whats your honest opinion concerning med aides?

[sasha2lady]

Im trying to get a roundabout idea of how nurses feel on the use of med aides, mainly in LTC settings. Both pros and cons.

What have been your best/worst experiences with med aides?

Where I work they have been using med aides on our assisted living hall, there are a total of 4 med aides. 2 are good, 2 are dangerous. The 2 bad ones have made many many many med errors, most of which were reported to mgmt and not addressed. One med aide just picks and guesses what a med is if she cant find it on the cart instead of asking a nurse for help. 2 of them also go beyond their allowed tasks sometimes.

We have been on our med passes at night and found that the med aide had signed in a med delivery from pharmacy, which is all computerized at the pharmacy. A nurse is supposed to sign for meds. Not to mention, when we have sealed totes to go back and they do this, those totes end up sitting for another 24 hrs and most of the time narcs are in them. The med aides dont know this.

We floor nurses have addressed this with the med aides several times and reported it to no avail.

I personally dont feel that med aides should be used in LTC settings. I dont think that a 3 day 4 hour class warrants the ability to safely medicate people. I do however see why they are used alot, its way cheaper to pay a med aide to do it vs a nurse. Our place is saving over 30000 dollars a year by using these med aides. They make me nervous no matter how good they are.

Ive also seen where they sign for injections and they KNOW they cant do this. They have also used white out on the mars and incorrectly marked meds. They are not cna 2's so they cant do tx's either. Id much rather have a cna 2 there to do txs vs doing the meds.

And we have one med aide who tries to boss the other one around and tell her what she "needs" to give to who and when. Maybe its just an issue I have at my job. Med aides are used at my other place and it doesnt seem near as bad...maybe because they are required to be na 2's also. The rules are stricter and enforced. There isnt all the what ifs like at my full time job.

What are your thoughts? Have you had to fill out med errors etc because of med aides? Who is really responsible for them on your shift? My nsg instructor always told us that whoever the nurses were in the bldg at the time they were being used was responsible, then others say we're not..yet that makes no sense. We nurses are responsible for everybody no matter whos working so if they mess up we have to take action to correct and report it?

Im just a lil confused on this matter.

[caliotter3]

The incidents you mention in your post are good reasons why using med aides is not a good idea.

[sasha2lady]

I think so too ! Not one nurse wanted med aides to be used but the DON put us all on mandatory 12 hr shifts to cut back nursing hours and sent 4 aides to get med aide certification.

Another big problem is that if there are not enough aides, the med aide on this hall is expected to do all the meds for 24 residents PLUS do cna work! That was NOT what they were put in these positions for...they were told by the DON that their focus was solely on the med pass, not to be doing cna work...yet now she has them doing both...a nurse sure wouldnt do that, we dont have time.

Thats a big safety issue to me. Whats even more annoying is when this particular med aide is on that cart and tries to tell the nurse in charge of that hall and another hall what to do!

She doesnt come to me, thank God, but she sure aggravates the fire outta the other nurses. She tried that once with me and I put an end to it before it became a habit of hers.

She had stayed over one night to see if I was going to change out O2 water bottles! I was so furious and annoyed by that that I told her to clock out and go home because I didnt need a babysitter and I have 12 hours to do my work and she needed to focus on her own job and not mine. I havent had any issues with this particular med aide since that incident.

It was a PMS moment truth be told haha.

[AZMOMO2]

Don't like the idea one bit! Cheap labor is all it is... medications can be dangerous! They do allow them in AZ... but are rarely used.

On the other hand I would love a CNA to help or do some of the blah treatments. I mean who can't put on bacitracin and a bandaide on a toe? Or spray proderm on some heals and hips? Sheesh... somedays all these dressing changes for skin tears drive me up the wall...the bigger wounds need more attention than I can give them because of these.

[TheCommuter, BSN, RN]

I love medication aides. They make my job so much easier.

To be perfectly honest, I don't like passing pills to 30+ residents. It consumes a huge chunk of time, so it is wonderful when a competent med aide does it. When I'm working with a med aide, I have ample time to take breaks, use the restroom, chart, complete paperwork, assess residents, do treatments, finger stick blood sugars, dressing changes, deal with emergencies, handle complaints, and so forth.

[sasha2lady]

I think the key word there is "competent". At my place of employment I only trust the 2 good ones because they dont hesitate to look something up or come ask one of us for help. They dont guess and give.

Im so particular in how I do things at work Id much rather medicate my 36-40 pts and do everything but the tx's..I hate doing txs. Like another poster said, the stuff you do for skin tears is ridiculous at times.

Im the type that Id rather just do it myself so I know for a fact it was done and done right.

I think they should be mandated to have more extensive training. Our mgmt wont even give us an employee policy book. would be nice to see more of what they can do

[systoly]

Based on my LTC experience (15 + years) , I believe at least 50% of med aides are performing poorly. I firmly believe performance could be improved dramatically by allowing proper and on going training and assigning reasonable workloads. Too many times med aides are set up for failure by management. A few examples:

brand new med aide assigned 50 resident med pass with little or no orientation

med aide is assigned CNA duties while passing meds

new med aides being reprimanded for being too slow

inadequate equipment ranging from pill crusher to cart to med room

no support system

I could go on et on

I have thoroughly enjoyed those times I got to work with competent and efficient med aides. The problem is not the med aide, it's the lack of tools they're given. After all, who can a med aide go to when they need help. The nurse? be honest.

[jjjoy, LPN]

The rules are stricter and enforced.

That's the key there, isn't it? Whether with licensed nurses or unlicensed personnel, if the management isn't effective and prefers to turn a blind eye to problems, the quality of care in a given facility will be at greater risk.