If I may vent for a moment.....the other day, as I was perusing through the usual social media sites, I cringed as I came across a post written by a Patient Care Technician (PCT) who works in a clinic I used to manage. She stated how good it felt to know her patient trusts her more than any of the RNs on the floor. Below this post were numerous other comments from other technicians applauding this and detailing other discussions they've had with patients about this same thing. "RNs are really only there for the license and to pass meds" (double cringe).
As an RN of almost 15 years now, this is certainly not the first time I've heard of this. I've heard it and experienced it many times before. Regardless, I have a great respect for LPNs and unlicensed professionals such as CMAs, CNAs, EMTs, and PCT. They are some of the most skilled, competent, and fast-on-their-feet individuals I've known. They were especially invaluable to my learning as a brand new nurse on the floor. In many specialties, an RN will spend a great deal of their orientation with them due to their technical knowledge and skill.
While the contention that exists sometimes between licensed and unlicensed personnel is an issue as old as time, my frustration is not with the viewpoints on the unequal division of labor, or who is more skilled/knowledgeable, or even who works harder. My issue is when we encourage these thoughts, discussions, and ideas with our patients and other team members---oh yes... and now on social media?? With the number of medical errors reported across the country and the negative media attention health care organizations and healthcare professionals receive for "incompetent care," we just can't afford this attitude and behavior. It undermines teamwork which ultimately undermines the quality and safety of the care we give our patients. More importantly (whether we realize it or not) it undermines the trust of our patients have in us as a department, unit, clinic, organization, and industry. Can we not lift each other up and support each other...especially in front of our patients?
What really bothers me is when people don't fully understand the scope of their role, or when they think that their role is more than it is. I have known PCT's that have "in their own mind" believed that they were more important or had a wider scope of practice than a RN. This poses a problem on multiple levels.
Here's the fact of the matter (and I know I'll get grief over this statement)... In a hospital, PCT's are not necessary but nurses are necessary. Why, you might ask? Well, a nurse can do EVERY aspect of a PCT's job, however, a PCT can NOT do every aspect of a nurses job. Therefore, PCT's are supplementary but not necessarily required.
In terms of jadelpn's post regarding CNA's giving medications, I'd be interested to know what state that is which allows CNA's to pass meds. For the life of me, I can't even begin to wrap my head around the concept of a CNA giving medications without having a solid foundation in anatomy, physiology, pharmacology, and pathophysiology.
There are CNA's that function as "medication aides" and give medications in LTC facilities. There are also some of that going on in AL, as CNA's "assist" in giving medications. I am not sure if this is happening at acute care facilities or not, however, it is a norm in LTC in any number of states.
There are CNA's that function as "medication aides" and give medications in LTC facilities. There are also some of that going on in AL, as CNA's "assist" in giving medications. I am not sure if this is happening at acute care facilities or not, however, it is a norm in LTC in any number of states.
I can assure you that it is absolutely not happening at my facility (acute care inpatient, Level 1 trauma center). I can also assure you that if I ever caught a CNA or PCT administering medications to one of my patients, that CNA or PCT would be immediately relieved of their duties and their employment terminated.
I can assure you that it is absolutely not happening at my facility (acute care inpatient, Level 1 trauma center). I can also assure you that if I ever caught a CNA or PCT administering medications to one of my patients, that CNA or PCT would be immediately relieved of their duties and their employment terminated.
Specializes in LTC,Hospice/palliative care,acute care.
Med techs are common in Pa. in assisted living.They are not required to be certified nursing assistants in AL in this state (unless something has changed)... Med techs are not utilized in LTC in this area.This is something AARP has lobbied against...
In Kansas where I used to live, we had CMAs (certified medication aide) and they had the same duties as a CNA but they were trained to pass meds. In Indiana where I live now, we have the same thing but they're called QMAs (qualified medication aide). I may be mistaken on this, but I think they have to be a CNA before getting their CMA/QMA certifications.
If it is ACTUALLY a CNA or PCT passing meds, that's not okay. But they do have certifications that allow CNAs to do this.
Specializes in Psych, Addictions, SOL (Student of Life).
What really bothers me is when people don't fully understand the scope of their role, or when they think that their role is more than it is. I have known PCT's that have "in their own mind" believed that they were more important or had a wider scope of practice than a RN. This poses a problem on multiple levels.
Here's the fact of the matter (and I know I'll get grief over this statement)... In a hospital, PCT's are not necessary but nurses are necessary. Why, you might ask? Well, a nurse can do EVERY aspect of a PCT's job, however, a PCT can NOT do every aspect of a nurses job. Therefore, PCT's are supplementary but not necessarily required.
In terms of jadelpn's post regarding CNA's giving medications, I'd be interested to know what state that is which allows CNA's to pass meds. For the life of me, I can't even begin to wrap my head around the concept of a CNA giving medications without having a solid foundation in anatomy, physiology, pharmacology, and pathophysiology.
I don't know about Hospitals or Clinics but in almost every state unlicensed "Care Giver's" who yes are often high school drop outs pass medications to patient's living in group homes. The state's mandate that these homes be "homelike" in every way. The rationale is that if they were living in the family home a family member would be giving the meds anyway. These care giver's take a one day course and pass meds under the license of the supervising RN. I know - This is all mandated under Title 22 of the healthcare institutions Code. It's primarily why I left the industry.
Specializes in Infusion Nursing, Home Health Infusion.
Absolutely it is wrong and childish to bring patients into discussions of this nature. You are correct that it has no place in healthcare and it can undermine the trust the patients and families have in the care we all provide. Unfortunately, there will always be immature, jealous misguided,neurotic individuals who work out their childhood issues or use the workplace as their own personal self esteem gym. I am sick of it, having witnessed it my entire career and will not and do not engage in any conversations of this nature. I believe that any employee that does this needs to be reprimanded for creating a toxic work environment.
I can assure you that it is absolutely not happening at my facility (acute care inpatient, Level 1 trauma center). I can also assure you that if I ever caught a CNA or PCT administering medications to one of my patients, that CNA or PCT would be immediately relieved of their duties and their employment terminated.
You are very misinformed. There are MANY Cna's that have completed medication certification classes that allow them to LEGALLY pass medications. They are called MA's and are mostly working in AL and LTC facilities. You're statement implies that these nurses are allowing this to happen illegally when that is not the case.
You are very misinformed. There are MANY Cna's that have completed medication certification classes that allow them to LEGALLY pass medications. They are called MA's and are mostly working in AL and LTC facilities. You're statement implies that these nurses are allowing this to happen illegally when that is not the case.
Thank you for that information, but I don't think I'm misinformed. In NY at my facility passing medications is well outside the scope of practice for a PCT or a CNA. Then again, I don't work in a nursing home. I've been in many hospitals and I've NEVER seen a PCT or CNA passing meds. While it may be accepted in nursing homes, I think it's far less of a common thing seen in acute care (if at all).
To the PP that asked if it's within my scope of practice to fire a PCT... No, I'm not able to directly fire a PCT because I'm not a member of the management team. However, I am a charge nurse. So it is well within my purview to send that person home from work and initiate an investigation and subsequent termination proceedings.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
I think what this discussion really points to is the complete lack of uniformity in what is frequently called unlicensed assistive personnel. There was a time when you had what we called a "nurse's aide" in hospitals and a "medical assistant" who worked in doctor's offices.
There has never been a consistent definition across all states for either of those but I believe with the increasing "for-profit" approach to healthcare as a business cost-cutting measures spawned two major trends where specifics will vary from state to state.
First, as in my state an MA does not have a scope of practice or requirement for "certification" so physicians/pcps push the limit as far as they can which at times includes things that are out of the Scope of Practice for licensed nurses. The worst case I've read here is a medical assistant cauterizing colon polyps. In a free-standing office with an unscrupulous provider in a state that can hire people off the street if the provider gives "on-the-job training" it opens the door for malpractice but apparently this is a risk they are willing to take.
The second trend, motivated by the same thing ($$$) is to parcel off traditional nursing tasks to a series of specialized techs, assistants, medication aides etc. A facility can create any number of these categories and call it whatever they want to and describe it however they want to. It ends up in things such as CMA meaning "certified medical assistant" and "certified medication aide".
I've seen threads here where I can tell one person is talking about a medical assistant and the other is talking about a medication aide. Then there are the PCTs, LNA, CNA II, Monitor Tech, etc. I'm sure there are many more location-specific and company-specific acronyms and associated job descriptions I'm not aware of but the potential for confusion is pretty much unlimited-- perhaps deliberately so.
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
We've all heard the alarming stats for "medical errors". Since health care facilities are deliberately blurring the distinctions between licensed nurses and everyone else, I start to wonder who is actually making all these errors. When the scope of tasks for unlicensed personnel is constantly expanding, how can there not be errors? And unfortunately they are often mistakenly attributed to nurses.
There seems to be a growing trend to educate ourselves away from the bedside. We're being replaced by people who are not qualified to do our jobs. Isn't that why nursing schools were invented in the first place? So that care was being provided by educated people?
And that, I might add, is done on purpose, so patients think that they are being cared for by licensed, educated, professional staff, when in reality, they are being cared for by HS dropouts.
jadelpn, LPN, EMT-B
9 Articles; 4,800 Posts
There are CNA's that function as "medication aides" and give medications in LTC facilities. There are also some of that going on in AL, as CNA's "assist" in giving medications. I am not sure if this is happening at acute care facilities or not, however, it is a norm in LTC in any number of states.