Medication aides taking nursing jobs?

VickyRN, MSN, DNP, RN · Jan 7, 2006

I agree.......................but I've known nurses ( RN & LPN) who just passes pills mindlessly, no consideration for side effects, no evaluation of the overall patient condition. The floor nurses in our NH spend 40-50% of their shifts on the med cart. If that time was freed up they could spend a lot more time on things like falls prevention, wound care, skin assessment and decub prevention, etc, etc, etc.

Do you honestly believe these facilities will keep the same numbers of licensed nurses (LPNs, RNs) once the med techs are on board? I think not. The number of licensed nurses will be cut to the bone and the nurses still will not have enough time for falls prevention, wound care, skin assessment, etc. That is the whole purpose of hiring these "med techs" - to save these facilities $$$$$. Now, instead of paying an LPN $20/ hour, they can pay a med tech a little more than minimum wage. Who ultimately will pay the price for the deprofessionalizing and deskilling of nursing? The fragile geriatric population

Marie_LPN, RN, LPN, RN · Jan 7, 2006

The number of licensed nurses will be cut to the bone and the nurses still will not have enough time for falls prevention, wound care, skin assessment, etc.

And i think the incidence of these things would also increase.

Plus, more of the nurse's time would be spend on PAPERWORK for these occurences, than the actual treatment.

If i wanted nothing but paperwork, i would have aimed for business management.

IowaKaren · Jan 7, 2006

Paperwork? Yes, you get all the paperwork and a full load of med passes and the Med. aides paperwork if you are informed about anything and hopefully not at the end of the shift (eg: "oh, his/her coumadin didn't come in today so I wasn't able to give it" of course, it's 2200 when this is said and it may have been able to be gotten per pharmacy if it were mentioned earlier but,...). Generally (where I work), if a nurse calls in, a CNA that happens to be a med. aide will be utilized which leaves the floor short of help and the nurse extra busy. At least if a CMA is scheduled, the floor shouldn't be short a CNA (generally, anyway). Don't get me wrong, there are some very competent CMA's but ultimately, it leaves the nurse with a double load of responsiblity.

Antikigirl, ASN, RN · Jan 7, 2006

It has already been implemented here, but CNA's and unlicensed caregivers can pass medications also (not injectables)...

It seems scary at first, but actually I find if the set up for med admininistration is done well, and teaching by RN's is done and on a constant basis....it works out quite well!

My CNA's were very cautious and thoughful about the responsibility. If there was any doubt, the got us RN's (we had a 24/7 nursing staff as well..very lucky!). They did AWESOME! And they were reviewed every three months, with any med errors caught fast and investigated to the best interest of the CNA and patient! I was so shocked..but I was so happy with it!!!!!! But my poor CNA's that was a LOT of work for them!

The rationale is that if it wasn't for someone with some medical experience giving meds..then the patient would have to do them themselves and that can be more than dangerous...so...they chose this option. Can't say that is right...but with money running the show, and medicare not footing the bill on most things without a fight...well...

The thing was is my facililty was set up that way, they really set it up beyond wonderfully to do this with the minimum of probelm. Most facilities I fear will not know how or will implement things as well (like a nurse 24/7, training, CME, investigation staff on any errors, voluntary classes if you aren't comfortable...etc).

What is scary..I just yesterday went to a facility with my agency and had to do a med pass...it was so messed up even I as an RN was like "what!?!?!"...things were horrid, I didn't know what resident was who, lables on meds didn't match orders, expired meds in cart, narcotics left from someone dead for two weeks in the cart! I mean..if it was hard for an RN use to med pass...what is to say a CNA wouldn't run screaming out the doors (and med aide too!)....that is what I fear most!!!!!!!

But if done correctly...heck it was better than having a small staff of RN's doing it, since you know no one likes hiring RN's for med pass..too expensive! But there better be an RN on staff during all this to help!!!!!!

lindarn · Jan 8, 2006

I am sorry, but RNs don't have to accept resonsibilty for anyone! If you are stupid enough to accept responsiblity for Med Aides, on top of everyting else that you have to do, than you deserve to put your license on the line.

What would they do if ALL OF THE RNs refused to be accountable for these, "MAKE BELIEVE HEALTH CARE PROVIDERS"? Nurses are enablers for these assisted living facilites and nursing homes owners. For that matter, nurses have been enablers for the entire health care industry, who have allowed health care to go to hell in a handbasket. We accepted the poor working conditions, lousy pay, and benefits, and the lack of respect by not organizing, and becoming a force to be reckoned with.

We have remained "martry maries", and continued to go to work, and accept as inevitable, the decimation of hospital nursing, and the entire nursing profession. We could have done alot better, but we didn't. We hide behind, archaic "right to work laws", instead of fighting them. We have the legal right to organize, but we don't. And this is what has become of nursing. De- skilled, de- professionalized, de- moralized, marginalized, and powerless. We are a disgrace to the title of health care professional. No other group of health care professionals has allowed to happen, what nurses have allowed to happen to their profession. JMHO.

Lindarn, RN, BSN, CCRN

Spokane, Washington

infoseeker · Jan 8, 2006

You are wonderful - you have stated what I have long thought. The nursing profession is in a sad state of decline (part of the "dumbing down of America") so evident in our schools and society. Unfortunately, nursing is still primarily a "female" occupation. Men entering the profession usually do not stay in staff positions - they use a "basic" RN or LPN license as a stepping stone to management or the higher paying specialties (i.e. nurse anesthetist). Nurses in the US have tremendous power - if only they were aware of it!!! If nurses organized properly, there is no limit to what they could do for the nursing profession (and themselves). It is no surprise to me that there is a nursing shortage. When I entered nursing in the 1970's, there were fewer options available in the health care field. Today, a young person can choose from a wide area of healthcare careers at a local community college, attend for 5 semesters, and graduate with a career earning much more than a nursing graduate (and better hours, and more respect!!!). In the 1970's, I was proud to be a Registered Nurse - today I am almost embarassed by it. The nursing profession today is exactly what nurses have allowed it to be.

infoseeker · Jan 8, 2006

This is not an "upward skill track" - that would be attained by experience and education. What we are allowing is more & more of our profession to be done by unqualified individuals. Let's not forget, the real reason for allowing unlicensed individuals more responsibilty for providing care is to save facilities money. That is the bottom line.

doodlemom · Jan 8, 2006

Do you honestly believe these facilities will keep the same numbers of licensed nurses (LPNs, RNs) once the med techs are on board? I think not. The number of licensed nurses will be cut to the bone and the nurses still will not have enough time for falls prevention, wound care, skin assessment, etc. That is the whole purpose of hiring these "med techs" - to save these facilities $$$$$. Now, instead of paying an LPN $20/ hour, they can pay a med tech a little more than minimum wage. Who ultimately will pay the price for the deprofessionalizing and deskilling of nursing? The fragile geriatric population

No, they will not - as I have seen in the state that I work in. The LVN's do wound treatments and any injections and documentation. They may have 2 aides working under them passing meds to all of their patients. You rarely see an RN on the floor. The LVN's use to be the ones passing meds, as well as doing wound care and injections. RN's used to be charge nurses. This is all about MAJOR cost saving. The big corporations will get away with spending as little as possible in order to fill their pockets.

Cute_CNA, CNA · Jan 8, 2006

I would not be comfortable giving meds after only 24 hours of training, and I'd be especially worried if it were someone with only a high school education!

doddlebuggin · Jan 8, 2006

A facility in the town where I live (assisted living) had its meds given by aides not even cnas just aides. A friend that was an LPN at the LTC facility where I worked decided to step up and out and be the nurse manager at this facility ,a position that an LPN could do because this facility was NOT a nursing home and there fore not under same guide lines .When she got there narcotics were mixed in with rest of meds,not under lock and key and because the ones giving pills had no clue about reactions and side effects restoril,ambien and a xanax may all be giving at one time cause MOMMA doesnt know to tell you she didnt take all 3 at one time,meds that had been long d/ced were given along with the drug that was prescribed to replace it because the aide didnt realize the Mrs smith didnt need to take 5 bp pills and 3 diuretics and no k+ replacement. My friend freaked began calling doctors to find out what had been dced and what this person should be on. Needless to say she turned in her notice and came back to LTC. Stated " I aint going out like this" Couldnt blame her..Ya gotta have guidelines .. :rolleyes:

joyflnoyz, LPN · Jan 8, 2006

OK, I'm a nurse working in LTC..could not survive with out my Med Aide.

In Texas, the courses ae not "24 hours". They are much longer..Jut did an online search, and the course seems to run around 100 hours, plus lab, plus clinical time of passing meds with supervision.

When I did the class several years ago, it was 8 hours class time per week x 12-16 weeks(can't quite remember how many weeks) PLUS lab time, PLUS clinical at local LTC facilities to observe and pass meds.

An RN taught the course. It was a basic pharmacology course, with classifications, indication, desired effect, adverse reactions taught, as well as HOW to give meds (eye gtts, ear gtts,nasal, PO, rectal, lady partsl, topical). when NOT to give meds, which need a BP or pulse before administration, *communication with the nurse*, and proper documentation

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Med Aides may NOT administer initial doses, anything injectable, no PRNS without nursing approval or emergency drugs. They may ONLY work in Nursing facilities, Assisted living, correctional facilities, and intermediate care/community based facilities for the mentally retarded..places which are not acute care facilities, residents are stable, and meds are not often changed.

Clinical was "pass/fail", then there was a written test given by/proctored by/graded by the state for certification

Have I worked with "bad" med aides? YUP. I've worked with far more "bad" nurses though. Most med aides are very conscientious and work very hard. They frequently come to me with a mistake from pharmacy(wrong dose sent), questions about order changes, reactions to meds. Just like the CNAs, they help by being my eyes and ears down the hall. Part of my team.

Marie_LPN, RN, LPN, RN · Jan 9, 2006

They may ONLY work in Nursing facilities, Assisted living, correctional facilities, and intermediate care/community based facilities for the mentally retarded..places which are not acute care facilities, residents are stable, and meds are not often changed.

In other words, vulnerable populations, acute or not.

Frightening.