Medication Aides

P_RN, ADN, RN · Jul 13, 2002

http://www.nursingworld.org/ojin/tpclg/leg_12.htm

This is from the online journal.

ERNurse752, RN · Jul 13, 2002

My cousin became a CNA, then a QMA, and she never even graduated high school (got a GED.)

I don't think QMAs should be able to pass meds...they don't have enough training to understand what the med is for, how it works, what to watch out for, and when you shouldn't give it. Some of that involves critical thinking, and you don't learn that in 40 hours of class.

I had to go through all but my last year of clinicals, plus the hospital's own med class before I could pass only po meds, under direct RN supervision...

I went with my bf to a medcheck once, and a medical assistant put him in the room and took his v/s. At one point, he made a comment about "the nurse." I educated him that not everyone who wears scrubs is a nurse, and told him to check out her nametag the next time she came in.

I also think it's wrong for QMAs to be called medics. When I hear "medic," I think of EMT-P, which is in no way similar.

Our profession is getting into more trouble all the time, with all the different people getting trained to do nursing tasks...the suits don't understand, or don't care, that nursing is not just about tasks.

mattsmom81 · Jul 16, 2002

I would bet that monitoring the patient for drug incompatibilities and side effects will fall on the nurse as this is within our scope of practice.

Nurses who work with med aides must be alert to the patients' condition and regularly review the MAR, and screen for problems, as I'd bet most states will hold the RN responsible for these things.

Rustyhammer · Jul 17, 2002

Wouldn't it be difficult to monitor when you aren't the one passing the meds?

I mean, If you are not giving the dig. are you still responsible for checking the pulse first?

-Russell

adrienurse, LPN · Jul 17, 2002

How can you even be sure if the patients are getting the right pills? You're not watching over the aide's shoulder.

nurseratchett29 · Jul 18, 2002

Interesting thread. I have some definate opinions. I, too, am from Mass. and work in a primary care practice. The medical assistants (most of whom are CNA's or PCA's) are legally allowed to give injections here after just being signed off by the nurse manager. They also have the responsibility of calling in prescriptions for the docs. They'll say "Call in Cipro 250mg BID x 5 days" and the MA's just do it. They have absolutely no concept of interventions, contraindications, lab values etc. I think this is very dangerous and have expressed my opinion to be told "The physician is taking responsibility, you don't have to worry" But of course, I worry about my license. And injections!!! A high school drop out with 9 months of general classes at a "health care institute" does not constitute a competant professional. I am very well paid, and sometimes I feel like they are giving these MA;s more responsibility so they can cut my position. I know that in RI when I was a new grad, they had CMT's (certified medication technicians) who did general meds and nebs and that type of thing. We had to give narcs, injections, and Iv's and it did save a lot of time for us. I was fortunate, I had two nursing students as my CMT's because ultimately, I was responsible for every med they gave. Scary, isn't it.

mattsmom81 · Jul 18, 2002

Beth, this is what i would be afraid of too...I have never done LTC so don't have to worry....but those who DO and have med aides passing their meds are probably responsible and liable at some point.

Seems to be the same as in the hospital, where PCT's are working under the nurses' licenses doing invasive procedures and the nurse can be held accountable for their screwups. This falls under delegation in my Nurse Practice Act. Kinda scarey, isn't it?

adrienurse, LPN · Jul 18, 2002

Why don't we teach the housekeeping staff to start IVs? I'm sure they can be taught in a 3 day workshop. Heck we son't need nurses at all they're overpaid and they complain too much. We'll get the care aids to do dressings, take orders from the doctors and we can just hire people off the street to pass out the pills. I mean how hard is it to follow simple instructions? And if something happens, well let's just stand by the legislators, if they feel that this system is okay, it's good enough for us! It's a win-win situation! $$$$$$$$$$$$ I'M KIDDING BY THE WAY!

SmilingBluEyes · Jul 18, 2002

I am w/rusty on this. I believe STRONGLY no one but a licensed nurse should pass meds. These aides simply do NOT have all the pharmacology, pathophys, etc to truly understand the implications of what they are "passing"; jeez it is SO MUCH more than just sticking pills in a cup and handing em over!!!!! Yet, I WOULD BE HELD LIABLE for ADR's and other untoward effects? How bout med errors? How can an AIDE be held to this standard when they lack the education and training? And don't tell me a 2 week crash course would meet the standard. I do not buy it.

Would I want my loved one medicated by an AIDE? NO way! In that same thread, how bout we train SCRUB NURSES to perform surgeries? Hey, why not in the cost-cutting environment we are in. COME ON!!!! This is wrong!

I am NOT putting down aides, but to me, this is just dangerous practice and should be ILLEGAL! Therefore, ......I disagree w/.t totally. Just Another way for greedy suits and companies to save money in my opinion.

Fran-RN · Jul 18, 2002

hello to all, in long term care medication aides have been used for years. Yes, the nurse is responsible for what they do. I'm not sure the public is aware of this, even some of the other CNA s are not aware that the QMAs have the same training they do except for a few hours of training in medications. they are usually trained for PO meds only. The CNA training is basically the same as the first semester in nursing training. Basic patient care. but all of that is crammed into 105 hrs. They also have to pass a written and skills test that is administered by an independent agency. They are trained to do vital signs and what normals are and to report abnormals to the nurse. Then it is the nurse's job to assess the situation and decide what to do. In long term care there is usually 1 nurse to 20-40 pts. so we have to have assistants. they are a valuable assest to the nurse. but as in any other profession there are good ones and bad ones. I don't think Qs should be used in acute care.

Yancy SPN · May 6, 2004

I've never heard of medication aides. Are you licensed to do this? And do you give out narcotics?

I am a medication aide in Kansas and yes, I'm licensed to do this and yes, I also give narcotics. I can also draw up insulin syringes but not allowed to do the injections. I geuss it depends on what state your in as to what is legal and what's not.

Yancy SPN · May 6, 2004

I'm not familiar with medication aides, I don't think they're legal where I'm from. I don't see how they can be very safe. Seems like just another quick fix from the higher-ups.

Depends on what state your in and no, I'm not a "quick fix" to the hire ups either and I take that in offense. I've been a cna for 14 years and a cma for 4 years, and obvioulsy someone trusts me enough to give narcotics. I'm just a peeon for the nurses who dont want to pass meds and just do the charting. CNA's and CMA's are the backbone to nursing here in Kansas and without us, they'd be in a lot of chaos.