Should medication aides exist?

lindarn · Jul 26, 2008

Lots of passion about stopping the use of CMTs, but does anyone have any suggestions other than "get a nurse"?
There are not enough nurses to fill CMT slots in LTC- not to mention the huge number of Med Level 1 techs giving meds in group homes, independent living situations, or RCFs.
What if there were more training involved?

How about our elected officials and our Boards of Nursing not giving nursing homes and assisted living facilities a "BYE" when it comes to protecting our elderly and debilited citizens? Do we see our public schools recruiting High School Dropouts to teach in our public schools? Why not? Because the public would revolt. Why is that? I could be mistaken, but I don't think that anyone in our public schools has ever died because they couldn't do long division, diagram a sentence, or recite the Bill of Rights. But how many patients die in hospitals and nursing homes, and probably assisted living facilites because WE have allowed our professional practice to be de skilled and sold to the highest bidder. My suggestion is for nurses to get off of their duff, and protest in front of the state capitol about these conditions. Why do teachers get what they want? Because they take to the streets with the PTA, get in the face of school officials, and make their demands known. Nurses, on the other hand, have refused unionizing year after year, and cannot go to the public with the concerns of the professionals who are on the front lines because they would get fired, and probably not get employed anyplace in this country.

It is a disgrace that WE have allowed it to come to this. Look in the mirror and see the face of the people who let the public down, (who trusts us more than any other group), because we have refused to take control of our profession. Spare me the sob stories about you needed the job and were afraid to take a stand and band together. Other professions have sucked it up and did what they had to do to keep control of their profession. They know make more money than us and have the respect of others. JMHO and my NY $0.02.

Lindarn, RN, BSN, CCRN

Spokane, Washington

mscsrjhm · Jul 26, 2008

I agree that most people don't get involved in serious issues. Still- if nurses protested, and laws were passed tomorrow- where would all those millions of nurses come from? It would take many years of planning to change this system. Is there a quicker path toward medication safety?

lindarn · Jul 26, 2008

I agree that most people don't get involved in serious issues. Still- if nurses protested, and laws were passed tomorrow- where would all those millions of nurses come from? It would take many years of planning to change this system. Is there a quicker path toward medication safety?

If the pay, benefits, and working conditions were rigtht, I guarantee that a goodly number of the 500,000 nurses who have left bedside nursing would come back to work. It happened in California and also in Australia when staffing ratios were enacted.

Lindarn, RN, BSN, CCRN

Spokane, Washington

BradleyRN · Jul 26, 2008

Lots of passion about stopping the use of CMTs, but does anyone have any suggestions other than "get a nurse"?
There are not enough nurses to fill CMT slots in LTC- not to mention the huge number of Med Level 1 techs giving meds in group homes, independent living situations, or RCFs.
What if there were more training involved?

Should we really need another suggestion besides "get a nurse" to do what is a nurse's job in the first place? If i mentioned allowing untrained personnel to do certain skills originally performed by a doctor, people would scoff at the idea. I dont know where people got the idea that nursing is so easy that anybody off the street can come in and do it. You can be certain though that this myth has been perpetrated by those who stand to profit. Like i said before, nurses are the cream of the student crop. They must have nearly 4.0 GPA's just to get into nursing school, and that is when the road really gets hard.

Handing our skills out to people who can get certified faster than a CNA is not only a slap in our faces, but in the face of every nursing home resident in the country. Dont we slap them enough already by providing substandard care? This is sub-substandard care. Would we want it for our parents? Let me finish by saying that there is indeed enough nurses to staff any nursing home. There are numerous nursing agencies out there more than happy to send all the nurses a facility needs. But many of these greedy facilities refuse to use them. Thus these CMT's are yet another greed-based decision that should never be supported by a nurse. We are here to advocate for our patients and ourselves. That would be doing the exact opposite. :twocents:

fireflies_for_me · Jul 26, 2008

Amen to that. I work with OMTs at my facility, and do so gurdgingly. I had a 4.0 GPA when entering the nursing program and walked out of it with a 3.2 and that was studying every night and having 20 hour study groups almost every day of the weekend! I worked hard to earn my license, and am working harder to earn my ADN. But the facts are the facts. LTC owners rarely staff according to need. I have been the only nurse on the weekends, in a facility that has 50 residents where I had no OMT. It is six of one half a dozen of the other. I work so short that I can't provide quality care, or I work with an OMT where I can't guarentee quality care. I hear a lot of comments about standing up and doing something about it, but other than the media, I haven't seen a lot of suggestions on just how to go about doing that. As I posted before, I have written to my state legistators and received no response. If anyone here has some viable solutions to this problem, I'd certainly be willing to see what they are. I too, would love to be able to go to my work place knowing that it I will be able to provide the best care possible to the residents that I am there to serve. And no, I would not place my parents in any longterm care facility. I am afraid they are stuck with me. I have worked in enough LTC to know that there aren't any available that I would trust with my family because of the very problems that are addressed here.

mscsrjhm · Jul 27, 2008

Should we really need another suggestion besides "get a nurse" to do what is a nurse's job in the first place? If i mentioned allowing untrained personnel to do certain skills originally performed by a doctor, people would scoff at the idea. I dont know where people got the idea that nursing is so easy that anybody off the street can come in and do it. You can be certain though that this myth has been perpetrated by those who stand to profit. Like i said before, nurses are the cream of the student crop. They must have nearly 4.0 GPA's just to get into nursing school, and that is when the road really gets hard.
Handing our skills out to people who can get certified faster than a CNA is not only a slap in our faces, but in the face of every nursing home resident in the country. Dont we slap them enough already by providing substandard care? This is sub-substandard care. Would we want it for our parents? Let me finish by saying that there is indeed enough nurses to staff any nursing home. There are numerous nursing agencies out there more than happy to send all the nurses a facility needs. But many of these greedy facilities refuse to use them. Thus these CMT's are yet another greed-based decision that should never be supported by a nurse. We are here to advocate for our patients and ourselves. That would be doing the exact opposite.

While I admire your passion, it doesn't produce staff.

Yes, the long term care, assisted living, group home, independent living industry might just ask for something more than a rebel yell of "use nurses". Having worked agency for 20+ years, I can tell you that there are not enough nurses to fill all the vacancies that would occur if laws changed tomorrow.

We can be active, but who would listen to any activist who doesn't have all of the necessary facts?

No, there are not enough nurses to cover all of the non-nurses currently giving medications at all of these facilities.

And we could not produce that amount in a short time.

Again, it would take years of planning.

So, that being said- does anyone have any suggestions for a more immediate road toward safety in passing medications?

BradleyRN · Jul 28, 2008

Having worked agency for 20+ years, I can tell you that there are not enough nurses to fill all the vacancies that would occur if laws changed tomorrow.
We can be active, but who would listen to any activist who doesn't have all of the necessary facts?
No, there are not enough nurses to cover all of the non-nurses currently giving medications at all of these facilities.
So, that being said- does anyone have any suggestions for a more immediate road toward safety in passing medications?

I dont have all the necessary facts? medication errors

Follow that link and you will see that "Each month, nearly one out of every ten nursing home residents suffers a medication-related injury". It is a few years old, and only one state, but you can bet it is a microcosm of the entire country. With the high number of medication errors that exist already just by nurses, it is such an ignorant concept that someone with a fraction of the training (4 days!) should be considered "qualified" to perform the same task. Medication Aides are not used in every state, YET. But our apathy for giving away our skills is doing nothing to thwart the spread. I sent a letter to the ANA and CNA regarding this issue several weeks ago, but have not received a reply as of yet.

Though i have not crunched the numbers on nurses, i do not see that you have either. You seem to base your evidence on your own experience as an agency nurse. "No, there are not enough nurses to cover all of the non-nurses currently giving medications at all of these facilities." Would you care to cite your source for this "fact"? In my nearly 8 years with an LTC facility, they refused to use agency as did other facilities. I dont think this practice was limited to my city and state either, as i have read the same complaints from others in this forum. It seems to be a choice to be short-staffed, and is certainly not based on calling agencies and being told "Im sorry, we are all out of nurses today". If these facilities would lower the hideous nurse/pt ratios and increase the wages, perhaps they could attract more nurses, maybe even the 17% that are not currently nursing.

I have already made it clear that ALF's have every right to use med aides. Their residents are required to be A&OX3, and it is up to them and their families to guarantee the safety of their medication administration.

Meanwhile, until you can provide actual evidence that there are not enough nurses to replace the med aides, i will continue to base my disdain for this practice on advocating for the elderly due to their compromised safety, and our loss of the most fundamental nursing skills to uneducated people .

The elderly are one of the most underserved groups in this country, not due to a shortage of nurses, but due to greed. :down:

True- it is all about greed. But that is what capitalism is all about, isn't it?

Miss Ludie · Jul 28, 2008

we need to realize that "health care" is no longer about the patient's well being. it is the $bottom line$ and that is all. the average patient doesn't know who gives them their pill. it's become "hi, i'm jill and here's your pill."

the average patients have no concept that there is something wrong with this picture. they know they have marble floors in the atrium, maybe a grand piano. lots of lush plants, catered meals with wine for supper if their physician oks it.

they went to the office and picked up a set of instructions for admission from the nurse ... of course she was, she had on a uniform and said she's dr. xxx's nurse. (ps she lied to the patient without batting an eye.)

the nurse in xray took several films and told her she would review them with the doctor. she was taken to her lovely private room $1200 a night ---but she has insurance so why worry? might even luck up and have a view of the rose garden out front.:zzzzz

and you know what? the hospital owners and administrators and board don't care one cotton pickin' bit. they make money on the deal. just like putting those susisb's in the slots in vegas. except in this lounge it's a jackpot every day.

sure why not medication aides......they go to school..dont they? the hospital wouldn't have them if it wasn't right......would they?

mscsrjhm · Jul 28, 2008

I dont have all the necessary facts? medication errors
Follow that link and you will see that "Each month, nearly one out of every ten nursing home residents suffers a medication-related injury". It is a few years old, and only one state, but you can bet it is a microcosm of the entire country. With the high number of medication errors that exist already just by nurses, it is such an ignorant concept that someone with a fraction of the training (4 days!) should be considered "qualified" to perform the same task. Medication Aides are not used in every state, YET. But our apathy for giving away our skills is doing nothing to thwart the spread. I sent a letter to the ANA and CNA regarding this issue several weeks ago, but have not received a reply as of yet.
Though i have not crunched the numbers on nurses, i do not see that you have either. You seem to base your evidence on your own experience as an agency nurse. "No, there are not enough nurses to cover all of the non-nurses currently giving medications at all of these facilities." Would you care to cite your source for this "fact"? In my nearly 8 years with an LTC facility, they refused to use agency as did other facilities. I dont think this practice was limited to my city and state either, as i have read the same complaints from others in this forum. It seems to be a choice to be short-staffed, and is certainly not based on calling agencies and being told "Im sorry, we are all out of nurses today". If these facilities would lower the hideous nurse/pt ratios and increase the wages, perhaps they could attract more nurses, maybe even the 17% that are not currently nursing.
I have already made it clear that ALF's have every right to use med aides. Their residents are required to be A&OX3, and it is up to them and their families to guarantee the safety of their medication administration.
Meanwhile, until you can provide actual evidence that there are not enough nurses to replace the med aides, i will continue to base my disdain for this practice on advocating for the elderly due to their compromised safety, and our loss of the most fundamental nursing skills to uneducated people .
The elderly are one of the most underserved groups in this country, not due to a shortage of nurses, but due to greed.

You are right- I based my opinion on my own experiences, not only in agency. Having passed medications at LTC, I would never do it full time. Attempting to crunch the numbers, I find myself lacking in the www skills necessary to locate census in LTC, RCF, MRDD group homes, ISL, etc, not to mention number of Level I, II, and III medication aides (identified this way in my state).

Any ideas on where to get the info?

Patti SW · Jul 28, 2008

Sorry, but it is not "health care" who no longer cares about the pt. It is the insurance co. If you have insurance you are more likely to get less than a traditional medicare pt. Your insurance carrier would never pay for $1200 a night for a nice room with a view of the rose garden. I have to try and convince a MD everyday to send a pt to LTC or Skilled Nursing. They hate it because they know all of the very hard work to save someone if out the window. The doctors who compose make up a lot of a hospital board wish they could keep their pts in acute care. There are no medication techs in the hospitals where I come from nor any of the nursing homes. Maybe nurses should stand together against this not caring about the pt unless you don't really care. I can tell you the doctors do care, I fight with them everyday.

pagandeva2000, LPN · Jul 29, 2008

I say not; more nurses should be hired, especially if I have to be responsible for the outcomes of their mistakes. For all of that, I would rather do it myself.

AdewaleRN · Aug 21, 2008

Only a licensed nurse should be allowed to give medications.