Published Aug 25, 2002
KlareRN
45 Posts
The state of Indiana has passed a new scope of practice for QMAs. Under the new guidelines; a QMA can administer G-Tube meds, do glucochecks for BS, and some more critical dressing changes.
In the facilities I go to- we are leaving it up to the facility to determine if they want to widen the scope of practice in each individual building. And- I think the nurse supervising the QMA should also have the option to say yeah or nay.
Do other states allow Qs to do more skilled practices like these? I am afraid that this will cause an increase in Qs on the floor because they are cheaper and easier to hire than a licensed nurse because they want to "be a nurse". I have worked with some very good competant Qs but I always have to remind myself that they are just a CNA that has had the medication class. I am certified to teach QMAs but am still leary about broadening what they can do. Would you allow a QMA working under your license to administer G-Tube meds and tell you what a residents blood sugar is so you can administer the insulin?
jevans
224 Posts
Sorry for my ignorance but I assume that QMA's are not Qualified is that so???
If so YES I find it scary cos at the end of the day it is the nurse who is Qualified and permitted any action or non action that is accountable
best of.......
j
caliotter3
38,333 Posts
When I worked in LTC many of the CNA's could not be counted upon to complete and report vital signs. I don't care how many times you explained to them how important this "task" was. These people just saw it as another bother and wrote down anything, or didn't bother to write down anything at all, or didn't report out of parameter findings. I just see this QMA, CMA trend as another lip-service action on the part of adm to save dollars. If I could not trust CNA's to get and report accurate VS's I sure would not trust these same individuals w/meds. I would not trust my license to anyone whose sole goal is to avoid as much work as possible. And I am not bashing the one out of 5 CNA's who does give a d**n about what they do. Soon enough, those CNA's would leave to become LN's or just leave period b/c they did not like the working conditions.
For the amount of money and time wasted in licensed nurses doing the work anyway, these adm could hire a medication nurse.
hfullerCNA
20 Posts
"Avoid as much work as possible"????
Okay, first of all your comment is completely and totally ignorant. Nurses, whether it be a Registered Nurse or a Licensed Practical Nurse do undergo much stress on the job. However, in a Nursing home setting, RN's and LPN's mostly do 20% patient care and the other 80% is paperwork. The Nurses mostly just change wound dressings, give insulins, and check vital signs, also they do patient assessments.
CNA's and QMA's handle MUCH MUCH more of the PHYSICAL work on the job and to be honest, our job is extremely tiring and rough. I would absolutely LOVE to see a nurse be in charge of only having Eight hours to take care of 11 or more residents at once with toileting, showers, brief changes, restorative walking, passive range of motion, etc etc. There is NO reason why a Nurse should be complaining about how "HARD" they have it. To be quite honest, they have it pretty F***ING easy most of the time. I am not saying that there job is NOT stressful, but I am saying and I know for a FACT that their job is about 70% less stressful then that of a Certified Nurse Aide or Qualified Medications Aide (QMA).
Nascar nurse, ASN, RN
2,218 Posts
"Avoid as much work as possible"????Okay, first of all your comment is completely and totally ignorant. Nurses, whether it be a Registered Nurse or a Licensed Practical Nurse do undergo much stress on the job. However, in a Nursing home setting, RN's and LPN's mostly do 20% patient care and the other 80% is paperwork. The Nurses mostly just change wound dressings, give insulins, and check vital signs, also they do patient assessments. CNA's and QMA's handle MUCH MUCH more of the PHYSICAL work on the job and to be honest, our job is extremely tiring and rough. I would absolutely LOVE to see a nurse be in charge of only having Eight hours to take care of 11 or more residents at once with toileting, showers, brief changes, restorative walking, passive range of motion, etc etc. There is NO reason why a Nurse should be complaining about how "HARD" they have it. To be quite honest, they have it pretty F***ING easy most of the time. I am not saying that there job is NOT stressful, but I am saying and I know for a FACT that their job is about 70% less stressful then that of a Certified Nurse Aide or Qualified Medications Aide (QMA).
Every job looks easier than the one you actually do everyday. There is no way that you know for a FACT that their job is harder or easier unless you have actually done both jobs. Every team member is important in LTC and after 27+ years in LTC, I have yet to find an easy job for anyone. FYI - I am currently a DON. I started many years ago in this field as an aide before there was any such thing as a certification process. I worked as an aide on the floor less than 2 weeks ago when the flu took out 50% of our staff. I know what I'm talking about and may have been at this longer than you have been alive so please - little less attitude may get you much further!
BrandonLPN, LPN
3,358 Posts
Um, do you realize how dumb it is
to say you "know" what a nurse does when you have never BEEN a nurse? Guess what, many (if not most) of the nurses here HAVE been CNAs. I was an aide for years. I know you work hard, but I also know my job DOES involve A LOT
more responsibility. You're responsible for the ADLs of 12 people? Well, I'm responsible for the LIVES of the entire floor! Who do you see staying over shift after shift to finish all their work? I bet it's NOT the CNAs!
As for your job being more physical than mine, you're right. It is. Get over it and stop whining. It's called being a CNA. Physical direct care is what your job is all about. You knew that going into it, so did I as a CNA. Besides much of what I do is physically demanding, too. Bending over someone while changing a dressing kills my back faster than CNA work ever did. If your facility has a TX nurse, I guarantee he has the most physically demanding job there.
Also, as a muscular guy working in a field dominated by women, you better believe I'm called upon to do heavy lifting all the time as a nurse.
As for the whole QMA thing, all I can say is I'm glad we don't have them in my state. In my mind, any skilled nursing facility that uses them has automatically downgraded themselves to assisted living by doing so. What's next? CNA "wound techs"? Unlicensed "assessment techs"? They'd really save money if they just get rid of all the staff nurses and all the QMAs and "techs" could just work under the DON's license!