Question About RNs Supervising Caregivers

[Katillac, RN]

Does anyone know where I can get a sense of the regulations for New York State that govern the obligation of an RN Case Manager in a circumstance where there are paid but nonlicensed caregivers (not from my agency) giving PRN meds to a demented patient? The lead caregiver looks to me for an OK to give PRN meds, and sometimes gives them on her own. Can I get in a bind here? Does it matter that she is private hire? I've been told that "it's OK because it's just like a family member", but I have my doubts about that. The patient is not self-directing in that she can't identify a need or ask for the meds. If it's relevant, the patient lives in an adult home, but the caregivers are from the outside. I'm just concerned about what I need to do to both protect myself and manage the case effectively.

I appreciate all viewpoints on this, but what I am really looking for is a hard copy or specific online reference I can consult, or a person I could ask who would know the regs. I've tried the Board of Nursing and the Regent's Rules, and can't find a reference.

Thanks in advance,

Kat

[Antikigirl, ASN, RN]

I live in Oregon, and I too was an RN overseeing CNA and unlicensed caregivers passing medications. I had tried numberous times to contact my state board to answer questions I had on many aspects of this...including what documentation I should have available for them about medication administation and medication, delegation/assignment paperwork and retraining, what needs to be posted and where...and rules governing it all.

I got no where! In fact, I never got a response after several tries.

So I just tried to stick with the rules as they apply under the board for training and overseeing unlicensed staff (administrative Rules under deligation and assignment of nursing tasks). Since the facility I worked for passed board twice I think just sticking to those rules have been helpful!

I know those differ from state to state.

Good luck to you...hopefully you get a better response than I did!

[canuckeh!]

The information is on the website of the Department of Health for New York State.

On the Department website

find menu entitled site contents

on right find laws and regulations and then click on title 18

find search box and type in 487.7 f,(resident services, medication

management) . Under personal care services the operator provides medication assistance. Medication assistance doesn't have to be provided by a nurse. However the operator must provide training to the personal care aid in how to provide medication assistance to the residents.

Hope this is helpful. Information like this should not be so hard to find. Unfortunately, it often is.