iam an lpn who works in an assisted living and i'm the only nurse on duty in my shift in a 7 floor facility so on top of having to pass medication on one floor with about 35 residents ,i'm in charge of the building plus about 118 total residents in case of any emergency, have to do some wound dressings,follow up on physician orders /residents change of conditions/ family members and a couple of times medicine aides have not been scheduled so have about 3 floors to pass meds_but the medicine aides come to my rescue.
Problem is they are not supposed to pass meds on more than two floors but i'm also overwhelmed and some of them they don't evn go thru the MAR to see if there are new orders and that freaks me out-My boss knows about this and she thought about hiring more lpn's to pass meds coz there are too many errors but the facility i work at thinks about saving money.It is frustrating just looking for another job right now coz i worked hard for my licence-rant
Just exactly as you say, I worked hard for mine, too, and there ain't nobody, and I mean NOBODY gonna work off MY license. I won't be responsible for someone else giving meds. I say let the admininstrator assume that responsibility. If they wanna save money, let them have that responsibility.
CNA's in LTC in Texas can pass certain routine meds too...the RN I believe is responsible for monitoring for side effects, etc. That would bother me. How many of these old folks are on Dig, , diuretics,beta blockers, etc...and how much time do the nurses have to check pulses, BP's and monitor patient s/s? We get lots of hospital admissions for dehydration, hypotension and lyte imbalances..these old folks don't eat for a few days or have diarrhea and they're in trouble...and it isn't caught til it's gone too far.
I've heard it explained in this way: the CNA/med aides are functioning like family would at home.
Specializes in Gerontological, cardiac, med-surg, peds.
CNA's in LTC in Texas can pass certain routine meds too...the RN I believe is responsible for monitoring for side effects, etc. That would bother me. How many of these old folks are on Dig, , diuretics,beta blockers, etc...and how much time do the nurses have to check pulses, BP's and monitor patient s/s? We get lots of hospital admissions for dehydration, hypotension and lyte imbalances..these old folks don't eat for a few days or have diarrhea and they're in trouble...and it isn't caught til it's gone too far.
I've heard it explained in this way: the CNA/med aides are functioning like family would at home.
Perhaps what is needed is a good nurse, who works with an attorney utilized in a lawsuit , to shed A GREAT deal of light on the short-staffing, legal risks associated with this type of thing. I an a new LNC and am learning how to put this type of thing into words. We have to look deeper into the issue. Perhaps management does not understand or they ignore their understanding. Regardless, as a facility they are liable. I am not sure how all this works yet, but I aim to do my part in exposing the evil nature of this greedy, careless industry. There has to be a way around the obstacles created by the facilities i.e. settling out of court so their name won't be mentioned. There has to be a way to bring them down, or at least expose their tactics to the world and embarass them. I am praying for a way. How about you?
If you want meds administered, you hire a NURSE.................
NOT a UAP, not a CMA....not anyone else.......NO!
But in the name of the bottom line, it's easy to see why so many places are motivated to go to the lowest common denominator, even in issues as important as the administration of medications. There is NO WAY ON EARTH an CMA will EVER possess the knowledge of pathophysiology and pharmacology to administer meds safely that the LPN or RN will---- and yet they do, and yet under OUR licenses? It's a disgrace, and I wonder if the public even knows what is going on under their noses? Or cares????? Only when harm is done does anyone's attention get drawn to the issue, right?
Well said! There are other things to consider when passing meds besides the fact that they are due at 'x' O'clock. Nurses need to make important decisions about when to withhold certain meds and also when to call up the doc to get verbal changes and orders for other meds, depending on what's going on with the pt. Where I work, they hire a lot of PCAs/CNAs but they do not allow them to pass any meds.
Perhaps what is needed is a good nurse, who works with an attorney utilized in a lawsuit , to shed A GREAT deal of light on the short-staffing, legal risks associated with this type of thing.
There are nursing attorneys. I've personal met one once, very interesting person. She is a full blown attorney and a nurse at the same time.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
And does she advocate FOR and ON behalf of nurses, or against them? Just curious....cause they are lawyers, and therefore, do usually take a side. Just wondering as some nurse attorneys can be our BEST advocates....some not quite.
In the hospital I work in, they recently increased the level of responsibility for LPNs. They can now flush central lines and give IV meds in the form of parfills premixed by the pharmacy. They can also do central line dressing changes. The hospital does require that LPNs take a class and demonstrate competancy before they can work with central lines.
In MA as an LPN we could do everything an RN could except pronounce death hang blood by ourselves, and of course some IV pushes. We NEVER used unlicensed for med passes in LTC or hospital and the *** living all had nurses also. But here in Las Vegas they are trying to use unlicensed for anything they can. Soo Sad
The day this system goes into effect anywhere I work , I am out of there . How scary ! I know myself that I have to still look up a med or two .How would they even know the patho phys that goes along with some of these meds . How scary .
in north carolina, there is a controversial new proposal by our board for a medication aide. this is an unlicensed person who will be able to administer medications in acute care facilities after only a 9-week or so course.
of course, this wonderful "med aide" (who will undoubtedly be payed minimum wage) is operating under the rn or lpn's license: "as defined in nursing law and rule, the licensed nurse may only delegate technical components of medication administration to unlicensed personnel. nursing judgment and decision making related to when or if a medication would be administered by the med aide and monitoring the client's response to medications are responsibilities of the licensed nurse that may not be delegated to assistive personnel."
this med aide position, if enacted, will undoubtedly put many lpn's out of work across the state of north carolina. this new unlicensed position will also endanger the practice of many rn's across the state. can you imagine the nightmare of being responsible for 30 patients and having medication aides dispensing medications right and left under your license?
i personally feel very disappointed and puzzled by the actions of our board, right now. i know that our board was never meant to be the "nurse's friend;" like all state boards it exists to protect the interests of the public from nurses who are incompetent and to ensure "safe, effective nursing care." our board is unique in that it is elected (the only one out of 50 states elected by the nurses of the state)--and we nc nurses have always been very proud about this. however, this latest action goes directly against the interests of the public in our state and will make nursing practice in our state very unsafe indeed.
remind me to stay out of north carolina! that sounds deadly to me! that is just another reason nurses (rn's and lpn's) need to band together and form unions and quit being the ones who are used and abused! there is still to much animosity between the two groups. i am an rn and i know some really terrific lpn's, two of whom are my cousins! lpn's are for the most part wonderful nurses and can teach us a thing or two, just as we can teach them a thing or two. we need to stand as sister nurses for a change and defend one another. i have found some rn's who should never have become a nurse and some lpn's who are so much more of a nurse than these, and vice versa. i also know some really competent cna's and cma's. but, i would not bank my license on turning the meds over to someone who probably doesn't even understand the side effects or reason for a patient getting these meds. i know i would not want my med handed to me by someone like that. certainly, i would not want my family to have meds given by anyone other than a qualified nurse. i think if they are going to train people to be cma's they need at least a 6 to 8 month training and be regularly tested. this being only for pills. nothing else. even a seasoned nurse can make a med error. so imagine the more mistakes by people who aren't even trained correctly. i worked in texas for nearly 2 years and met some really good cma's in one nursing home there. but there was at least one cma that i would have been afraid to allow the use of the med cart!
Specializes in Med-Surg, Geriatric, Behavioral Health.
This trend is very frightening. You see the movement rapidly going across the country. This is another good reason for this BB, to keep all of us informed and to see what's coming around the corner. Amazing, and nurses/nursing appears unable to stop it...this is probably the scariest part about it all...unable to stop it. I can't tell you how many times I've held a med each day due to a patient's symptomatology. I can't tell you how many times I've had to look up a med in a drug book or call our pharmacy each day regarding meds, compatability, substitutions, adverse/side effects, and drug interactions. I as a nurse, who has been around for awhile, still do this DAILY. I can't imagine how a CMA/CNA/UAP can understand the complexity of meds...even with their so called orientation or training. It is frightening...just plain frightening. I've heard the rationale too, which Mattsmom brought up, that the use of CNAs is like what family would do at home. This rationale blows my mind. Folks....this is NOT Home!!!! And patients deserve better, especially if they pay a pretty price for being there in the first place. There needs to be some counter-movement some way...to get the message out to how unsafe and dangerous this practice is for having CNA/CMA/UAP giving meds out. They DO NOT have NURSING JUDGEMENT. They also do not have the authority to question NOT to give a med. I can see the rationale now if a CNA/CMA/UAP did express some judement. The response could possibly be..."just pass the d*** pill. You're not being paid to think"...which would be true!!!! Frightening. The writing is on the wall. LPNs are in danger of losing their practice. The other frightening aspect to this movement is...what is to prevent the same from happening to RNs down the near road. RNs...we need our brother and sister LPNs...for our own sake.
They Are Talking About The Same Thing Here In Oh. Scarey Thought. If You Don't Know Side Affects, What Will Happen. Fall On The Nurse In Charge?!
LPN1974, LPN
879 Posts
Just exactly as you say, I worked hard for mine, too, and there ain't nobody, and I mean NOBODY gonna work off MY license. I won't be responsible for someone else giving meds. I say let the admininstrator assume that responsibility. If they wanna save money, let them have that responsibility.