I have a diploma in emergency medical technology, a diploma in clinical medical assisting, and a nursing assistant certificate. About a year of experience in prehospital care with an incredibly heavy volume of critical care. And 1 year of experience in outpatient internal medicine. I recently took a job that I feel combines both of these skills incredibly well as a medication technician. They don't require certification, and since my training already encompasses everything and more in a medication aide program they were comfortable hiring me. This is where my first concern comes in. I assumed that meant they would be hiring primarily people with medical training. However I am the only person on staff with any training or licensure besides the DON. Including the other medication technicians. And the orientation included no training in pharmacology at all.
One of the med techs recently asked me if morphine was addictive. She also cannot perform any nursing assisting Duties because she's never been trained as that either. The other med techs have only CNA experience before hand. One of them suggested PRN lorazepam for pain. A resident had a respiratory emergency and all they did was take BP. Which was low and they charted it as normal. We had a resident with coffee ground Emesis and melena, for 8 hours before I got on shift and they didn't even take a BP. I took it and she had a map of 60, and HR in the 140s. I genuinely feel unsafe leaving the residents under their care sometimes. This is a pretty high acuity population, and a nurse is only there 9-5M-F. Besides that the fully responsibility is on the med tech. But they for the most part show they don't know anything about how medications works or side effects, etc.
second.
more then once I have been surprised with a shift with no nursing assistants at all. Just me for all three floors. Passing meds, and trying to provide nursing aide care. I don't feel comfortable with these assignments, it was nearly impossible and some of these are two person assist. But I can't just leave them with no one.
Specializes in EMT/Medical assistant: Emergency care, geriatrics.
londonflo said:
I have no idea what the scope of your practice could be based on some titles that are unfamiliar to me.
It sounds like "anything goes" there. Please fill us in on your education/certification. You must have provided this information when you applied for the job. Then we can help you with the legal job parameters/
To restate I am clinical medical assistant and EMT.
vintagegal said:
Woah... let me unpack all of this for a minute. First off, I am very glad that you have some health care experience that will indeed make you a great asset to the team. However, it is not your position or scope to assess, diagnose, plan, implement or evaluate. You also should not delegate to anyone. For assisted living, the DON should be on call for questions, concerns, or changes in patient condition. This is their job to improve if this is not happening. The medbook should be clear what PRNs are available and what they are for. This again is not your issue to undertake. If you have concerns, relay them to the DON. If they don't address the concerns, you can report them to the state or seek out other employment. Don't get yourself in the weeds...
A lot of this works differently with my EMS designation in my state.
If is fully within my scope to ask a CNA to do needed patient care, it's actually in my job description to supervise them and make sure they do so. As you said though I cannot delegate things in my scope (but not theirs) to them.
The Med book is very clear, however the problem is the Med techs often don't have the prerequisite knowledge to really get it.
However I will say the DON is aware of many of the problems. I'm going to be bringing it back to her awareness after speaking with people here.
Specializes in EMT/Medical assistant: Emergency care, geriatrics.
londonflo said:
You are very conscientious and have the patients safety at heart. I would make an anonymous call to the agency the monitors this institution for the patients own health care needs. If this lack of care, medication oversite etc, continues to fester, you may go down with a bad reputation to get another job...(Pnwmedical worked at that institution that got shut down for poor patient care)
A GI bleed needs to be at the ER immediately. Whether or not vitals showed the drop in blood volume. the patient needed to go the ER at the first sign of coffee ground emesis.
I agree, I was blown away nothing had been done for them til I got there.
Please understand this program and individual designation is not available where I live, Hence not understanding the role.
I should add some of those are slightly different state by state. For example I studied for 2 years to become an EMT (above the minimum), and have a larger scope/responsibility.
Job has ranged from assisting paramedics with critical care, to assessing/managing complex pts on my own (such as traumas, MI's, etc). Obviously paramedic is still the highest level of care however.
Specializes in EMT/Medical assistant: Emergency care, geriatrics.
londonflo said:
Are you sure technician and technologist mean the same thing?
The Title is emergency medical technician, which is gained by studying emergency medical technology. If that makes sense, I've heard both EM technician and EM technologist used in the field.
Thank you for you clarification. I did correct my post above yours. Have you thought about nursing school? It seems you have an interest on providing safe, expert care to patients
Specializes in EMT/Medical assistant: Emergency care, geriatrics.
londonflo said:
Thank you for you clarification. I did correct my post above yours. Have you thought about nursing school? It seems you have an interest on providing safe, expert care to patients
To restate I am clinical medical assistant and EMT.
A lot of this works differently with my EMS designation in my state.
If is fully within my scope to ask a CNA to do needed patient care, it's actually in my job description to supervise them and make sure they do so. As you said though I cannot delegate things in my scope (but not theirs) to them.
The Med book is very clear, however the problem is the Med techs often don't have the prerequisite knowledge to really get it.
However I will say the DON is aware of many of the problems. I'm going to be bringing it back to her awareness after speaking with people here.
Specializes in EMT/Medical assistant: Emergency care, geriatrics.
vintagegal said:
Is that your hired position at the facility ?
Nope, my hired position is medical technician. However this is where things get different in my state. As licensed EMS provider, I may work under any unprotected job title, and my scope of practice is set by the facility I work for. They are simply required to verify that I have either been trained/educated prior in that particular competency or they must provide the training themselves.
this unique situation gives me a different role then a typical medical technician. My personal job description is Identical to the PRN LPN who covers for me, and works the shifts I do not.
this works really well in my facility and has greatly helped out the licensed nurses by giving them another set of trained eyes/hands that can, assess, contribute to care plan, etc. all of these duties are outside the normal role of a MT, but standard for EMS. The only difference is outside of EMS in this facility I'm double checked by a nurse, in the ambulance (depending on the unit) the entire assessment/planning/treatment process is on me enroute. On top of that my training and experience as a clinical medical assistant fills in gaps in non emergency care fund of knowledge.
Pnwmedical
13 Posts
To restate I am clinical medical assistant and EMT.
A lot of this works differently with my EMS designation in my state.
If is fully within my scope to ask a CNA to do needed patient care, it's actually in my job description to supervise them and make sure they do so. As you said though I cannot delegate things in my scope (but not theirs) to them.
The Med book is very clear, however the problem is the Med techs often don't have the prerequisite knowledge to really get it.
However I will say the DON is aware of many of the problems. I'm going to be bringing it back to her awareness after speaking with people here.