For the past two decades, North Americans have been cautioned about the impending nursing shortage that is headed our way. With an aging population and lack of registered nurses to meet current health care needs, the United States is expected to experience an alarming shortage of registered nurses across the country until at least 2030.
Read more about the nursing shortage and how Certified Nursing Assistants (CNAs) and Medication Assistants can help nursing homes and residents during this time.
A Nursing Shortage in the U.S.
According to the American Association of Colleges of Nursing, there are several reasons for this shortage, including:
- An aging workforce: A 2013 survey identified that 55% of the RN workforce is age 50 or older and nearing retirement.
- Changing demographics: By 2050, the number of U.S. residents age 65 and over is projected to rise to 83.7 million.
- Insufficient post-secondary training/institutions: A 2017 report revealed that U.S. nursing schools turned away 64,067 qualified applicants from baccalaureate and graduate nursing programs the previous year due to an insufficient number of classroom space, clinical preceptors, clinical sites and faculty.
- Insufficient staffing levels: Many skilled nurses are driven to leave the profession due to heightened stress levels and limited job satisfaction.
The lack of skilled nursing care is felt in every sector of healthcare, from acute hospital settings to long-term nursing home care.
The Role of CNAs and Medication Assistants in Nursing Home Care
According to an article published by McKnight’s Long-Term Care News, to help combat this shortage and reduce the load of registered nurses, Certified Nursing Assistants (CNAs) and Medication Assistants are being trained to administer certain medications to patients.
Traditionally, the role of a CNA has been divided into 3 C’s, “namely the provision of Care, Comfort and Communication,” says AMN Healthcare Education Services. AMN Healthcare explains that CNAs have always been an integral part of the healthcare team, “performing routine patient care… and providing for the comfort of the patient.”
Now, CNAs who possess the proper education, experience and training can administer certain medications to patients, including:
- Intra-dermal injections for allergy testing
- Oral, suppository or topical ear drops or eye drops
- Single dose immunizations administered intramuscularly in the deltoid muscle
It is important to note that CNAs are under the direct supervision of registered nursing staff and they are not permitted to administer any controlled substances, medications requiring dosage calculations or medications to patients who are deemed medically unstable.
The Advantages and Disadvantages of CNA Medication Administration
A recent study conducted in a long-term care facility using nursing assistants with 104 hours of training – “who had at least three years experience, limited absences, emotional maturity and positive attitudes” – had positive results, revealing:
- Decreased patient fall rates
- Decreased resident re-hospitalization
- Faster call light response times
- Improved medication error rates
- Improved staff satisfaction and workload
The pilot project also revealed that it was more cost-effective to utilize CNAs to administer low-risk, routine medications, rather than registered nursing staff, allowing the RNs to concentrate on more complex tasks.
Although the benefits of training and utilizing CNAs to administer medications is evident, there are still lingering concerns. The National Council of State Boards of Nursing reveals that there is currently no uniform testing or training process that CNAs and Medication Assistants must undergo in order to be certified.
Regulations vary greatly depending on the jurisdiction or state, including:
- Applicant requirements
- Continuing education
- Regulatory oversight
- Role limitations
- Work setting
However, with the introduction of standardized regulations and oversight, CNAs and Medication Assistants have the ability to improve the way in which certain medications are provided to nursing home residents and can potentially improve the overall care they receive.
What do you think about CNAs and Medication Assistants administering specific medications in nursing homes? We’d like to hear your thoughts in the comments below.