LPN passing meds all over the place!

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Talk about a scary situation. I work for a community college and take nurse aide students into a wonderful state owned facility. I have the biggest concern and no one else seems bothered by it and I am just an instructor USING their facility, so really I have no voice, or do I?

There is an LPN who passes the morning and noon meds. She has the meds lined up on the med cart, hands the medication to MY students and the cna's who work there to give to the residents. In my wonderful state only nurses can give medications unless they are med techs who have had an approved med course. This is usually only people who are med techs who work with the developmental disabled. Not this case.

Anyway, this LPN leaves medicine cups all over the tables, some still full of medicine! Anyone of the residents could pick the medicine up and take it at any given time. I have never encountered this type of med pass in my 12 years of being a registered nurse. I have worked in many long-term care facilities and I always stood with my resident and made sure they took the medication and I cleaned up my mess! I always took my med cups to the trash.

Am I just too picky? :uhoh21:

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Specializes in Cardiac Care.

Not picky at all. Sounds like a sloppy practice.

We're taught that we do not give a med that someone else has prepared. Your students don't do that, do they?

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Specializes in Community Health, Med-Surg, Home Health.

I am hoping the same, that your CNAs are not actually passing the medications. I have seen sloppy people all over the creation, and this is a high alert for mistakes. I do wonder, though, what the nurse-patient ratio is. Many times, in LTC, one nurse is responsible for passing medications to 60 residents...too many for my taste. Even with my strict organization, I would be a basket case. Not saying that I support this, but, I can see how this would lead to unscrupelous med-passes from an overworked, burned out nurse.

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ok, i see several problems with this.

First of all, CNA's in my state are NOT allowed to dispense medication, period. I have heard of medication aides, but there are none in my state. Maybe this LPN thinks that your students are SPNs?

Second, ALL(well, most) of us have prepared meds in advance, especially when working LTC. However, She should not leave these pills on top of the med cart. What if someone happens to notice a juicy narc sitting in one of those cups? I would HATE to have to count with him/her. If she is going to prepare her meds in advance, then at least leave the cups in the med room.

Third, yes, you DO have a voice. HAve you told your students to REFUSE to dispense medication for her? Thats too risky, not only for the patient, but for your license. YOUR there w/ student NA, YOU caught wind of them dispensing meds, and it's YOUR @$$ if someone says something or is given the wrong meds.

I would def. say something to the LPN in question, and if problem wasn't resolved, I would speak to DON. Just because your using their facility doesn't mean your license has to be jeopardized like this.

Just my :twocents:

Hope all works out, and I didn't sound too harsh.

P.S. I've only been an LPN for a short amount of time, and I was a CNA before then. Huge difference. Let your students know that what there doing is outside the scope of practice for CNAs. Would be a great time to discuss the nurse practice act!

:redpinkhe Luckie

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if you as a licensed nurse are taking these students to this facility then they are working under YOUR license, any mistake that is made is something that you will have to answer for

this is not to say that the lpn will also be at fault but this is dangerous for you and you will have to act on it

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thanks for the responses, everyone.

No, I don't allow my students to give any medications. I think that is the reason why the LPN doesn't really like me. LOL. Her loss. My students know that it is illegal in this state to pass medications as a nurse assistant, cna, etc... unless they become DSP's and take a med course. My daughter is a DSP and has went through extensive training through her work and her boss (RN) to become med tech certified.

Today I went to throw away a couple of her medication cups that were on the tables. I asked her to not give drinks with medications in them to my students to give to the residents. She doesn't like me anymore! Good for her. She had about 30 medicine cups lined up with liquids and crushed meds. She must have some kind of crazy system because none of the medication cups had names or any way to identify them. :no:

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Specializes in Cardiac Care.

I'm certain that she's probably overworked and overwhelmed, but good Lord! I'm glad your students are not passing her meds.

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oh yes, she is overworked. She is the only LPN on the day shift and she passes medications for 70 residents. Most of these residents must have their medications crushed and mixed with drinks or food. I really do feel for her. She has total responsibility of the med pass when there are at least two other RN's in the building, but this LPN is the only one that passes meds, does accu-checks and all injections.

I am always nice to her, though she doesn't care for me. She is run ragged and I know that feeling. :banghead:

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In my facility I would get fired for pre-pouring, let alone leaving it on top of the med cart and NO cna's can not pass our meds. Not even the one that is a med tech. I don't think pre-pouring is against state rules, they do it in jails, but it may be against LTC/SNF (AACHA) rules. I believe my state also has rules regarding nurse/resident ratios too. There is no excuse for pre-pouring, learn time management, quit chit-chatting with co-workers, don't go smoke a bunch of times. Pre-pouring is an accident waiting to happen.

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Specializes in Community Health, Med-Surg, Home Health.

I have seen medications pre-poured often. Usually, the nurse has already checked the MAR, placed the resident's name in the cup, placed in the resident's drawer and rechecked against the MAR before being administered. When a person has to administer so many drugs to so many patients, (70 is TOO MANY), then systems are developed. This is why I don't really like LTC for nurses particularly an LPN. It is an accident ready to happen and facilities that leave nurses to their own devices do not care for the nurse or really advocate for patient safety. A place like that is a meat factory.

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You are not being too picky. What she is doing is very dangerous. Have you thought about taking her aside and speaking to her about this? I would have done this as soon as I noticed what was happening. If she blows you off, then a word with her supervisor would be in order. Be careful, because you could be seen as responsible, due to you being an RN. That is why you should take steps to correct the situation.

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we had a night nurse who would pull up 6am meds and put them in the drawer in the cart

at 5 am one morning state surveryers walked in..she was in trouble and ltc facility was written up, i know what being pushed to the wall is like but there really is no excuse when you get caught

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