Use of Certified Medication Techs in a Prison

[WRCRN]

HELP!!!!!! I am an 18 year veteran RN in a State Prison for male offenders who also have a mental illness or behavioral problem. We are suffering a 25% vacancy and Management has come up with this "brainchild" of taking unit personnel (who are NOT CNA's by the way), giving them a 60 hour hybrid course in medication passing at a local vocational tech. college, and then putting them under our direct supervision to pass all kinds of psychotropic and anti-anxiety (ie controlled meds) meds to guys who don't have a hoot about what they are taking at times. This is making all of us verrryyyyyy uncomfortable to say the least. I have done some research about med techs in other states and there appears to be statutes that govern their certifications. But not so in Wisconsin.....there are no such accredited positions here. Can anyone help me??? I need some info to take to management as I have volunteered to be on the development committee for this outrageous idea and I want some ammo to help me and the dwindling pool of nurses I work with.

[ceceliajane2003]

franklin5

to sbic56

i believe techs to pass meds in a very controlled environment. such as prison. they're in a booth with a window pass them like that.

yours truly

cj2003

red

the practice of using techs in this capacity has long been used in maine in resdential settngs such as with the elderly and in psych. the tech are called crma's, certified residential medication assistants. their only requirement is that they pass a 40 hour med course and a refresher every two years. supervision of crma's is part of my job at the mental health agency in which i am employed. they do need alot of support and teaching, but this system does work. major med errors are not the problem you might expect they would be. the clients we serve receive several medications for psych and medical reasons. no harm has come to them at the hands of the med techs over the years. would it be ideal to have nurses in all these settings instead? sure, but the money is hardly there for this nurse, so this is the reality. i am not suprised this is going on in the jails now. i won't be at all suprised to see this catch on as it is a viable solution to the shortage of both nurses and the money to pay them in certain settings. i can see not many agree with this and i understand the fears, as i was quite concerned when i first took this position, but i think you will be suprised to see the outcome is not a bleak as you think.

[ceceliajane2003]

franklin5

why do we waste time, picking font, colors,etc.when they dont come out anyway

to sbic56

i believe techs to pass meds in a very controlled environment. such as prison. they're in a booth with a window pass them like that.

yours truly

cj2003

red

[fiestynurse]

This is legal in Wisconsin. When I worked at the University of Wisconsin Hospital in Madison in the early 80s we had Med Techs passing routine meds on the nursing units. They were Supervised by a licensed Pharmacist. They did not pass prn meds, like narcotics and did not do Insulin or other injectables and of course did not do IV meds. If a patient refused his/her medication or they had any problems they would contact the nurse. The system seemed to work in the hospital, so I don't know why it wouldn't work in the Correctional setting.

[Jailhouse RN]

A very dangerous thing to do. I would not supervise an unlicensed person to pass medications in this environment. It doens't happen in the NYSDOCS. I know it it used in some LTC facilities.

[nurseT]

I Have Worked With Cma's. It Looks Like Companies Will Use Them If We Like It Or Not. I Say We Should Go With The Times And Get The Laws Changed To Make The Companies Who Hire Them Be Responsible Since They Will Not Heed Our Warnings. Then We'll See Who's Crying!!!!

[Delorus Menere]

Hi my names Delorus and I am a L.V.N. from California who works in a jail facility. I saw your post and wanted to know how you feel about pharmacy techs pouring medications for L.V.N.'s to pass. I have a big issue with this because some of the medications are not prepackaged and we will have to go by site of the drugs. I know most of the drugs by sight but there is always room for mistakes and I better know what I am pouring into someone's hand!! They said we will have a book that is made up from the pharmacy with name of med, dosage, and a picture of them. We will carry this book on our med cart when passing meds. This is their way of solving a shortage of L.V.N.'s and reducing workload! I feel I am putting my licence on the line. I plan to call the Board of Nursing tomorrow and try to talk with a real person about my concerns. Please write me back. Thanks!:angryfire

In Florida Med-Tech's are not allowed to pass pills (or pour them for that matter). Even our pharmacy tech's, who are a lot more familiar with meds and dosages,are not allowed to pour or prepare pills unless they are under the"direct" supervision of the Pharmacist. Speaking of "direct supervision". I have yet to figure out how that saves employees. If I were to have to 'directly supervise' another employee, that's exactly what I would do. I'd watch each and every pill that was poured and handed to the IM. Now PLESAE!!!!!!!!tell me how that's gonna help if you're short handed already. Maybe "they" think you'll just let the med-tech pour and pass the meds and sign off the appropriate papers while you're busy doing something else? I don't think I'd leave but I certainly would follow the letter of the law."direclly" supervising."sorry I'm busy now supervising the med-tech for whom I am responsible if a mistake is made". It's time for us to put our foots down!!! Just because there's a nursing shortage(and don't get me started on THAT subject) dosen't mean that we have to accpt every lame-brained idea 'they' come up with. Contact your Board of Nursing and get a copy of the Nurse Practice Act in your state. Review it VERY carefully.

[sa48sh]

Hi my names Delorus and I am a L.V.N. from California who works in a jail facility. I saw your post and wanted to know how you feel about pharmacy techs pouring medications for L.V.N.'s to pass. I have a big issue with this because some of the medications are not prepackaged and we will have to go by site of the drugs. I know most of the drugs by sight but there is always room for mistakes and I better know what I am pouring into someone's hand!! They said we will have a book that is made up from the pharmacy with name of med, dosage, and a picture of them. We will carry this book on our med cart when passing meds. This is their way of solving a shortage of L.V.N.'s and reducing workload! I feel I am putting my licence on the line. I plan to call the Board of Nursing tomorrow and try to talk with a real person about my concerns. Please write me back. Thanks!:angryfire

Delorus, Sorry I'm a year late but I was just reviewing some of my past posts and saw this..In Florida DOC our pharmacy tech's may prepare meds(as in fill a prescription) only under the direct supervision of the pharmacist. Now our meds may come pre-packaged for the day(since they did away with a pharmacist in each prison). I can assume that these unit dose pre-packaged meds may even be put together by a med-tech under the supervision of a pharmacist(or at least one that takes responsibility for the med-tech). ALL meds MUST BE LABELED as to NAME(generic and trade)& dosage when they come from the pharmacutical company. I couldn't imagine getting pills without identification printed on the bottle and then have to look up a picture of them in a book........that sounds like a pharmacists responsibility......besides with so many generic brands out there, the PDR couldn't possibly picture all of them. As a matter of fact it doesn't.When I pass pills, whether I get them from a bottle or a punch out card, there is a label on it that says it was filled by a pharmacist, and his name is on there. I couldn't imagine standing by watching a pharmacy tech cruise around a "Picture book" and decide what it is. If he/she then handed it to me to give to an inmate, I'd refuse. In this state if you get caught with pills in a cup or bottle or envelope and it's not labeled as to exactly what's in there (Med&dosage) you're in BIG trouble. And the label has to be put on by the pharmacist.Even the nurses are not allowed to put pills in an empty bottle and stick a label on it. That's called dispensing and is not part of our nurse practice act. Life has become soooo confusing about who's allowed to do what anymore but whenever I'm in doubt, I refuse. MY nurse practice act says I must refuse. As far as I'm concerned, and according to the Fl. Nurse practice Act, If I pour them, I must administer them. If you poured them, I'm not giving them..... I'll bet pre-pouring for someone else is against every State's nurse practice act....It is your personaly responsibility to know the boundaries of your scope of practice. Even if your boss tells you to do something, if it goes beyond the scope of your practice(as noted in your state's nurse practice act) you are held responsible. And believe me honey, it's done all the time. "My supervisor said to do it this way." NUH, UH" she says at the hearing, " didn't even know they were doing that".