Medication Aides

VickyRN, MSN, DNP, RN · Aug 18, 2005

i may be out of line with my post, but here goes.
i am glad to see that nc is getting some feedback on this issue. yes, at the 11th hour, this legislation was slide into the 2005 appropriations bill. how sad! please keep in mind: this was all after the board of nursing voted "that an rn could not delegate the task of medication administration to a medication aide and after the north carolina community college system decided not to add medication aide to their cirriculum."
i am sure that the public and even the rn's and lpn's of nc would love to hear about this legislation. not only are these uap's/med aides going to be in ltc, our schools have been targeted now. these twp target areas house our most vunerable populations: our children and our elderly. i am the designer of the website www.ncpama.org. referenced in an earlier post. i applaud the nc nurses forum for taking on this issue because i believe that an informed public can have an opinion and should be given the opportunity to make an informed decision, instead of having an issue shoved down their throats, as this is.
i wrote my legislators and here is part of my plea to them.
:rotfl: "... "the nc board of nursing states, "the medication aides will administer "routine" meds." what constitutes routine meds? all medication can have potentially dangerous side effects, especially in our elderly and compromised patient's. they are an extremely fragile group of people who very often are subjected to medication errors even from licensed personnel whether it is a doctor, pharmacist, or a nurse. the legislation proposed is focused mainly on medication aides passing meds to our elderly population. (and now schools)what does this say about our society? how much value do we place on our elderly (and now young) population? what about the disabled? are they, too, such a disposable group of people?
i have worked very hard and made a lot of sacrifices to get through nursing school. i will obtain my license shortly after may 2005. my purpose for going to nursing school was to study hard, learn nursing theory, criticial thinking skills, pharmacology, and clinical abilities. i have learned to apply theory to practice and know the side effects of medications i give to my patient's. i know when to question a dose of medication or whether to hold a medication. there is so much more to learn. i, as a future nurse, would never delegate medication administration to a person who has had 24 hours of training. plus, if they make a medication error, it is my license. i cannot take the risk of supervising these aides. this is unacceptable! we are taught in nursing school, to never administer a medication drawn up by another registered nurse or you could lose your license. i am not just passing medications and neither should a medication aide.
let me say, that medication aides are not the answer to the impending nursing shortage. the answer to the nursing shortage is money and resources for educational facilities and nurse educators. solving the nursing shortage would put an end to this potential unsafe practice and provide the care our clients are entitled to and deserve. medication administration is so much more involved than just giving a person a pill. our primary function should be patient safety and medication aides do not ensure patient safety.
there are still too many unanswered questions regarding this program. how will problems be identified if this program takes off? would a charge nurse, nurse supervisor or physician take the responsibility of these aides administering medications under their supervision? medication aides pose a constant and direct safety threat to the nursing population. i do not support the administration of medications by medication aides in any setting. i urge each of you to really research this. do not just talk to doctors or facilities. i encourage each of you to go out and talk to nurses in all healthcare settings. after all, they are the profession most affected by this proposed legislation. if this passes, i hope there are many other written stipulations prior to implementation of this program. patient safety should always be our main focus!
there are over one million medication errors in the u.s. that are documented by medical professionals. these errors are made from professionals with many hours of schooling. do our patient's mean so little to our society, that we can subject them to the lesser trained? how many patients in that time frame will be injured or die before our eyes are opened? if this answer is even "one" that is too many. let me ask you, "would you want a person to take a 3 day course to give you, your child or one of your loved one's medication?
i have had 5 general replies to my letter from our legislators thanking me for my letter. plus, two sincere replies, whom i believe actually took the time to read my letter. it is a sad day when we, the taxpayers, are not given the opportunity to decide what is best for ourselves and our loved ones.
some say to give up, but i say to go forward. there will come a day soon when the general public will have a chance to speak regarding this subject. until that time, i encourage each of you to continue to write your legislators and your local newspapers. ask your neighbors have they heard about this legislation? tell this story and pass the word. the general public has the right to know.

you are to be commended for your patient advocacy and nurse activism! :) may we all follow your example. please keep us updated, especially on the time and place for public comment concerning this very dangerous legislation.

caydon2 · Aug 27, 2005

I had no idea this was happening and I consider myself informed of political matters! How did you hear about this?

VickyRN, MSN, DNP, RN · Aug 27, 2005

I had no idea this was happening and I consider myself informed of political matters! How did you hear about this?

This whole thing is underhanded beyond belief. North Carolina nursing faculty have access to excellent first-hand sources concerning important nursing and patient care political matters throughout the state.

jsteine1 · Aug 27, 2005

Yes, we did. This is the resurrection of NC Senate Bill 662 and NC House Bill 783, both of which were tabled in committee after 12 of the 14 members of the NC Board of Nursing voted to no longer support this very dangerous legislation, back in the May NCBON meeting. At that point, the executive director of the NCBON vowed to bring the medication aide back. It was tacked on to the very popular 2005 Appropriations Act (NC Senate Bill 622) as "back-door legislation," which apparently has passed. This is a very dark day for nursing in North Carolina.
http://www.ncga.state.nc.us/Sessions/2005/Bills/Senate/HTML/S622v7.html

Nothing short of terrifying. Does anyone know how many states alllow Medication aides?

VickyRN, MSN, DNP, RN · Aug 27, 2005

nothing short of terrifying. does anyone know how many states alllow medication aides?

this article provides some insight: http://www.nursingworld.org/ojin/tpclg/leg_12.htm

the whole concept of the medication aide is confusing, as there is no consensus as to what sort of training the medication aide should have, the work setting, and the types of medications. medication aides have been legal in north carolina for years, but only in assisted living environments. this new legislation is dangerous, in that these unlicensed personnel may now dispense medications in acute care facilities, nursing homes, prisons, psychiatric units, and schools. the big fear is that politicians and hospital executives will use the nursing shortage as an excuse to deskill and deprofessionalize nursing. this new frankenstein version of the medication aide is a prime example. the real motive is to save $$$$$$ - but at what cost??? who can place a dollar value on our frail elders' or children's safety? the public needs to know before it is too late.

a few other links:

http://www.alfa.org/public/articles/regs_medicationmanagement.pdf

http://dhfs.wisconsin.gov/rl_dsl/nhs/medaides.htm

http://www.findarticles.com/p/articles/mi_qa3928/is_200401/ai_n9351456

boulergirl, CNA · Sep 3, 2005

I recently resigned from my med tech duties, just in time for the new company we work for to buy out our building. Anyway, the new company has four days' training for the new med techs (now they're "med aides") BUT they have so much responsibility that I cannot imagine being in their shoes. It was one thing to pass pills and be shift supervisor, but now the med aides are drowning in paperwork and don't even time to take a break anymore. (Now one med aide passes meds for the whole building--that's about 50 people--on each shift.) They have alert charting, skin care charting, progress notes, pharmacy orders, vital sign charting, etc., then there's the faxes they have to send to pharmacy, to the doctor asking about this or that resident's medication, oh and did I forget to mention that we're on a first-name basis on the guy who delivers our meds EVERY NIGHT? (and sometimes more than once a night). That new doctor must really love pumping our residents full of meds. Needless to say, the med aides are burning out and the raise they were promised four months ago has not happened, but the promised increase in workload and job stress, has. Now that the med aides are virtually working as staff nurses, they're beginning to wonder what our boss has to do.

M&MRN2005 · Sep 3, 2005

nothing short of terrifying. does anyone know how many states alllow medication aides?

there are 14 states that currently allow medication aides. other states are trying to impose this type of legislation, but thanks to their nurses associations, the legislation was defeated. the ncna (north carolina nurses asssociation) was for this legislation along with the nc hospital association, as long as hospitals were not affected. gee thanks!! it is a sad day when associations agree with legislation "just because it doesn't affect them." the relief efforts for hurricane katrina victims really doesn't affect nc, but i hope that we are outraged at how the relief efforts have been handled. suppose we as american citizens sat back and did "nothing" just because it did not effect us. we live in a sad state of affairs when $$$ comes before people's health and safety.

M&MRN2005 · Sep 3, 2005

i recently resigned from my med tech duties, just in time for the new company we work for to buy out our building. anyway, the new company has four days' training for the new med techs (now they're "med aides") but they have so much responsibility that i cannot imagine being in their shoes. it was one thing to pass pills and be shift supervisor, but now the med aides are drowning in paperwork and don't even time to take a break anymore. (now one med aide passes meds for the whole building--that's about 50 people--on each shift.) they have alert charting, skin care charting, progress notes, pharmacy orders, vital sign charting, etc., then there's the faxes they have to send to pharmacy, to the doctor asking about this or that resident's medication, oh and did i forget to mention that we're on a first-name basis on the guy who delivers our meds every night? (and sometimes more than once a night). that new doctor must really love pumping our residents full of meds. needless to say, the med aides are burning out and the raise they were promised four months ago has not happened, but the promised increase in workload and job stress, has. now that the med aides are virtually working as staff nurses, they're beginning to wonder what our boss has to do.

what type of facility did you work in? who is supervising these people? why are the med aides ordering medications for the patients. a med aides only responsibility is the task of giving the med to the patient. nothing more. if so, this is violation of nc state law!!!!

boulergirl, CNA · Sep 3, 2005

what type of facility did you work in? who is supervising these people? why are the med aides ordering medications for the patients. a med aides only responsibility is the task of giving the med to the patient. nothing more. if so, this is violation of nc state law!!!!

this is an assisted-living facility i work in, but it's in georgia. the med aides don't order new meds for the residents--the doctor does. however, if a resident falls or has a uti or something, the med aide has to contact the doctor and ask them if the resident should be prescribed an antibiotic. i'm assuming that these orders have to be cleared with the facility nurse (our boss).

these new guidelines, btw, are courtesy of the new company (which is based in oregon, thousands of miles away).

M&MRN2005 · Sep 3, 2005

This is an assisted-living facility I work in, but it's in Georgia. The med aides don't order new meds for the residents--the doctor does. However, if a resident falls or has a UTI or something, the med aide has to contact the doctor and ask them if the resident should be prescribed an antibiotic. I'm assuming that these orders have to be cleared with the facility nurse (our boss).
These new guidelines, BTW, are courtesy of the new company (which is based in Oregon, thousands of miles away).

For assisted living facilities, they use med techs and they fall under the federal guidelines which are different than the NC guidelines and the Medication Aides. There is a lot more training for med techs under the federal govt, than NC is proposing for med aides. Also the residents in assisted living facilties are mostly capable of taking care of themselves. They have the mental ability to know if a mediciation is incorrect.

sunny78 · Nov 12, 2005

i live in n.c. and i started out as a cma and as far as the duties go for a cma,its really up to the dr's as to what you do and as to how far your responsibilties go, i know i done things that were beyond my duties as i am sure we all have at one job or another,so i can say the best learning tool for me was hands -on learning from dr's and other nurses at the time and i think that is the best experience,and also,i have found that dr's here would rather train someone the way they want things done as opposed to someone fresh out of school!! i have actually been turned down for a job because the dr felt i had too much experience! its weird but i would like to hear how other states work!

Jane RCC · Jan 8, 2006

HI. I am new. I am a nursing student scheduled to graduate in May. My state is proposing legislation soon regarding Medication Aides. I am very leary of the wording of the proposal because it states that these aides are mandatory in non-healthcare facilities such as: daycares, prisons, schools, group homes, and long term care facilities. However, it is optional for other healthcare facilities such as acute care facilities. I know programs such as this has passed in over half of the states. Does anyone have any imput? How is it working? Has there been any problems? Are med errors increasing? It really bothers me because these people have no prior medical experience and will have 24 hours of training. The RN will delegate to them. This is real scary. This program came about in our state because these med aides were already working in some of these facilities and had no formal training. From what I understand, this is suppose to help alleviate the nursing shortage for our state. I am looking for help, please. I would love your imput and any suggestions.

WE HAVE REASON TO BE MORE THAN A LITTLE ALARMED. I WORKED CONTRACT AT A FACILLITY FOR A SHORT TIME ( ASSISTED LIVING FACILLITY) THEY WERE IN MY OPINION FUNCTIONING AS NURSES. THERE WERE SOME ERRORS (INSULIN) THEY ARE NOT ALLOWED TO GIVE IM INJECTIONS. ONE OF THE PROBLEM I SAW AND THE SCARIEST, THEY WERE COMMUNICATING BY FAX RE MRS SO AND SO IS CONGESTED....MD ACTUALLY CALLED IN RX FOR THIS URI DX BY MED TECH... THE MD'S DO NOT KNOW WHO SENT FAX...ME THINKS THEY THINKS...THEY GOT FAX FROM RN..I DID NOT STAY LONG...WORKING ON MY LISCENSE AND I REALLY DON'T THINK A LITTLE IN HOUSE TRAINING IS STRUCTURED ENOUGH. ESP WHEN RN IS NOT THERE. THINK NC DOES NOT REQ RN ON STAFF( IN GROUP HOMES AND ASSISTED LIVING...MOST ARE CONTRACT:angryfire