also, having been in a long term care setting for quite awhile I have noticed that while the nurse assesses, when patients are going south or have a change in status it's the CNA's and not usually the nurses that notice. It's the CNA's that tell the charge nurse, hey Mrs. X isn't looking so good, or so and so is doing this or that. Doesn't take a rocket scientist.

Also, what your school teaches is not important, what the BON teaches is. Most states have the med techs under the facility or DON. Unless your state specifically says they are under you they aren't. Plis how is it different having a med tech under you vs a bad nurse???

Also, as to saving money, that's why they have LPNs. If they didn't try to save money and could pay whaever they liked without being hurt by it I imagine all the nursing homes would only employ RNs...

Jewl · Feb 26, 2009

Great, thank you for your insight.

Jessica

stlgirl2803 · Mar 25, 2009

In St Louis we have CMT (certified medication techs) pass the meds. We nurses give the insulins, coumadins, all injections, all flushes, anything per rectum and all the treatments, and direct the care provided by the CNAs.

I could not imagine working in a SNF or Residential facility with the 50 resident load AND pass all the meds.

CrunchRN, ADN, RN · Mar 25, 2009

"Kinda funny, in the few years I have been a med tech I have yet to make a med error. Can't say the same as some of the nurses I have worked with."

Stan,

Trust me. you have made them. You just haven't caught them. Unless you are the 1st ever infallable human ever made.

Atheos · Mar 25, 2009

"Kinda funny, in the few years I have been a med tech I have yet to make a med error. Can't say the same as some of the nurses I have worked with."
Stan,
Trust me. you have made them. You just haven't caught them. Unless you are the 1st ever infallable human ever made.

Nope, not perfect, I am however obsessive at times and I can say I haven't made an error.

To assume that either I would make errors or that I wouldn't catch them or worse, that I'm a liar is an error on your part.

But if it makes YOU feel better. Go right ahead and keep thinking that.

CrunchRN, ADN, RN · Mar 27, 2009

Stan,

I was not calling you a liar. My point is even when we think we have done everything right. Followed all the rules. Done everything we are taught percfectly. Errors still happen and often they are never discovered. I really doubt you have never made an error, but what the heck do I know? I have only been a nurse for 15 years and worked in the hospitals since age 15.

chevyv, BSN, RN · Mar 27, 2009

I'm a relatively newer lpn and would love to think I've never made a med error, but I'm sure I have. We have so many stock meds that I don't think any of us can keep up with the new ones that take the place of the old ones. I've been told that I don't take that green one. Well that green one is the new calcium with vit d. I know it's not the usual dose so I have to give one and break the other in half. Now, nobody ever told me that it was the wrong med, but I have this sneaking suspicion that maybe out of the 50 stock meds in my cart that perhaps that wasn't the right one. I can only do the best that I can. I would have investigated this more had it been a cardiac or psych med. I can only imagine the other errors I've probably made. I'm so far from being the best lpn that I can be, but everyday I'm still learning.

My rn clinicals, I can honestly say that I've never made a med error for sure. The hospital is much more protected as far as meds coming up for each person individually. If you scan a med and it's the wrong time or med or even dosage, the computer tells you and won't let you scan to give it. You have to override which really cuts down on the errors. I like that way so much better.

Jewl · Mar 27, 2009

Hi Stan. Way to go on being a nurse for 15 years. Are you ready to kill yourself yet? Im messing with you. I haven't even been a nurse for a year yet and I went in blind not really knowing what a nurse actually does. It's definitely not glamorous. I think people need to be more aware of how to preserve their health and not end up sick cause I think 20 years from now the hospitals are going to be over crowded and hopeless to a degree. What are your thoughts on our ever evolving nursing shortage?