Nursing student CNAs passing meds in ALF

choksantos, BSN, RN · Jan 28, 2011

yes, they are qualified to pass meds, I work in SNF right now but we have an ALF too, CNA's are allowed to pass meds but they cant perform assesments or give meds with parameters like hold if BP is this or that. withold for loose stool cause assesment is beyond their scope.

I'm pretty sure they have some training but not as indepth as nurses

noctanol · Jan 28, 2011

Passing meds is not an art, its pills in a cup, rude as this may sound. EXpectina a nurse with a load of 80 plus patients to do the med pass would be close to impossible. Medications passed by CNA's, med techs are low level meds like stool softners, vitamins, alzheimers/dementia pills, cholesterol, diabetic pills etc. Pills with paramenter such as BP meds, narcotics, diuretics etc would require a nurse.

Cinquefoil · Jan 28, 2011

Passing meds is not an art, its pills in a cup, rude as this may sound. EXpectina a nurse with a load of 80 plus patients to do the med pass would be close to impossible. Medications passed by CNA's, med techs are low level meds like stool softners, vitamins, alzheimers/dementia pills, cholesterol, diabetic pills etc. Pills with paramenter such as BP meds, narcotics, diuretics etc would require a nurse.

Good theory. In reality I don't know if this would be efficient, since most residents in my ALF have a LOT of pills and the BP meds are supposed to be given at the same time as the stool softeners etc. Why have two people go to the same room at the same time for something that could be done by one?

MrWarmHearted · Jan 28, 2011

Perhaps it depends on the state. In Washington, assisted living facilities are a different creature. Yes you need to be a CNA but you don't need to be in nursing school. You'll get training by the ALF - ours was 2 days - your MARS will probably be on paper (NOT like the computing systems in the hospitals). it's super easy

our facility allows the "med techs" to pass narcs as the nurse is only there during "business hours" (and they are busy with paperwork/admitting - they actually NEVER pass the meds - the only med they do is insulin).

TheCommuter, BSN, RN · Jan 28, 2011

I am in Texas, where medication aides are widely used in nursing homes and assisted living facilities. To be perfectly honest, I love working with them.

I don't like being tied up with a medication pass to 30+ residents, so it is liberating when a medication aide is employed to do it. Medication aides in Texas are allowed to give all p.o. meds, including those for blood pressure. They also vitalize the residents, give eye drops, patches, and reorder meds when the supply is low.

Having a medication aide frees me up to do fingersticks, injections, wound care, topical treatments, nebulizers, charting, admissions, dealing with families, and so forth.

kcksk · Jan 28, 2011

My SIL took a course (I think 8hr training) so she could pass meds at a NH. She wasn't even a CNA or any type of med tech/PCA training. I almost had a stroke when she told me she was giving insulin as well as all other meds. She is so scattered, I wouldn't even trust her to give my kids tylenol and she is giving insulin??! Very scary situations.

RNmilwife · Jan 28, 2011

At my previous job I was working a SNF in NH. We had med techs there but they weren't allowed to give any injections. They could do finger sticks but not give insulin. They could give PRN narcotics with nurse permission. Med aids were not utilized well where I was working though. For instance, I would have my own med pass to do (30 or so resident), plus all the injections, skin assessments, wound care, topicals and such for the whole wing (60 or so) I ran my a** ragged. When med aids were being brought in, they were supposed to be used to pass meds so that nurses were freed up to do all that stuff. Just didn't happen that way for some reason.

Southern Magnolia · Jan 28, 2011

I'm a CNA and the state I trained in (IA) CNA's could not give meds but after additional training you could be a CMA certified medication aide. It was an additional training comparable to CNA training.

etaoinshrdluRN · Jan 28, 2011

FWIW, I worked with a lot of med techs in LTC, and while it was NICE not to have to do a 50-person med pass four times a shift, it felt easier and safer when a subordinate nurse was doing the passes, simply because of the meds requiring parameters and before/after assessments. So, several times a day I got handed nebulizer meds and was continually asked to assess patients having behaviors and to decide what kind of intervention to do (psychotropic, pain med, behavioral intervention)

I also suspect that one of those med techs could not be bothered to measure BP/Hr before giving beta blockers, though I was never able to pin him down. Early on, I had to make him understand that he couldn't just give lorazepam to someone who looked as if he were escalating WITHOUT GETTING ME FIRST. :uhoh3:

Some things are best left to nurses.

ObtundedRN, BSN, RN · Jan 28, 2011

I can't remember the exact wording by my BON, but it has something to do with the fact that the med techs are not administering the medications, they are assisting the patient to take their meds. The patient must actually take the medications themselves. I'm not sure where insulin comes into play. For the most part, I guess they manage to do it safely, even though I don't think they have enough education to do it.

While working in EMS, I've had plenty of calls in the middle of the night to a SNF or ALF for an unconscious patient. Blood sugar in the toilet. When we ask what was their accucheck before giving their insulin, they realize nobody ever checked it. Or it turns out that the patient didn't eat dinner (and maybe lunch too) and they gave the insulin anyways. The med tech is taught how to physically give the med, but not to know when it should be held or questioned.

CrazierThanYou · Jan 30, 2011

I'm a CNA and the state I trained in (IA) CNA's could not give meds but after additional training you could be a CMA certified medication aide. It was an additional training comparable to CNA training.

That's how it is in my state as well. I'm an RN student, a CNA, and a certified medication aide. I can pass any kind of meds: narcs, BP, anti-convulsants, psychotropics, benzos, insulin, whatever my residents need, I can give it. Except of course, for IM injections. I can only do those in a clinical setting since I am a student. The controlled drugs are kept double locked, of course. Oh, and, I do work in an ALF.

I can understand why it might be surprising, though, because when I was a brand new CNA just out of high school, it would have been unheard of for a CNA to be giving any kind of medications.