Medication Aides

[R.L.Silva]

I am asking this question of you because I have looked for days for my answer and am still empty handed. I need to know where I might find information on medication aides and their state practice limitations for Massachusetts. I know this is an odd forum to ask this question but I am at my wits end. I am doing this for a friend who Manages a Community Health Center. Thank you!

[explorer]

perhaps I do. I know a couple prior nurses and techs who work with State Legislature. Fortunately, none of the hospitals where I have worked use them. It's mostly a LTC thing, I think. Which, to me, anyhow, still is not right, given how many meds some of those folks use. Yes, I still think it ought be illegal, myself. If that offends, you , I am sorry. That is not my intent. My intent is to protect my patients and my own license. Period.

I don't think that the med techs have the background to be passing medications

and they have restrictions on them such as can't give insulin or sched IV meds.

:chair:

[caroladybelle, BSN, RN]

hmm....i myself am a Medication aide in the state of Texas...i went to school for 6 months to get my med aide license...its not that big of a deal as most of you are acting...

we can only work in LTC settings...not hospitals and can only give PO meds and nothing that goes into the lungs....

we work under the care of a nurse just like CNA's do..we can not give PRNs without letting the nurses know and have there acceptance to give it. We can give narc's but have to sign out for them just like the nurse...and count every change of shift...we are humans too - we dont want to steal the narcs and anybody can steal narcs - even NURSES can be drug abusers...

i dont understand why so many of you are against medication aides....we take our licenses very seriously....we dont mess around..we know how to read the MARS and chart correctly...

" Can only give PO meds and nothing that goes into the lungs...". That statement right there scares me. I have suctioned enough meals out of patients with dysphagia after an aide fed them to know the fallacy of that statement. I personally think that doing MDI's (which do go into the lungs) would be safer than PO meds in many cases.

Is what you hold a certification or is it a license? There is a difference.

As long as ANYONE else is held legally responsible for the errors that an aide may make, then an aide should not be giving meds, in my opinion. In LTC, or anywhere else. And I do not work with med aides and frequently, not with any aides at all.

[Achoo!, LPN]

please don't think that CMA's can't get sued because they are certified and not liscenced. Their butts are on the line too. It isn't as if they make a mistake it's " oh well, I won't get sued, the doctor or nurse will".

It is the law, that medical assistants when providing patient care have to remain within their limited scope of practice; if they don't, and a mistake happens that injures a patient, they may face a serious malpractice lawsuit, especially if it can be shown that they acted outside the professional norm, and their specific scope of practice!

[SmilingBluEyes]

please don't think that CMA's can't get sued because they are certified and not liscenced. Their butts are on the line too. It isn't as if they make a mistake it's " oh well, I won't get sued, the doctor or nurse will".

It is the law, that medical assistants when providing patient care have to remain within their limited scope of practice; if they don't, and a mistake happens that injures a patient, they may face a serious malpractice lawsuit, especially if it can be shown that they acted outside the professional norm, and their specific scope of practice!

Maybe so. But you can bet the nurse responsible overall, (along with the doctor possibly), likely, are going down, too. You won't read of too awfully many cases where non-licensed people were sued alone. Sorry, I am not going down for ANYONE else's actions under my license. I have enough to worry about, taking care of what I am responsible for as an RN. I am sorry, I know this is sounding OLD, but just because CMA' s CAN be sued, does not relieve me of my responsiblity charged by the BON to ASSESS each patient in my care. I can't get out from under that mandate, no matter how "legal" or very good at what they may do CMA's may be. They do NOT assess patients. They do not have pathophysiology or pharmacology knowledge to back up their giving medications to people.

Honestly, I don't mean to sound superior, because I am not. I know CMA's are making a living just as I am. I am just stating the facts, trying to show you why some nurses are so upset about all of this.

Someone here stated "all you nurses have is higher education". It illustrates the serious lack of understanding non-licensed folks have of our concerns regarding the the safe administration of medications. The greatest emphasis in school we received was SAFETY in care of our patients. It was drummed again and again our legal and ethical responsibilties to them. I can't see shirking this off to UAPs,and I can't see how it's legal, even though, obviously it is. Blows my mind. I am sorry we can't be more clear to help you understand why some of us are so concerned and that you think we are just attempting to "put you down" or protect job security. It goes SO far beyond all that.

I am sure that is one of the things that may keep me out of LTC nursing. I will worry a lot if/when I see them coming into the hospital setting where I practice. I just can't handle having others give meds under my license.

[Achoo!, LPN]

I understand. I am currently a CMA going back for ADN, and I do understand the difference. I work in a clinic, not LTC or hospital. I do know of med passers at assisted living facilities though, that go to a ONE DAY class and become certified. As others have said, in that instance they are giving out prescription meds from the pharmacy as a family member would. They don't even have an RN on site at the facility I am speaking of, she is on call. That I feel is very scary.

I will also say though that in the clinic setting I do give injections, from Rocephin to epi, to solu-medrol. I work Urgent Care, and we also have a supply of medications to dispense which I fill (I was a pharmacy tech while in school), as well as topical meds ( silvadene/ let solution). I have been doing this for over 10 years, and it was never brought up that this was not in my scope of practice. We do take a pharmacology class, as well as medication administration. It may not be as in depth, but we are taught and it is listed in our job description.

http://www.medicalassistant.net/ma_can_do.htm

[SmilingBluEyes]

Thank you for that information. I am checking out that site now.

[NurseFirst]

I understand. I am currently a CMA going back for ADN, and I do understand the difference. I work in a clinic, not LTC or hospital. I do know of med passers at assisted living facilities though, that go to a ONE DAY class and become certified. As others have said, in that instance they are giving out prescription meds from the pharmacy as a family member would. They don't even have an RN on site at the facility I am speaking of, she is on call. That I feel is very scary.

I will also say though that in the clinic setting I do give injections, from Rocephin to epi, to solu-medrol. I work Urgent Care, and we also have a supply of medications to dispense which I fill (I was a pharmacy tech while in school), as well as topical meds ( silvadene/ let solution). I have been doing this for over 10 years, and it was never brought up that this was not in my scope of practice. We do take a pharmacology class, as well as medication administration. It may not be as in depth, but we are taught and it is listed in our job description.

http://www.medicalassistant.net/ma_can_do.htm

I think there may be a bit of confusion. There is a difference between a "Medication Aide" and a "Medical Assistant". Huge difference. I think the confusion may come when people use "CMA" -- which generally refers to medical assistants in my experience. Not being exposed to med aides, I don't know whether they have a certifying organization or not. One difference between the two is that medication aides tend to work in LTCs and medical assistants tend to work in clinics (not really trained in anything related to the bedside.)

NurseFirst

[SmilingBluEyes]

Yea I was thinking the same things as I checkedout that Medical Assistant site. Not really the same things.....

[Achoo!, LPN]

I wasn't sure who was all being reffered to in the context of passing meds, I just saw CMA listed with CNA and PCA. Like I said, I only work clinic, but know of many places that have medication aides that have had little training. In doing my CNA training for the nursing program, I spent a few days in an assisted living facility and their med passer was not even a CNA but a " residential aide", trained on the job.

[KRVRN, BSN, RN]

I think part of why this sort of debate gets going is because the nurses talk about how they're unwilling to (and legally can't) delegate and the CMAs talk about how we think we're superior.

Maybe this will help with that feeling a little. If I have a pt that needs an IV med, I can legally have my RN coworker give that IV med for me if I'm too busy. If he/she totally screws up giving that med and does something truly terrible (such as injecting air into the vein instead of the med and the pt dies, for instance), then it is not my fault, it's his/hers. (That is not to say that my name won't get drug into it too if there is a lawsuit, of course)

So because of this, we RNs even have mental lists of which OTHER RNs we will and won't delegate tasks to! We all have at least one RN coworker that we would prefer not to delegate to! Even though the person is another RN, that doesn't mean I want this person to do something for me and then muddy up my shift and my pt.

I'm not entirely sure why the certification/license/whatever of CMA exists since RNs are very clearly taught that we CAN'T delegate med administration to them.

And besides that, we are also skeptical to delegate something to a person that is not a LVN/RN. Yes, a CMA has a course of X months long. Nurses get an entire course just on pharmacology and the knowledge is also integrated and reviewed in regards to various disease processes and conditions throughout the REST of the program as well. If all is well with the pt and it's merely a matter of reading the MAR and handing the meds to the pt, I'm sure a CMA is fully capable of doing it. It's the adverse reactions and drug interactions and changes in pt condition that make us too uncomfortable to delegate meds to a non-nurse. We're just not able to believe that a CMA's knowledge of medications and interactions and such compares.

[Karley9336]

Yesssss! Exactly! Well put!

[schmuffin]

I just want to say that I agree with all of you about this whole medication aide thing. How can you pay someone 8-10 dolllars an hour to do the same thing as what people go to school for, for 2-4 years....its nonsense. I am that someone. But i do agree, it is terrible. I kept refusing to do it for 5 years at my job, cause i didnt agree with it. But, for a little more money (and trust me, not much more than being just an aide) It has saved my back from so much pain.....and that is the only reason why i have done this.