Nursing Issue - Medication Aides

Nurses Safety

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Hi. I am new to the post. Very shortly a bill will be presented to our legislation on Medication Aides for my state. I am looking for some feedback regarding these aides. I know other programs have been implemented in many other states. How is it working? What are the current problems? Where can I go to find out more information?

In my state they will be mandatory in non-health focused care settings such as: schools, prison, assisted living, daycares, and group homes. The health focused areas are: long term care facilities, rehab centers, home health, hospice, public health depts., clinics, and acute care settings. However, some say it optional for health care facilities. The training is 24 hours. I feel this is very dangerous. It is being implemented to help alleviate some of the nursing shortage we will experience in the near future. Plus, a lot of these med aides already work in some of these facilities and there has never been any formal training. How they were hired is beyond me, but now there is a need to train these individuals. The only requirement to date is: 21 years old and a high school graduate. No prior medical experience. Scary!!!

I am looking for information on how programs of this type are working in other areas? Any problems experienced with the program? Is there an increase in med errors? Where I can go to gather more information?

That's just it, a medication aide DOES NOT need to know the consequences of the drugs they administer because that is the nurses responsibility. The med aides ONLY responsibility is to ADMINISTER the drugs. There is a limit on some drugs. SCARY for the RN.

I think the biggest problem about med aides, it that it is unrealistic to even think that a med aide could possibly know about the process of medication administration and for 10 months of a 13-month LPN program is focused on medication admisnitsation (among other things) as well as medication math-in whcih in order to graduate, you must obtain a 90% or higher.

This is also wasted money that could be diverted to nursing schools, nursing instruction, as well as wasted money which will be won in law suits. I refuse to work in a facility that hires medication aides, and If they do, I will be doing my own meds, thank you very much.

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Let's hear your side of this. Do you feel safe in the administration of meds? If you were not able to work along side that nurse, how do you think you would feel? What is your scope of practice? Do you feel 24 hours is sufficient training?

I'm a QMA at an LTC. I had 60 hours classroom and 40 hours practicum. I have to agree, it doesn't seem enough. Fortunately I worked closely with a nurse at first until I got routine developed.
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Well, good for you and your co-workers.

I'm glad for you that you feel confident enough to take it on.

But there is more to it that "routine".

I'm still studying and learning something new everyday.

What kind of facility do you work in? I'm just curious.

The one I work in we give meds to approximately 120 MR/DD people.

I'm responsibile for an average of 40 to 60 people depending on staffing any particular day. That's medications, treatments, tube feeders, charting, calling the doctor, sending people out to ER PRN and anything else that comes up.

Thank God I don't have to do all that. I give meds and (do treatments) to 2 halls (approximately 36 residents-some of them skilled). I am going to give it a good try. Hopefully with time and tenacity I will be good as my peers. I must admit that sometimes the sheer volume of it can be overwhelming.

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Hi! I am new to posting, please forgive me if I error in the beginning. I read quickly about med techs. Here in California, they are trying to get them legalized. I am against it for all the same reasons you are. I went to school for a long time to earn what I do now. I can see facilities hiring 4 med techs & 1 LVN/RN as charge. Then will come the talk of hiring a med tech for (example) 7 bucks an hour vs an LVN 18.50 an hour. We all need to stick together & stop owners from lining their pockets. :angryfire

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Not meaning to disrespect YOU in anyway, but I went to LPN school and studied for a whole year.

And they gave you 60 hours of class room and 40 practicum?

That's 2 and 1/2 weeks altogether, right?

Okay folks, let's think about this for a second.

1 semester unit is equal to 18 classroom "hours" (50 minute hours)

1 quarter unit is equal to 12 classroom "hours" (50 minute hours)

1 semester unit is equal to 3x18 hours or 54 hours (50 minute hours)

1 quarter unit is equal to 3x12 hours or 36 hours (50 minute hours)

Therefore, the person who had 60 classroom hours had the equivalent

of a little over a 3 semester or 5 quarter unit lecture class, and about 3/4 unit of "lab" in semester units, and slightly over 1 quarter unit of lab.

While I have pharmacology for a full year, to compare it to what the QMA had I need to compare hours to hours; not "semester" vs "weeks" -- that is like comparing apples vs. oranges.

NurseFirst

PS And yes, I think med aides are a bad idea. So, does the med aide give all meds? Or just PO meds? PR meds? Do they give dig? Do they know which medications to check bp and/or pulse rate for? How would they know? Heck, I've even seen nurses miss the comments that the pharmacy puts into the MAR about appropriate administration. And does the aide mark down what time the medication was given? How does the nurse know when to go in to check the patient for any reaction. It really does seem like it's more work than it's worth.

Oh yeah, and then I was wondering...if someone is a CNA and a med aide, will they start thinking that's equivalent to an LPN??

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I don't disagree with you at all that the more education the better. I would rather get my pills from a doctor and an experienced one at that! My point is that I have great confidence in the veteran Qs that I work with. They have passed inspection year after year. They also have the respect of our nurses. I just started so I have yet to establish myself.

What do you tell them if they ask you what the meds you are giving them are, or are for?

(NOTE: train all patients to ask what the medications they are getting are, and what they are for!!!)

What if they say, gee, I always have gotten a blue pill before, instead of that red one you have?

What if they say they feel funny?

What if they start to faint?

What if they start to break out in red spots?

What if they start to wheeze?

Surely, med aides have had to deal with these things. What are they supposed to do??

With the delay in getting a nurse, who knows that the patient (or P&P) has an order for epinephrine, it takes time to get the epi--that delay, not there if the nurse gave the med, could mean the difference between life and death.

Patients' lives in terms of dollars and cents. Reminds me of, I think it was gas tanks, in Ford Mustangs where the Ford execs put prices on human lives vs. the amt of money they would lose in lawsuits. ..............

NurseFirst

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Specializes in ICU, ED,.

The answer to so many of the issues debated here can be summed up simply.

Because modern medicine is a profit driven enterprise.

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No. We are not the equivalent of an LPN. We are QMAs. We were taught all those things in class but not in depth. Even though the State board exam only comprised of 100 questions we were expected to know everything in our syllabus and textbook. My problem at work has a lot more to do with the volume of work and the interruptions and on weekends the sometimes chaotic environment when not everybody shows up. I do take a full set of vitals when I give drugs such as Metoprolol and I make the nurse aware if the VS is too low or even borderline. Many times we have to withhold it. Same thing with Digoxin. I won't give it with a pulse less than 60 bpm. When it comes to charting: each drug is assigned a time. Some PRNs I have to chart 4 times: once in the MAR, then in the back of the MAR and then I enter it in the controlled drug book and then I write it down on the report sheet so the next person at a glance knows that Mrs. Smith had, say, 1 vicodin po at 1:45P and I also chart the result when the med takes effect.

NO DOUBT there are a lot we have to learn. Many of the residents families will ask me what these drugs are, and what they are for and I have to be able to tell them. But that's not the hard part. Sometimes some of our residents get confused and will argue with you that they didn't get their supper meds or something like that. I always let the nurse know and she charts on the resident and the next time I bring her meds I bring another person with me.

Okay folks, let's think about this for a second.

1 semester unit is equal to 18 classroom "hours" (50 minute hours)

1 quarter unit is equal to 12 classroom "hours" (50 minute hours)

1 semester unit is equal to 3x18 hours or 54 hours (50 minute hours)

1 quarter unit is equal to 3x12 hours or 36 hours (50 minute hours)

Therefore, the person who had 60 classroom hours had the equivalent

of a little over a 3 semester or 5 quarter unit lecture class, and about 3/4 unit of "lab" in semester units, and slightly over 1 quarter unit of lab.

While I have pharmacology for a full year, to compare it to what the QMA had I need to compare hours to hours; not "semester" vs "weeks" -- that is like comparing apples vs. oranges.

NurseFirst

PS And yes, I think med aides are a bad idea. So, does the med aide give all meds? Or just PO meds? PR meds? Do they give dig? Do they know which medications to check bp and/or pulse rate for? How would they know? Heck, I've even seen nurses miss the comments that the pharmacy puts into the MAR about appropriate administration. And does the aide mark down what time the medication was given? How does the nurse know when to go in to check the patient for any reaction. It really does seem like it's more work than it's worth.

Oh yeah, and then I was wondering...if someone is a CNA and a med aide, will they start thinking that's equivalent to an LPN??

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I bet the requirement is that the RN evaluates all medications (on 8 MS patients?) prior to shift, making sure they are appropriate (on patients they have not yet assessed) and the MAs then do the grunt work of passing the pills...all within the first hour of the shift! Hey, bet then you can have one RN for 16 MS patients, sure that is the ticket...

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The answer to so many of the issues debated here can be summed up simply.

Because modern medicine is a profit driven enterprise.

That's not an answer--that's a reason.

And, to be true to our profession, we must fight when the profit driven enterprise interferes with the health of our patients. Remember, at any time, that patient could be YOU or ONE YOU LOVE.

NurseFirst

Student Nurse

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Specializes in Home care, assisted living.

The longer I've been a med tech, the more I'm CONVINCED that passing meds is a NURSE'S job. Med techs at our facility are expected to pass meds, call or fax in drug refills, check blood pressures, and act as shift supervisors (with or without a nurse on the premises). We're not allowed to give injections, use an epi-pen or test blood sugar. (Home health comes in to do these.) We are also not allowed to use souffle cups to hold a person's meds. They have to be placed directly in the resident's hand and we have to tell them what we're giving them. Sorry, but I barely know anything about the medications I'm passing! Now, due to mistakes in the med books, the nurse has decided she will not write up med techs anymore--they will be fired. Personally, this would not even be an issue if assisted-living facilities paid nurses to pass their own meds! How can my boss do her assessments properly if five or ten other people are passing her meds? :banghead: Med techs are not trained to "think like a nurse", so we don't know to assess a person's reaction to a new drug. One time a resident broke out in a body rash and her face swelled up, so she was sent to the hospital. Turns out she was having a sulfa drug reaction to the Bactrim we were giving her. Who knew? All I know is that this med tech stuff is scaring me more and more every day, and I have half a mind to put in my notice without another job lined up. Get me a job where I don't have to worry about protecting my BOSS' license AND my own rear end. A lot of my med tech co-workers are talking about leaving as well. We don't get paid any extra for the huge liability we take on by passing meds (with no real pharmacology training) and working under someone else's license. For me, it's no longer worth $8/hr. to play nurse. No thanks. :no:

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The longer I've been a med tech, the more I'm CONVINCED that passing meds is a NURSE'S job. Med techs at our facility are expected to pass meds, call or fax in drug refills, check blood pressures, and act as shift supervisors (with or without a nurse on the premises). We're not allowed to give injections, use an epi-pen or test blood sugar. (Home health comes in to do these.) We are also not allowed to use souffle cups to hold a person's meds. They have to be placed directly in the resident's hand and we have to tell them what we're giving them. Sorry, but I barely know anything about the medications I'm passing! Now, due to mistakes in the med books, the nurse has decided she will not write up med techs anymore--they will be fired. Personally, this would not even be an issue if assisted-living facilities paid nurses to pass their own meds! How can my boss do her assessments properly if five or ten other people are passing her meds? :banghead: Med techs are not trained to "think like a nurse", so we don't know to assess a person's reaction to a new drug. One time a resident broke out in a body rash and her face swelled up, so she was sent to the hospital. Turns out she was having a sulfa drug reaction to the Bactrim we were giving her. Who knew? All I know is that this med tech stuff is scaring me more and more every day, and I have half a mind to put in my notice without another job lined up. Get me a job where I don't have to worry about protecting my BOSS' license AND my own rear end. A lot of my med tech co-workers are talking about leaving as well. We don't get paid any extra for the huge liability we take on by passing meds (with no real pharmacology training) and working under someone else's license. For me, it's no longer worth $8/hr. to play nurse. No thanks. :no:

Well, I'm glad to see that someone who has been doing this is willing to speak up about it.

You are RIGHT. They have given you many of the responsibilities that were formerly a NURSE's responsiblity, and now the facility you are working for is saving money off of YOU.

IMHO it's nothing but a scam to save money, by these facilities.

And I have a question.....why do they not let you have souffle cups to put the residents meds in?

You are NOT supposed to touch the medication, and without souffle cups how do you manage that?

What about liquids? How do you pour up those? Do you have the graduated measuring cups for liquids?

I bet that's another way of saving money....they just don't purchase the cups for you.

Some facilities are notorious for not having supplies on hand.

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