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?

Several years ago, I was hired at an assisted living facility as a CNA. I had been a CNA for many years and had worked in nursing homes and thought the assisted living job would be a welcomed change of pace. My duties when I was hired, I was told, would be much like a light duty CNA job. Okay, great, I thought. I didn't last more than one hour on my first day. I was told that part of my job would be to give meds to the residents. Ofcourse, I immediately refused because I knew a CNA couldn't administer meds. I wasn't comfortable doing that and I certainly didn't want to jeopordize the license of the RN I would be administering those meds under. I don't know, I may seem closed minded, but even back then, before I even knew what it took to be a nurse, I KNEW that nurses went to school for several years to learn about meds and there had to be a reason for it. I didn't want to risk the lives of people by giving meds when I didn't have the full knowledge it requires to administer them. I don't agree with med assistants. To me, its very scary and dangerous. I wouldn't do it then, and I certainly wouldn't want an aide giving me meds if I needed them. If they want to give meds, they should go to nursing school. But, that's just my opinion.

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Thank you all so much for your replies. I would like to clarify one thing. The RN is responsible for the delegation of med administration to the Med Aide. The only thing that med aides does is give the med. The nurse is responsible for review and follow up of the labs, side effects, and response of patient to the meds, etc. The RN is responsible for teaching the med aide about the med and questioning said person to make sure the RN is comfortable with this person fulfilling this task. If the RN is not comfortable, then don't delegate. My question is: Who would want to delegate this responsibility? These people are only listed in a registry. Are there problems with med errors? What are done to these people when an error occurs? How much drug diversion is there? There are just to many unanswered questions.

My biggest question is: HOW DID THESE PEOPLE EVER GET HIRED IN THE FIRST PLACE? What is really scary is legislation has been passed in 29 other states, with many, I am afraid, to follow. Yes, this is a real scary thing.

However, we as nurses and nursing students need to stand together as ONE VOICE to fight this. With the right stipulations and credentials, med aides might could be a good thing in some areas, and that is a BIG maybe. However, I feel that if the states and federal government contributed more money for educational facilities and nurse educators, a nursing shortage would not exist. I know 1,000's are being turned away yearly because there just simply are not enough slots.

NURSES WE MUST BECOME ONE VOICE ON THIS ISSUE! NAD OTHER ISSUES THAT INVOLVE OUR FUTURE AND ESPECIALLY ONE'S THAT COULD HAVE OUTCOMES THAT AFFECT OUR FAMILIES BECAUSE WE CAN LOSE OUR JOBS OVER THIS!

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I agree with you 100%. I keep a drug book with me and we have them on the floor to refer to if needed. Drugs change so rapidly. Let me say, that your rant is justified. Keep in mind, that the RN is always ultimately responsible for the delegation to that med aide. The med aide ONLY gives the med. The nurse is responsible for the side effects and follow up, etc.

I try not to let things upset me very much, but, when I think about the months of studying that I did in pharmacology and the oh so many days that I came home from class and cried because I just knew I would never learn everything I needed to know to give meds, and then, I read something like this. 24 hours training!!!!! I just get down right mad. Sorry for the rant, but it just sounds down right dangerous to me. Most of us still keep a drug book handy because with sicker pt. and newer meds there is always something to learn. Or is it that people in "non-healthcare facilities don't deserve the same quality of care". If I had a child in school that was on medication, I would want someone overseeing that child that had more than 24 hr. "training".
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Good for you!!!

I will never work with a medication aide. They screw something up, and if i'm the one in charge, then i'm the fall guy. I don't THINK so!
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THank you for your honesty. Good luck in puursuing your BSN. We need good nurses.

Hey it looks like the majority of y'all hate the thought of med aides. I guess they are legal in OR cause I have worked as one at an assisted living facility. It was scary though a lot of the med aides had no previous medication or nursing educaiton. Me, I was a CNA and was on my spring break of nursing school and had one year left of my BSN. I was the ONLY med aid with any background in pharmacology and nursing. We all worked under a RN who was only at our facility once a week. Lets just say I only worked there for 4 months cause it was scary. Lots of med aides were getting fired cause they made major mistakes on the MAR sheets and many patients had either recieved the wrong dosage or the wrong meds. I never had any mistakes but it took me only a few weeks to figure out that this was really a bad thing, having unsupervised med aides with no background. They were not trained in looking up meds in the med books or even the simple tasks of the 5 R's.

I agree with all of you, med aides are a bad thing. They should have some form of prior education in pharmacology and nursing. It is indeed a scary thought, having one of your relatives in the care of an unsupervised non-educated person. They also did no criminal background checks. Thats really scary!

Take care. Curleysue :confused: :nono:

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Specializes in Hemodialysis, Home Health.
Thank you all so much for your replies. I would like to clarify one thing. The RN is responsible for the delegation of med administration to the Med Aide. The only thing that med aides does is give the med. The nurse is responsible for review and follow up of the labs, side effects, and response of patient to the meds, etc. The RN is responsible for teaching the med aide about the med and questioning said person to make sure the RN is comfortable with this person fulfilling this task. If the RN is not comfortable, then don't delegate.

So by the time you've done all the above, you could have passed a whole shift of meds already... wouldn't it have been quicker/easier/safer to have just done it YOURSELF already??? :rolleyes:

Don't nurses have ENOUGH to do, and enough responsibility ALREADY without having to take on this one as well? :angryfire

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Specializes in Mostly Peds.

I was taught, you never give medications that someone else "prepared", and I sure am not going to risk someone giving what I put together, because you never know are all the meds you prepared given, how do you know they have not "added" something to the meds you prepared? And yes I am sure the med aides, at least most of them are honest and will give them as you prepared them, but, since they are not having criminal background checks done on them before hiring, how do you know you won't be "lucky" enough not to have "that one person that is not honest/crazy"?????? I worked hard for my LPN license, and I am working even harder for my RN license, and I sure am not going to let someone else "ride" on my license and take a risk of losing it!!!!!!:smackingf :smackingf :smackingf

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So by the time you've done all the above, you could have passed a whole shift of meds already... wouldn't it have been quicker/easier/safer to have just done it YOURSELF already??? :rolleyes:

Don't nurses have ENOUGH to do, and enough responsibility ALREADY without having to take on this one as well? :angryfire

Amen, sister!

My thoughts EXACTLY.

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After that super long post about nurses having to have their BSN's in NY it seems a bit of an oxymoron to have people who are trained for 24 hours passing meds.

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And plus the sad thing is, the assisted living facilty that I worked at who's RN was hardly there, she trusted the MA's to fill out the MAR sheets on their own even with new meds and all that. We had one of the med aides who was actually working as the supervising med aid (with absolutely no background in pharm or nursing) and she had written the wrong times and dosages on the MAR sheet one day and the patient went TWO WEEKS with it like that until the doctor found out about it. Lets just say she is now working as just a resident assistant.

What I find odd is that the RN who was hardley ever there, only delegated us on insulin shots. She never asked us about the MAR's or even trained us herself on them. We were actually just trained by other med aides. It just insane! Honestly. The amount of mistakes these so called med aides were making would of easily been avoided if they would of taught them about the 5 R's rule. And some of the most stupidest MA's were caught many times by me or other CNA's as giving the patients the wrong meds and it was like the RN would say, "this is to be kept between you and I, nobody needs to know about this" Yah right, I knew right then that this place was definetly not for me. Its scary to know its still operating today. Scary.

Curleysue :o

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Hey it looks like the majority of y'all hate the thought of med aides. I guess they are legal in OR cause I have worked as one at an assisted living facility. It was scary though a lot of the med aides had no previous medication or nursing educaiton. Me, I was a CNA and was on my spring break of nursing school and had one year left of my BSN. I was the ONLY med aid with any background in pharmacology and nursing. We all worked under a RN who was only at our facility once a week. Lets just say I only worked there for 4 months cause it was scary. Lots of med aides were getting fired cause they made major mistakes on the MAR sheets and many patients had either recieved the wrong dosage or the wrong meds. I never had any mistakes but it took me only a few weeks to figure out that this was really a bad thing, having unsupervised med aides with no background. They were not trained in looking up meds in the med books or even the simple tasks of the 5 R's.

I agree with all of you, med aides are a bad thing. They should have some form of prior education in pharmacology and nursing. It is indeed a scary thought, having one of your relatives in the care of an unsupervised non-educated person. They also did no criminal background checks. Thats really scary!

Take care. Curleysue :confused: :nono:

:angryfire The first time we hear of a facility doing this in Ohio we are going to picket big time. we want to let family members know the dangers of having med aides.
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Specializes in Pediatrics, Emergency, Trauma.
Thank you all so much for your replies. I would like to clarify one thing. The RN is responsible for the delegation of med administration to the Med Aide. The only thing that med aides does is give the med. The nurse is responsible for review and follow up of the labs, side effects, and response of patient to the meds, etc. The RN is responsible for teaching the med aide about the med and questioning said person to make sure the RN is comfortable with this person fulfilling this task. If the RN is not comfortable, then don't delegate. My question is: Who would want to delegate this responsibility? These people are only listed in a registry. Are there problems with med errors? What are done to these people when an error occurs? How much drug diversion is there? There are just to many unanswered questions.

My biggest question is: HOW DID THESE PEOPLE EVER GET HIRED IN THE FIRST PLACE? What is really scary is legislation has been passed in 29 other states, with many, I am afraid, to follow. Yes, this is a real scary thing.

However, we as nurses and nursing students need to stand together as ONE VOICE to fight this. With the right stipulations and credentials, med aides might could be a good thing in some areas, and that is a BIG maybe. However, I feel that if the states and federal government contributed more money for educational facilities and nurse educators, a nursing shortage would not exist. I know 1,000's are being turned away yearly because there just simply are not enough slots.

NURSES WE MUST BECOME ONE VOICE ON THIS ISSUE! NAD OTHER ISSUES THAT INVOLVE OUR FUTURE AND ESPECIALLY ONE'S THAT COULD HAVE OUTCOMES THAT AFFECT OUR FAMILIES BECAUSE WE CAN LOSE OUR JOBS OVER THIS!

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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