stardust80916

I also fear that potential employers will not hire me. I've already applied and interviewed at a job and they wouldn't hire me because of my past. They didn't even allow me to explain the nature of my charges and refused to hire me even after I told them I could provide documentation that I have been rehabilitated.

Here a background check is required before entering CNA classes. That's the part that worries me the most. I'm afraid the BON won't grant me my license because of the nature of my charges.

I am currently trying to get my CNA in Colorado, however I have a charge on my record from 6 years ago. Unfortunately the charge sounds much worse than what it really is. The charge reads(on my background check)cruelty to children. However, the charges were brought up because of unsafe living conditions, unlike what the charge implies. I have been working in ALFs since the charge and have gone without incident since then. I went through intense therapy and completed everything the courts asked me to, even finished probation early. I'm even willing to do the footwork to get the documentation on my rehabilitation as well as character statements, letters from my former employer, and anything else I could possibly need. I realize I made a mistake, but that was in my past. I'm a different person now and I can prove it. I want to obtain my CNA, so that I can move forward in my career and become a nurse. I would like to continue in geriatrics with a focus on hospice. My question is: can I even get a CNA and will anyone hire me? I'm very worried about this. If I can't get my CNA then I might as well change careers. I feel as though I was born to be a nurse, as everything comes so naturally to me. Any advice would be greatly appreciated!

In Colorado no, all you are allowed to do is remind them and/or hand them the prefilled syringe. Usually HH or hospice comes in to fill the syringes, however the client must be able to give themselves the injection. If they cannot, then home health or hospice comes in to give the injection. If that isn't possible then they are sent to a skilled facility.

Coumadin is another one worth mentioning. Make sure you pay CLOSE attention to the MAR! The dosing can change daily and orders change as often as weekly depending on the patient's INR results.

One time we had an almost full bottle of roxinol that was found in the fridge and the bottle was broken. There was roxinol EVERYWHERE! Talk about a huge fiasco.

I've never heard of that practice and I've been working in ALFs for 5 years. We documented missing pills in the narc sheet. Never in the MAR. Now I have seen people refer to the MAR as well as the narc sheet to make sure all pills were double accounted for. If the situation did ever arise, we were to call our RSD for further instruction. Usually we'd be told to document the missing pill on the narc sheet with explanation as well as write an incident report. Both QMAPs would have to sign the narc sheet.

That is up to the doctors discretion. I agree, however that there doesn't seem to be any meds that would require those parameters. We just do as we're told. Never question or argue because we don't have the authority to do so. As a QMAP we are not trained to really do much of anything except follow doctors orders exactly, admister meds properly, fill out a MAR, and fill MRBs. So, no assessing allowed. That is why I want to further my career. I've had more than enough of these restrictions.

No we still have the 2 hour window for all other meds. Some doctors specify a specific time at which they want the med given. Only in those cases does the 1 hour window apply(30 min before and after). Fortunately that doesn't happen often.

I think Nurse Amy Jolie meant QMAP. Which is a qualified medication administration person.

In Colorado in an ALF if a doctor specifies a time on the the order then there is only a 1 hour window.

In Colorado no. The regulations are very vague. However, most facilities on the front range will only employ CNAs and LPNs. They use CNAs with their QMAP to pass the meds under the supervision of an LPN. The western slope has not caught up to speed with this practice yet. Most tend to not require CNAs, unfortunately in most cases, you are doing the work of a CNA without adequate training or pay. With that said, some residents at one point or another require basic skilled care. This is when HH or hospice is brought in for further assistance as long as the resident still meets the criteria of AL. Then skilled care can be completed under the supervision of an LPN or RN, while the resident continues to live at the ALF. On another note, QMAPs are NOT allowed to administer anything considered invasive. We aren't even allowed to do finger sticks. So, if a resident is diabetic, then they must be able to perform their own finger sticks and their own injections. If not then one of two things happens, either they are sent to a nursing home or they bring in HH or hospice(which ever is appropriate) to do the invasive procedures. Insulin is tricky though, QMAPs are not allowed to fill syringes. So, generally HH is called in to fill them, although there is a growing trend towards the insulin pens as long as the resident can use it with minimal assistance. The regs are vague there too. The same goes for ostomy care and incontinence. They MUST be able to manage it on their own. However, if an incontinent resident has an accident every once in a while that is considered acceptable. We're all human, it happens whether you're young or old. If the incontinence accidents become more frequent though, then they are sent to skilled care. What if a resident has a medical need and HH or hospice is not appropriate you may ask. Then we contact the resident's doctor or nurse via phone or fax and get their advice. However, QMAPs are not trained to assess, so wording is key! We can only make observations and report that as such. We can also contact the nurse or doctor on resident request, however per resident request MUST be stated in the inquiry. A growing trend among QMAPs is they are going out of their scope of practice, which is very easy to do. Trust me! I've heard of plans to eliminate QMAPs all together. However, I feel if better training were provided(instead of a 2 day course that only teaches you how to fill out a MAR, administer medications according to state regulations, and fill MRBs)this problem could be alleviated. I can't tell you how many times a resident has asked me what a medication is and what it's for. The only thing they teach you in QMAP class is to refer to your drug handbook. I for one feel that this kind of information needs to be included in the curriculum, such as commonly given geriatric medications. (Lasix, Metoprolol, Warfarin, etc...) I believe that if I am the one administering the meds, then I should be aware of the uses, common side effects, and affects. Any one else in CO that is a QMAP feel this way? Also, QMAPs are NOT allowed to administer anything, prescription medications, OTCs, even titrate O2 without doctor's orders. Doctor's orders can be even more of a headache. They MUST be complete and detailed! We cannot assume anything, as we are not trained to do so. A lot of doctors and nurses do not understand this practice and send incomplete orders. Then we have to contact the office once again to get them complete. So, Colorado seems to be somewhat different than the aforementioned states. The state regulations are difficult to decipher because of so much gray matter. I for one am fairly knowledgeable after 5 years experience. It does take time to fully understand all the regulations, some of which I am sure I do not know. As mentioned before it does vary by state. I just gave what knowledge I had. Hope it helps!

PCP or PCW- depending on company and state are treated even worse than CNAs. We're looked down upon for our seemingly lack of knowledge in the medical field. I for one choose to be different and pay close attention to what my CNAs, LPNs, and RNs have to say and absorb that information like a sponge. I know all that all that experience and information gained will only help me in nursing school. Although, it is a hindrance now because I have the knowledge, yet I am unable to use it.

Thank you so much for bringing light to this issue. I am considering nursing as well for my career field. In fact I've found that hospice is my calling and that I want to open a campus dedicated to the well being of patients and their families. I too suffer from bipolar II as well as borderline personality disorder, depression, and anxiety. I have heard of people being successful, despite these illnesses, yet it's never heard about in the medical field. It gives me hope that there are other nurses out there that suffer from this illness and are successful. Your post also sheds light on how compassionate and patient us bipolars are. I thought it was just my personality, however now I'm considering that it is part of the disorder. Once again thank you for touching on this subject. You are an inspiration to us all!