Nursing Issue - Medication Aides

TWnursingstudent · Apr 27, 2005

Ok I am going out on the limb here cause I am currently a Med Aide, I work in an assisted living facility with 23 residents, I pass meds on 2nd shift, do physicians orders, telephone orders, yes I do have to have a LPN or RN sign my orders and I am not allowed to do insulins or blood draws. I have been doing this for about 4 yrs now and it has been a great learning experience towards my nursing career which I am currently taking pre-req's to start program Jan 06. I have only made 1 med error in the 4 years and I did not let the Rn or LPN take the heat for it, I was asked what happened, I told my DON what happened, I did it, so I took full responsibility for it.

Just wanted to add my 2 cents worth, and a positive note for those of us that are working as med techs.

sbic56, BSN, RN · Apr 27, 2005

Ok I am going out on the limb here cause I am currently a Med Aide, I work in an assisted living facility with 23 residents, I pass meds on 2nd shift, do physicians orders, telephone orders, yes I do have to have a LPN or RN sign my orders and I am not allowed to do insulins or blood draws. I have been doing this for about 4 yrs now and it has been a great learning experience towards my nursing career which I am currently taking pre-req's to start program Jan 06. I have only made 1 med error in the 4 years and I did not let the Rn or LPN take the heat for it, I was asked what happened, I told my DON what happened, I did it, so I took full responsibility for it.
Just wanted to add my 2 cents worth, and a positive note for those of us that are working as med techs.

I wish you hadn't felt like you were going out on a limb to tell your story, but I understand how you might feel some trepidation in expressing yourself. It's good to hear the positive experiences of med aides. It's clear the nurses you work with appreciate you and you should be proud of a job very well done! One med error in 4 years is mighty impressive by anyone's standards. Plus, your experience with give you a leg up on things once you start nursing school.

GLORIAmunchkin72 · Apr 27, 2005

For crying out loud, this is supposed to be a free country. No one should force you into a position that you do not wish to be in. There are higher authorities than your bosses. Don't lie down and accept the punishment. :uhoh3:

Recently I had made a decision to step down from my med tech duties (effective next month).
Now I have coworkers telling me that, according to our boss, those of us who chose not to be med techs are getting an unpleasant surprise when see our schedules next month. In other words, she thinks we made this choice in order to "get off easy" and she's going to mess around with our hours in order to make us sorry. :angryfire
I did NOT choose to step down from my med tech position to "get off easy". I did it because I am tired of playing nurse. If anything, my job will be harder, because soon I will be working in the Alzheimer's wing EVERY night (only med techs can work in the AL section of the facility). I will have about 15 people to get up by myself every morning. I also have an hour-long commute now.
If this is true, and my boss has a trick up her sleeve for us, I might just have to leave.

jude11142 · May 4, 2005

Very dangerous, I feel. I would never work in a place where there are medication aides. No way!! Med pass is not just doling out pills(as we all know)...what about side effects, allergic reactions, monitoring effects and so on??? :uhoh3:

This is nothing but asking for trouble.

JUDE :Melody:

BandEmom · May 4, 2005

Hi curleysue,

I was a med aide in oregon, except I didn't go to the special training for it. I was a cna in a residential care facility, and they gave me a quick rundown about how to pass meds, and got to work with the med aide for one shift. No explanation of what the meds were, or anything like that. I couldn't even pronounce most of them. Scary huh? That was long before I was a nurse. I hear that lots of places around the state do it that way too.

boulergirl, CNA · May 5, 2005

Med pass is not just doling out pills(as we all know)...what about side effects, allergic reactions, monitoring effects and so on???

Exactly. My boss came up to a med tech recently as she was signing out the result for a PRN med. She started to write "effective" in the med book and our boss stopped her right there. "How do you KNOW it was effective? You can't write "effective" if you don't know that." According to state law, we are to write a result for every PRN med one hour after we sign it out. The boss was telling us not to write anything in the results column, period.

This is an illustration of how patient assessment cannot be separated from medication administration (as other nurses have pointed out here). If we cannot tell whether or not a medication is working or not, and know nothing about reactions or interactions, why are we allowed to handle meds at all?? :confused:

mtymom · May 6, 2005

I work as a hospice field manager, and deal with a few assisted living facilities that use med techs. As an RN, I can tell you it's truly frustrating to have nonlicensed staff giving meds to my terminal patients! I have one ALF that won't allow our patients to receive Roxanol (liquid morphine) unless their local pharmacy draws up individual syringes of the med. This means that instead of a bottle with an eye dropper for dosing, the techs have about a hundred individual syringes, each with 0.25ml of morphine in them! When I ordered a regular bottle of Roxanol from our mail-order pharmacy, you'd have thought I'd tried to kill someone - apparently, at this ALF, the med techs can't count liquid meds. The facility RN told me that in the past, the techs had been off count by bottles - yes, BOTTLES, not ml's - of Roxanol. :uhoh21:

That is VERY, VERY scary that they were off by bottles. One question I have though is who did they do their med count with? Was it the nurse or another med tech? If it was the nurse; shame on her. If it was another med tech; shame on the nurse. All narcotics need to be counted by licensed people thats all there is to it. :angryfire

**RosesrReder, BSN, MSN, RN** · May 6, 2005

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?

24 hours for any kind of training is absurd IMO :rolleyes:

It doesn't seem right and sooner or later something should be done to increase the requirements don't you think?

tracytoon · May 7, 2005

We have "medtechs" in Florida. I worked with some of them in an ALF and I was astounded to learn that they had a course that lasted just hours to be certified to pass medications!!!!! In Florida they can work in an ALF setting, but not in nursing homes or hospitals. We had a couple of nurses come from another state who said "Where are the medtechs?" when they arrived. We explained that medtechs cannot work in nursing homes in Florida. I wondered why an 11-7 nurse would need a medtech in a small facility.

I mean no disrespect to anyone, but there is a good reason nurses are required to have extensive training. I know many CNA's who are top notch and very knowledgeable, and many who think the only difference between a CNA and a nurse is that the nurse gives pills. :uhoh3:

I personally am not comfortable with this trend. It smacks of greed and it is the slippery slope of irresponsible practices. It is not the answer to the nursing shortage!

VickyRN, MSN, DNP, RN · May 7, 2005

NC House Bill 783/ Senate Bill 662

Submitted on March 17, 2005, and referred to the Committee on Health.

House Bill 783 (H783):

http://www.ncga.state.nc.us/Sessions/2005/Bills/House/HTML/H783v1.html

http://www.ncga.state.nc.us/gascripts/BillLookUp/BillLookUp.pl?Session=2005&BillID=H783

Senate Bill 662 (S662):

http://www.ncga.state.nc.us/Sessions/2005/Bills/Senate/HTML/S662v1.html

http://www.ncga.state.nc.us/gascripts/BillLookUp/BillLookUp.pl?Session=2005&BillID=S662

Medication Aide Proposal (as outlined by the NCBON):

http://www.ncbon.com/Education-factsheet.asp

Only 24 hours worth of video training required. "Curriculum for med aides focuses on the six rights of medication administration via oral, topical and instillation routes. It is a 24-hour course and addresses these common routes of medication administration but excludes injections. After passing the course the med aide may take the state competency test. The med aide must pass the state test and is then placed on the Medication Aide Registry." Of course, these "med techs" are operating under the RN or LPN's license (who will be ultimately responsible should any adverse patient reactions occur).

http://www.ncbon.com/forms/Interface%20between%20Licensed%20Nurse%20and%20Med%20Aide.pdf

This legislation was originally intended to regulate medication administration in assisted living facilities, but both the House and Senate versions of the bill make no distinctions as to the type of facility in which these medication aides will be utilized. As such, these unlicensed personnel with only 24 hours worth of training could potentially be utilized in both nursing homes and hospitals. I believe nursing homes are the primary targets.

The "medication aide" is already being piloted in eight settings, including several nursing homes, one hospital (Dorothea Dix), and a correctional facility.

The Executive Director of the NCBON, with the Institute of Medicine's blessing, made a presentation before the Health subcommittee in support of these bills. Apparently, there are also large numbers of physicians backing these bills.

This latest action by our Board is perplexing, as they are the agency who safeguards public health by ensuring "safe, effective nursing care." Instead, they are instigating legislation which could cause medication errors to skyrocket, as well as placing our frail elderly population at considerable risk.

On March 17-18, the North Carolina Council of Practical Nurse Educators (NCCPNE) came out with the following press release concerning the medication aide:

While we as an organization acknowledge the increased demand for more qualified nurses, we do not believe that the solution to the problem exists with creation of a larger unlicensed workforce. The average geriatric client that is in long term care is a person with age related physiological changes and multiple chronic diseases that require a variety of medications, critical thinking skills, complex health care, and other health services. We believe that we need more licensed nurses not more unlicensed personnel to safely care for our geriatric population. Issues exist that have not been addressed as to competency evaluation, supervision, number of unlicensed persons supervised, access to controlled substances, etc. We believe that the movement will produce adverse effects in a vulnerable, valuable population.

Deskilling and deprofessionalizing nursing by eroding essential nursing tasks (such as medication administration) is not the answer to our statewide nursing shortage!

Please help! Please email the ranking members of the Committee on Health with your concerns about the Medication Aides. You do not have to be a North Carolina citizen to do this. In fact, your experiences with this form of unlicensed personnel in other states (particularly in skilled nursing home situations) would provide valuable insight to the legislators who are on this committee.

Health Care Committee

http://www.ncleg.net/committees/

Co-Chairmen:

Senator William R. Purcell [email protected]

Senator Stan Bingham [email protected]

Vice-Chairmen:

Senator Austin M. Allran [email protected]

Senator Katie B. Dorsett [email protected]

Ranking Minority Member:

Senator James Forrester [email protected]

ka71639 · May 7, 2005

Hi curleysue,
I was a med aide in oregon, except I didn't go to the special training for it. I was a cna in a residential care facility, and they gave me a quick rundown about how to pass meds, and got to work with the med aide for one shift. No explanation of what the meds were, or anything like that. I couldn't even pronounce most of them. Scary huh? That was long before I was a nurse. I hear that lots of places around the state do it that way too.

Hi,My name is trena,i am currently a cna at a correctional facility and a good one i might ad.I work with RN'S and LPN'S who showed me on what to do and how to do it.I wasn't shown the right way,i learned on my own,i asked ?'s and read alot,also i asked my DON.The higher up people look at cna's as nothing where i work at,but they ought to be glad they have help from whom ever.I understand cna's dont have license to pass meds.The good thing is I am going to school to become a LPN.I had to vent.

SmilingBluEyes · May 8, 2005

NC House Bill 783/ Senate Bill 662
Submitted on March 17, 2005, and referred to the Committee on Health.
House Bill 783 (H783):
http://www.ncga.state.nc.us/Sessions/2005/Bills/House/HTML/H783v1.html
http://www.ncga.state.nc.us/gascripts/BillLookUp/BillLookUp.pl?Session=2005&BillID=H783
Senate Bill 662 (S662):
http://www.ncga.state.nc.us/Sessions/2005/Bills/Senate/HTML/S662v1.html
http://www.ncga.state.nc.us/gascripts/BillLookUp/BillLookUp.pl?Session=2005&BillID=S662
Medication Aide Proposal (as outlined by the NCBON):
http://www.ncbon.com/Education-factsheet.asp
Only 24 hours worth of video training required. "Curriculum for med aides focuses on the six rights of medication administration via oral, topical and instillation routes. It is a 24-hour course and addresses these common routes of medication administration but excludes injections. After passing the course the med aide may take the state competency test. The med aide must pass the state test and is then placed on the Medication Aide Registry." Of course, these "med techs" are operating under the RN or LPN's license (who will be ultimately responsible should any adverse patient reactions occur).
http://www.ncbon.com/forms/Interface%20between%20Licensed%20Nurse%20and%20Med%20Aide.pdf
This legislation was originally intended to regulate medication administration in assisted living facilities, but both the House and Senate versions of the bill make no distinctions as to the type of facility in which these medication aides will be utilized. As such, these unlicensed personnel with only 24 hours worth of training could potentially be utilized in both nursing homes and hospitals. I believe nursing homes are the primary targets.
The "medication aide" is already being piloted in eight settings, including several nursing homes, one hospital (Dorothea Dix), and a correctional facility.
The Executive Director of the NCBON, with the Institute of Medicine's blessing, made a presentation before the Health subcommittee in support of these bills. Apparently, there are also large numbers of physicians backing these bills.
This latest action by our Board is perplexing, as they are the agency who safeguards public health by ensuring "safe, effective nursing care." Instead, they are instigating legislation which could cause medication errors to skyrocket, as well as placing our frail elderly population at considerable risk.
On March 17-18, the North Carolina Council of Practical Nurse Educators (NCCPNE) came out with the following press release concerning the medication aide:
Deskilling and deprofessionalizing nursing by eroding essential nursing tasks (such as medication administration) is not the answer to our statewide nursing shortage!
Please help! Please email the ranking members of the Committee on Health with your concerns about the Medication Aides. You do not have to be a North Carolina citizen to do this. In fact, your experiences with this form of unlicensed personnel in other states (particularly in skilled nursing home situations) would provide valuable insight to the legislators who are on this committee.
Health Care Committee
http://www.ncleg.net/committees/
Co-Chairmen:
Senator William R. Purcell [email protected]
Senator Stan Bingham [email protected]
Vice-Chairmen:
Senator Austin M. Allran [email protected]
Senator Katie B. Dorsett [email protected]
Ranking Minority Member:
Senator James Forrester [email protected]

Mattsmom had a great suggestion to post this information in the NC State forum as well. I think you should! Nurses need to be aware what the State is doing to their practices and the safety of patients in their care.