Med Aides giving PRN meds

catlynLPN · Jun 6, 2008

I knew it!

I knew we'd be hearing about a situation like this eventually.

I don't have any advice for you, but as an LPN, I do not intend to take responsibility for med aides to pass meds.

If a facility hires them, then IMHO, the facility should take responsibility for them.

Haven't we heard talk that med aides were "trained" and have their own certifications and don't work under a nurse's license??

If that's true why is state saying YOUR license is on the line??

The day that start where I work is the day I go into retirement.

pagandeva2000, LPN · Jun 6, 2008

I guess the state thinks that you are a combination of a fly and an octopus to believe that you are able to supervise them doing anything once a month. I would not be feeling that too much, either. Maybe, just maybe, this is a hint that you should move on.

racing-mom4, BSN, RN · Jun 6, 2008

I just cant believe that I am reading this correctly...once a month you go make sure they are passing the meds correctly?

There is no liscned/registered nurse on site at all the other 30 days of the month??

Yes this needs to go back to your facility. They are the ones the hired the them, not you. As far as I am concerned you work there one day a month and on that day they are passing the meds correctly. You have no idea what goes on the rest of the month.

FYI in our state we have QMA, qualifed med assistants, they are allowed to give certain oral meds, they are used in the nursing homes mainly, but a nurse of some sort, LPN/RN must be on site at all times.

pagandeva2000, LPN · Jun 6, 2008

I just cant believe that I am reading this correctly...once a month you go make sure they are passing the meds correctly?
There is no liscned/registered nurse on site at all the other 30 days of the month??
Yes this needs to go back to your facility. They are the ones the hired the them, not you. As far as I am concerned you work there one day a month and on that day they are passing the meds correctly. You have no idea what goes on the rest of the month.
FYI in our state we have QMA, qualifed med assistants, they are allowed to give certain oral meds, they are used in the nursing homes mainly, but a nurse of some sort, LPN/RN must be on site at all times.

This is the same for my state. Actually, to show how insane this policy is...if there is no nurse, then, WHO, pray tell would be administering these PRN medications if one is not available?? I really hate the state sometimes... :banghead:

Batman24 · Jun 6, 2008

I'd turn this over to your facility ASAP and look for another job PRONTO. There is no way I would sacrifice my license here. NONE. How do you know who does what when you aren't even there?! That's insanity. PLEASE get out of there.

DusktilDawn · Jun 6, 2008

One of my tasks as an LPN at my facility is to oversee the medication aides at an Adult Daycare which is at an off site location from mine. Once a month (go figure) I'm required to visit their center to make sure they are passing medications correctly.
Well, the State was at their facility doing their inspection and they questioned the med aides giving PRN meds without a nurse on site. They said my license was on the line and that I need to create a policy and a competency test over PRN meds.
Does your facility have such a thing? If not, do you have any advice as to what I should include in this policy or competency test?
I'm not so sure I like the idea of having this responsibility...
Thanks for all your help!
jacesmom2:o

You realize that the State is enabling your facility to put ownership of their staffing practices onto you? Why are they theatening your licensure AND telling YOU that YOU need to create a policy and competency test over PRN meds? Why are they not going after your employer for not adhering to THEIR standards?

When is legislation going to make health care facilities responsible for THEIR OWN staffing policies, policies that by the way nurses usually have zero to nil input when they are made.

lvnsandiego · Jun 6, 2008

When I worked in Assisted Living, where they used med techs this is how PRNs worked:

Facility must have on file in each resident's chart a form signed by doctor that states patient's ability to determine their OWN need for PRNs. If they are deemed able to determine, then the resident can request specific PRNs and med tech/LVN can administer.

If patient CANNOT determine their own needs for PRNs, then med tech/LVN must call MD to get permission to administer.

To further enrage and confuse me, the licensing even wanted LVNs to do this, because RCFE and assisted living regs don't require licensed nursing, so the regs are not written to include them. I argued beyond blue in the face that LVNs are qualified and licensed to determine need for PRNs with proper MD order but licensing said no.

This is in CA, for facilities with RCFE licensing. This was also over 5 years agao, so the regs may have changed.

Now of course this raises the question of a med tech taking a verbal order, which they cannot. To cover all bases, you need to have the MD fax over a written order EACH and EVERY time the patient needs a PRN.

Can you imagine how much the doctors love this?? SO frustrating!!

BlueRidgeHomeRN · Jun 6, 2008

i'm sure this varies from bon to bon, but i'm getting ready to take a course to certify me to teach medication administration to non-nurses (it's for a home-based program for mr adults, not for any facility or group setting.) my class is two days long; the one for the "civilians" is four full days.

here in va, the syllabus clearly states that a medication aide may not give meds in a nursing home, call scripts into the pharmacy, or give im injections [remarkably, insulin is okay!!]

but to expect you to develop this program is outrageous!! let your don do her job..including doing the monthly visits herself. she and the owners' or administrators are the ones making money off this--let them risk their licenses!!:angryfire

Psqrd · Jun 7, 2008

Forgive my ignorance...I'm a new grad.

My question is who determines the patient needed the PRN med?..I thought an assessment of the patient needed to take place and as aids that is not within their scope and therefore illegal.

I have never worked in a LTC but my Grandmother lives in one and it would bother me to think that PRN medications were being dispensed to her without an RN doing an assessment.

I don't know, sounds dangerous.

p2

kcochrane · Jun 7, 2008

Forgive my ignorance...I'm a new grad.
My question is who determines the patient needed the PRN med?..I thought an assessment of the patient needed to take place and as aids that is not within their scope and therefore illegal.
I have never worked in a LTC but my Grandmother lives in one and it would bother me to think that PRN medications were being dispensed to her without an RN doing an assessment.
I don't know, sounds dangerous.
p2

As a LPN in NYS I can give PRNs. Most of my PRN orders are written with parameters....i.e. for anxiety or for pain/temp. Most PRNs do not require a RN assessment if written correctly by the MD with good parameters.

But I do agree that if you don't have the proper training, giving a PRN in some cases could be dangerous if you don't have the ablility to look further than what is presenting to you.

BTW are there states where LPNs cannot administer PRNs? Also, how long is the med tech training?

To the OP, I'm ditto the rest who are worried about you taking on the responsiblity of the med techs under you. Those that decide to use them should be taking on that liablity.

Psqrd · Jun 7, 2008

No offense meant to LVN's...even that being said KC, a NURSE is evaluating the patient, whether it be an RN or LVN.

I have heard of these medication techs as we discussed them is school...and it sounds like a huge gray area that LTC's are using to save a few bucks. I know I wouldn't want them giving my patient meds...I assessed em', I'll medicate them... but lets not forget I'm a newbie, so I am only goin' on the NS way of things.

P2