Hi everyone. I just found out that an MNA will be working on our 50 bed LTC unit:eek: ! Has anyone worked with an MNA? I'm a new LPN, just got used to passing meds to 25 pts, and am really on the fence about this. On one hand, I'm disgusted that I spent 13 G's obtaining my LPN, and struggled through a tough Pharmacology course :angryfire . On the other, maybe this will be a help. I really like working alone on my side. I keep people(LNAs, residents, visitors) around my cart at a mininum, cause I find it distracting. Am I going to be constantly bumping into the MNA? How does it work? BTW, there has been NO mention of an orientation for the nurses in regards to this. Oh, and the MNA will be earning 3 dollars an hour more than I do. Hmmm. any feedback will be welcome:) .
Specializes in Gerontological, cardiac, med-surg, peds.
Your post....was most magnificent!!!
I almost broke down in tears.
And Tweety, you are correct....some places of management look at only quantity (bodies...increase UAP usage and jack up your ratio as a nurse ) vs quality...because, you and I both know, quality costs. At our hospital at least, UAPs are used in a limited fashion...they support the nurse by taking on the ADLs, call lights, pass water, pass out trays, insert foleys, ambulate, keep the rooms tidy, turn patients, and give baths/hs care. This IS the appropriate use of UAPs! I and all our nurses, RNs and LPNs alike, would just have a cow if they did much more than that. For one, these duties keep them very busy as it is already. These tasks are NOT essential tasks for the nurses to complete, but ARE essential to the patient and their perception of care. Secondly, I know many a nurse would walk if UAPs were utilized to perform "NURSING procedures" which entail a firm knowledge base as to how and why those certain procedures need to be performed in a particular way. In many, there are no shortcuts. There is "genuine rationale" why things are done in a certain way and in a certain order. I'm sorry, but I totally have to disagree that UAPs are appropriate in passing meds. They do not possess the necessary science of nursing. I'm sorry, it is not just like working at McDonald's flipping burgers. Management at some of these places would have you believe "you can train a monkey to do that"....borrowing an old expression and no disrespect here on my end. But, you have to think like upper management, distant to the actual goings on in their own facilities. UAPs as "little nurses" is insulting to us and to our profession, ridicules my license and my education as well as yours, and places patients at unnecessary risk. It is a totally unnecessary burden to UAPs to place "that level" of care and responsibilty on their shoulders. If mom or dad has a change in condition, do YOU want a UAP at your side to assess and immediately intervene or do YOU want the nurse? YOU can answer that question very simply as well as I can. No, YOU would want your nurse. But, let's say that change in condition is SUBTLE. Is your UAP equipted for this level of discrimination that is required? Hmmm, doubt it. But, many places in management have turned the perception of medical/nursing care from places of health care as the yardstick of quality to a customer service venue as a measure of outcomes...like, Disney or a restaurant service. Look at how your Press Gainey is structured. Shameful, just shameful. Some of this is beginning to turn around for the better where NOW indicators of good service are infection rates, mortality rates, and staff level of education. I honestly do not believe that UAPs are equipted to understand, to assess, and to intervene in the proper use of medication in a health care setting. I will even be so bold as to say, even in TLC. If I where an elderly resident on 13 different pills and I have a change in my condition, are you trying to say that that UAP has the knowledge, the wisdom, the assessment skills, and the authority to give or to withhold a particular medication based on my condition or change in condition? I hope you are not saying that, because it bears no merit to yourself as a nurse or to the care of your patient. Many have said that the use of UAPs is a response to the nursing shortage. Partially, this is true. But, what is more true is that there are NOT enough nurse educators or incentives for nurses to become educators to trim our long waiting lists to nursing schools across the country. Much of this is due to poor state and federal funding to our schools, the lack of educator incentives, and the BONs and state legislatures giving in to state lobbies to use UAPs as a "cost effective" measure to the nursing shortage. This rationale of the quick fix by creating UAPs is short sighted and degrades the profession. What would be more cost effective would be training more nurses without these long waiting lists. Put the energy there, not in creating aids to be nurses in a couple weeks of instruction...if that! Our patients deserve much better treatment than this. People ARE OUT THERE banging on the school doors to become nurses...that is not the problem. The problem is that the door has been barred for too long, to too many. Many potential nurses give up because they have waited too long outside the door to enter. This is shameful. Down right shameful. No, I totally disagree. UAPs are NOT appropriate.
Sorry for the rant. But, YOU got me started.
Oh, well.
:yeahthat: EXCELLENT post, Wolfie! ITA and couldn't have stated it better...
I have to say something in defense of Med Techs every once in awhile in these threads, as I do support them. I think it's drifting more now into the use of UAP's, which I can't defend or even give a valid opinion on, as I haven't worked directly with them.
I don't get so fired up as to the point of being explosive, but I love that emoticon!
I just copied part of your post to save space, but I hear you loud and clear regarding bad UAP's. Competency is an individual thing. Good management is very important everywhere, but if a facility is going to use UAP's, it's imperative. I think some UAP's may be more apt to do sloppy work as they have not had to sacrifice as much as the nurse to get where thye are. Better standards for training need to be set, as well. This is a concern to me, too. That had to happen in nursing, too. Not all UAP's have to be on a registry either and I don't think that should be allowed. Yes, there are problems, but I am more for solutions than turning a blind eye to a staffing problem that isn't going away anytime soon. In a perfect world I would love to see ideal nurse/patient ratios, but I have to be relaistic.
The application of how UAPs are utilized in a facility varies from facility to facility and even state to state, that is another problem. Definately better standards and training need to be set, just as not everyone is cut out to be a nurse, not everyone is cut out to be an aide.
Management also plays an important role in this. Not just those in nursing management either. The problem is that whether it's the housekeeper, maintenance, CNA, transporter, etc, if they are not doing their job it falls on the unit staff. For instance, I had a maintenance personnel call me while I was in CAT scan with a pt the other night, he wanted me to return to the floor so I could move another pt's bed so he could change the light....ARE YOU KIDDING ME (my response to his request). It's also this kind of nonsense that takes alot of a nurse's time away from their patients.
Tweety brought up the point of nurse patient ratios in regards to UAPs, essentially more UAPs and less nurses. Yes, facilities will take advantage of this because they can. As long as the numbers look good on paper.
Thunderwolf also brought up the point of about the lack of nurse educators and the lengthy waiting lists to get into school for nursing. There are thousands who are waiting for the opportunity to get into a nursing programs and are being turned away. I'm going to refrain from getting on a soap box about the "Disney" mentality in regards to the negative effect that has on our jobs and how Press Ganey has educated me on how little comprehension the public has about what a nurse does as does alot of hospital administrators.
Having another person involved in the process of medication administration who does not have the educational requirements of a nurse, would seem to me to increase the risk of medication errors. I'll agree that there may be "nursing tasks" that could be delegated to UAPs, however medication administration should not be one of them.
It may cost less to employ a UAP as opposed to an RN or LPN to do a nurse's job, but what is the REAL cost of this in the long run?
Having another person involved in the process of medication administration who does not have the educational requirements of a nurse, would seem to me to increase the risk of medication errors. I'll agree that there may be "nursing tasks" that could be delegated to UAPs, however medication administration should not be one of them.
It may cost less to employ a UAP as opposed to an RN or LPN to do a nurse's job, but what is the REAL cost of this in the long run?
Back to the med tech discussion, as I really don't know enough sbout UAP's in general to speak on it. I saw no higher incidence of med errors in my expereince with Med Techs passing meds. I can only speak of my own experiences, though. If there could be a standardization in the training of Med Techs throughout, we would be alot better off. In this state, the BON sets the curriculum for Med Techs. They have to be CNA's for a year before they can take the 120 hour course to pass meds in LTC, mental health, MR facilities, jails. They cannot pass meds in hospitals. I have never known of a nurse whose license was placed in jeopardy because of an error made by a Med Tech. Undoubtedly, the savings are great. It would be interesting to see the patient cost of LTC in facilities where Med Techs are used instead of nurses, but I do not have statistics on that. The media would run with any story that attributed injury to a patient related to the use of med techs if it were occuring. I don't see it, presumably because nurses make just as many mistakes. The fears are not congruent to the reality.
Back to the med tech discussion, as I really don't know enough sbout UAP's in general to speak on it. I saw no higher incidence of med errors in my expereince with Med Techs passing meds. I can only speak of my own experiences, though. If there could be a standardization in the training of Med Techs throughout, we would be alot better off. In this state, the BON sets the curriculum for Med Techs. They have to be CNA's for a year before they can take the 120 hour course to pass meds in LTC, mental health, MR facilities, jails. They cannot pass meds in hospitals. I have never known of a nurse whose license was placed in jeopardy because of an error made by a Med Tech. Undoubtedly, the savings are great. It would be interesting to see the patient cost of LTC in facilities where Med Techs are used instead of nurses, but I do not have statistics on that. The media would run with any story that attributed injury to a patient related to the use of med techs if it were occuring. I don't see it, presumably because nurses make just as many mistakes. The fears are not congruent to the reality.
What I can say is that the CNAs I work with in general, I would not want to see trained as a medication aides. My concern would be that what I see where I'm at would be the very "pool" from which medication aides would come from. I think the fact that nurses make mistakes is hardly a valid argument for medication aides.
First Assisted Living, then LTCs, then mental health, then MR facilities, then jails, where is line drawn. Once established here then why not acute care hospitals? You better believe that will come next. Then what comes after?
I have to say something in defense of Med Techs every once in awhile in these threads, as I do support them. I think it's drifting more now into the use of UAP's, which I can't defend or even give a valid opinion on, as I haven't worked directly with them.
Your not working with Unlicensed Assistive Personnel? A certification is the same as licensure?
Notice the population where med techs are used...some of the most vulnerable, undervalued people in society. Coincidence? I think not.
Won't argue with that. This is about economics. No one wants to pay higher taxes to take care of those w/o insurance. But, that in itself doesn't negate the value of med techs.
What I can say is that the CNAs I work with in general, I would not want to see trained as a medication aides. My concern would be that what I see where I'm at would be the very "pool" from which medication aides would come from. I think the fact that nurses make mistakes is hardly a valid argument for medication aides.
First Assisted Living, then LTCs, then mental health, then MR facilities, then jails, where is line drawn. Once established here then why not acute care hospitals? You better believe that will come next. Then what comes after?
Your not working with Unlicensed Assistive Personnel? A certification is the same as licensure?
UAP's is such a lose term, I don't even want to go there. I am talking about med techs who have taken a course with a cirriculum endorsed by the BON in the state they are in. They do not pass meds if they don't pass the course, same as potential nurses in nursing school fail. Maine med techs are on a registry. If they are reported as unsafe, there goes their certificate to pass meds. This is not a new concept. It's been working well here for at least the last 25 years that I personally know about. Nurses are fearing the worst without good reason. No one ever has anything to say asside from fearing for the patient or their licenses, but have nothing to back it up. People make med errors. Most errors are ones that occur not from lack of knowledge, but from being rushed or careless. No degree needed to avoid those errors. I want to hear a real argument against med techs, not baseless fears. It just hasn't happened yet.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
You have heard MANY eloquent and sensible arguments against the use of MA's; you simple choose not to acknowledge such and are actually minimizing those arguments as "baseless fears". Kind of hard to get a point across to someone who has already made up their mind that we are "elitist" and have "baseless fears". I see your mind is made up. So is mine. Take care.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Notice the population where med techs are used...some of the most vulnerable, undervalued people in society. Coincidence? I think not.
yep. It's clear where our priorities lie. And this is why I feel more than ever, we have to stop using med aides. These people are the ones LEAST LIKELY to protest or protect their rights---or have too many others doing so. However, such people are of no less value than the next one. No one deserves less than a licensed person administering his or her medications, plain and simple.
I just want to add to the pile here again.. yeah yeah I know.... ALong with this extensive death defining pharm class I had to take, was one year of get down and dirty med -surg that taught me why those meds are given. You have pharm all the way through nursing school not just for 1 class. I agree with Marie here , it all ties in together.
Hi TXSPADEQUEEN.....I totally agree, but you know that in the Dallas/F.W. area you can be reported to Groupl One by any incompetent supervisor who thinks you are "insubordinate" if you don't go along with the hospital/facility decision, and you are usually not backed by the BNE either....so what do we do?
VickyRN, MSN, DNP, RN
49 Articles; 5,349 Posts
:yeahthat: EXCELLENT post, Wolfie! ITA and couldn't have stated it better...