pct debate

lpnga · Mar 12, 2003

just because you can "train" someone to do a task does not mean that they should be doing that task.

I also hope that somehow in your nursing classes - whatever kind that they might be - that you are instructed in the difference between teaching and training.

I agree with you caroladybelle

nurseBe · Mar 12, 2003

I thought that PCT's were the same as CNA's. I have never heard of PCT's that strted IV's or inserted catheters, just basic ADL's. Only lisenced people do these tasks (including blood glucose monitoring). Anybody else in California seen PCT's doing these other skills?

mattsmom81 · Mar 12, 2003

PCT's and invasive procedures are risky business in my state...as the RN is ultimately responsible. I tend to delegate CNA type work to my PCT's and do the invasive stuff myself. Call me paranoid but I like to insert my own NG's and foleys and do my own fingersticks. Too much room for error and injury, IMO.

Everywhere I go as agency the task- trained PCT's seem to get on the same power trip and don't want to do nurse assistant type work, but if they are working under my license I will decide what they will and will not do with my patients.

Some PCT's give po routine meds in LTC, ALF's, etc...just like medication aides, they take a course and can do it. They function like family would if they were present..this is my understanding...but I don't work in LTC so it is hearsay from me.

I don't think I'd want to be the RN ultimately responsible in these places...it sure seems like a load of liability to me. But we all need to know our individual BONs' position on PCT's in order to make our decisions on delegation.

catrn10 · Mar 13, 2003

I am an RN, and I too live in GA, near Chattanooga, Tn. I would like to know which hospital it is around here that is now allowing PCT's to start IV's. I personally refuse to work in most of the hospitals in the surrounding area due to what I feel are unsafe practises, this will definately go down as one of them. I work only at one area hospital Chattanooga, one of only two in the area I considerer to have high standards, and to be safe to work at or send a family member to.. Neither of them are located in Georgia. Unqualified personel are being trained by the dozens to perform duties normally reserved for Nurses. Shortage?, you bet. I'd rather not work than work with unqualified personnel doing procedures that should only be performed by a Licensed RN.

lpnga · Mar 13, 2003

email me and i will email you back

hogan4736, BSN, RN · Mar 13, 2003

most group homes in Phoenix allow behavioral health techs to "pass meds"

they call it "self administering" as the tech sets up the meds, gives the cup to the patient, and voila, self administration!

Brownms46 · Mar 13, 2003

I worked in a facility...in S. C. and in Washington state, that allowed CNA...trained by the facility to give meds, and not just routine meds! I became aware on my first nite of supposedly a 6 week contract, that the nurse's aids were giving out PRNs(even controlled med) to pts, depending on their complaints! I only found this out after the aids got worried about a pt., and called me from upstairs.

I thought I was only acting as the nurse for one floor of this facility. Come to find out ... I was the only LICENSED person in the building. First I told the aids to not give any meds again, and to call me for any problems. Second I made it thru the nite, and everyone was doing fine when I left. Third I called the agency and told them I wouldn't be going back.

In Washington state I did one shift at a ALF, and during the nite I talked with the aides there. I was shocked to find out they had been hired as N. A's., and were told they would be provided with education to obtain their cert and become CNAs. What they didn't know was the training would include learning to give meds. The training they received taught them little or nothing about the medication they would be giving.

While they wanted the CNA training, they didn't want to be responsible for giving meds, with so little education about the meds they would be giving. One young woman was worried how this would affect her going into an ADN program, and she felt it wasn't legal for her to give meds with such limited knowledge. But she needed the job, and didn't know what to do. They were told they couldn't refuse to give the meds, and still work there.

I also have worked in the PHX area, and CNA's there, cleared pumps, Dc/d IVs, did blood sugars, and inserted/dc/d foleys.

The same thing in Texas, and in Washington they also drew blood. CNAs doing blood sugars, inserting foleys, and drawing blood has been going on for a long time in some places. And others are just starting to allow CNA's or PCT's to do more skilled tasks. The hospital in the the Phx area was just starting to allow CNA/PCTs to expand their scope.

Vsummer1 · Mar 13, 2003

For crying out loud, lets get it straight!

BIG difference between "starting an IV" and actually administrating drugs IV. I am sure the IV meds were not calculated nor administered by a PCT, CNA or whatever you want to call yourself in this thread.

You do blood sugars. Wooo hoooo! And report them. But do you actually administer the insulin as required once the blood sugar is determined? Do YOU call the doctor to report the variations? No, I didn't think so, because that requires a double check to insure dosages are correct.

As once was said to me, you can teach a monkey to do these things, but the monkey isn't gonna be able to make judgements based on variable physiological factors which apply over time to an individual.

WHO CARES!??? Take care of the patient within your scope of practice, WE VALUE YOUR CONTRIBUTIONS so move on and keep your perspective: DO WHAT IS BEST FOR THE PATIENT!!!! WORK TOGETHER TO INSURE THE PATIENT IS RECEIVING THE BEST OF CARE!

Stop nitpicking the assignments to death.

Gator,SN · Mar 13, 2003

Hello to all! I usually stay out of these types of threads, but I have a question~

I understand from previous posts that you can become certified to pass meds. What does this mean? I'm thinking: just being able to put the proper med in a cup and give it to a patient. What does it mean to be certified to insert IV's and other invasive devices? Just that you are physically able to do so?

How much training does this involve? Do you have to know the side effects, action, drug interactions, dosages, calculations, nursing interventions...such as HR 60+ to give digoxin etc... or does this fall on the RN in charge of the patient? If you improperly insert a line and cause damage to a patient, who takes the liabilty for the actions of the PCT (CNA 1,2,3, whatever)

If you blow a vein, overlook an infiltration etc, who takes the blame for that? If you give medications do you know what to look for in an emergency situation??

So far it has taken me 2 years just to learn the basics of medication administration and all the actions of the drugs I may administer. How long are these certification sessions?

Gator

Tweety, BSN, RN · Mar 13, 2003

Gator, don't know all you are asking but to answer one question.

"If you improperly insert a line and cause damage to a patient, who takes the liabilty for the actions of the PCT (CNA 1,2,3, whatever) "

If I deligate an IV start to a PCT, and that PCT causes damage to the patient. I'm NOT liable for the damage that PCT caused...IF that PCT has the proper certifications and is acting within hospital guidelines.

Same as if I cause damage to a patient for whatever reason my manager is not responsible for my harming a patient, as long as my assignments and ordered duties were within my scope of practice.

Does that make sense? If you deligate a task, as long as that person is qualified to perform that task (and usually hospitals keep those on record, i.e. the PCTs have three documented IV starts undersupervision before they can start one on their own), then you are not liable for any harm they cause.

Gator,SN · Mar 13, 2003

THANK YOU 3rdShiftGuy. I appreciate the response.

txtopaandback · Mar 13, 2003

I've seen ads here advertising for LPN's, EMT's and CNA's to hire on as Patient care techs. Does it seem that they would want them to provide more than adl care? It seems strange to take these 3 titles and group them all in to PCT's. Unless you are trying to give an RN a larger number of patients because the RN doesn't have to do all of the skilled tasks.

I also have spoken to uncertified nurse's aides working in ALF's dispensing meds-- they have recieved only enough training to match the name on the package to the name on the med admin record -- they know nothing of the purpose, side effects or adverse reactions of these meds.

I know of a rehab that has primary care nursing that CNA's do wound care.

It's getting scar out there and this is just the start of the nursing shortage.