Medication is the induction of formulated chemicals Essay Example

Medication is the induction of formulated chemicals Essay Example Medication is the induction of formulated chemicals Paper Medication is the induction of formulated chemicals Paper An important part of the health care process is the administration of medications to the clients in a medical facility. Medication is the induction of formulated chemicals with relatively predictable effects to meet the homeostasis of the body to alleviate an illness. This said medications include the forms of oral medication like tablets and capsules, intravenous medication that may be directly injected in the intravenous line or in the vein itself, subcutaneous medications which may includes the different transdermal patches and subcutaneous injections, and topical medications which may take form of creams or fluid for instillation. Oftentimes, it is the duty of the registered nurse (RN) to administer and manage patients during and after medication up to the evaluation of the effects of the medicine, but this intervention is collaborative in nature which involves the combined coordination and judgment of the attending physician, the licensed practical nurses, the registered nurses, and the licensed pharmacist. This is the ideal setting of medication management of the client under the health care providers, but because of the different shortages in the hospital staffs for the past years and with the overwhelming financial crisis, the unlicensed assistive personnel (UAP) has been utilized by the hospitals to overcome the understaffing and financial issues of the different medical facilities. While most of the medical institutions are requesting for a more flexible utilization of the UAP’s because of their advantages to the institution, the clients are addressing some quality and safety issues with regards to the use of those unlicensed personnels in place of services, competency, and judgment of a licensed medical practitioner or registered nurses. Unlicensed Assistive Personnel, or UAP, are individuals who are trained to function in an assistive role to the registered professional nurse in the provision of patient/client care activities as delegated by and under the supervision of the registered professional nurse. (ANA, 1997). Those personnels are under the supervision of the registered nurses and practical nurses, and the delegation of task to this personnels especially in medications should not include task that uses professional judgment and interventions because this is an exclusive function of the registered nurses. In medication of the patients, the unlicensed personnels are legally not allowed to administer medications without the supervision of the licensed practitioners or registered nurses because of the possibility of incompetence in the administration of medications in the part of the unlicensed personnels or the possibility of unpredictable situations which may call the use of professional nursing judgment and interventions as in adverse reactions or anaphylaxis. Overview and History of Issues: There have been an increasing number of unlicensed personnels that is hired to assist registered nurses and licensed practical nurses in the hospital routines. Such practices have caught the attention of the clients of health care because of the fact that those personnels are unlicensed yet they are performing task and duties that they often observed as duties and task of registered nurses. While competency of the unlicensed personnels is questioned, the clients need not to worry because all of this services that are rendered by unlicensed personnels are strictly supervised by the registered nurses. As cited from the Texas Administrative Code of 2003, it says that â€Å"In situations where the RNs regularly scheduled presence is required to provide nursing services, including assessment, planning, intervention and evaluation of the client whose health status is changing and/or to evaluate the clients health status, the RN must be readily available to supervise the unlicensed person in the performance of delegated tasks. Settings include, but are not limited to acute care, long term care, rehabilitation centers, and/or clinics providing public health services† (Texas Administrative Code, 2003a). This explains that the accurateness of the procedures done by the unlicensed personnels are strictly supervised and analyzed by the registered nurse, and further implies that the professional nursing care will not be deprived from the client because only selected task are given to this personnels. The administration of medications by this unlicensed personnels are included in the bracket quoted above, wherein in case that an unlicensed personnel gives medication to the client, it is assured that the personnel have enough competency to do the medication administration, and that it should be provided that the registered nurse accompanies this personnels in giving the medication. The fact that there is a widespread use the unlicensed personnel in the medical profession, steps are being undertaken to control the quality of their service. Some states requires a certification of those unlicensed personnel before entering a medical institution; some have institutional examinations on hands-on ability of the unlicensed personnels; and some have a period of observation and training in the hospital facility before being able to render care. Still, the fear of the clients of the fact that this personnels are still unlicensed forced each government of the states in collaboration with each local board of nurses to release a memorandum or administrative order to set the scope of practice of the unlicensed assistive personnels. For example, the State of Texas Board of Nursing Examiners has released administrative orders to set the scope of practice of these unlicensed personnels by quoting on their administrative order that â€Å"The nursing task must be one that a reasonable and prudent RN would find is within the scope of sound nursing judgment to delegate. † and â€Å"The nursing task must be one that, in the opinion of the delegating RN, can be properly and safely performed by the unlicensed person involved without jeopardizing the clients welfare. † (Texas Administrative Code, 2003b) The Pro’s and Con’s of the Issue: The utilization of the unlicensed personnels has greatly improved the speed of the health care delivery system, sparing the time of the registered nurses in making routine care for clients. It is very beneficial for the registered nurses if there will be unlicensed personnel that will aid him in giving medication if he is assigned in the ward with 20 or more patients under his care, which commonly happens on understaffed hospitals in some states. The double checking of the right medication towards the appropriate patient will be further improved and strengthened because of the joint effort of the nurse and the unlicensed personnel and by observing the regimen of the patients and confirming it to the nurse on duty if any confusion occurs. This is especially beneficial on the hospitals who do not observe the functional routine wherein nurses are assigned in different field of works like charting, vital signs monitoring, medication, and the like. Another benefit of this system of hiring unlicensed personnel is that the hospital administration will just have to hire competent unlicensed personnels who can do nonetheless close to what a pure staff of registered nurses can do because it is much more cheaper to do so. It is implied that before the hospital do this steps, they assure first that the competency level of the unlicensed personnel are beyond average and can be trusted with minimum assistance and supervision from the registered nurses. The negative side of this system of hiring unlicensed personnel is that the health care delivery system is delivered with speed but with less accuracy and possibility of errors because this personnels are not really trained and legally qualified to do so, like in giving medications. It is given that the medication done by this personnel are supervised, but the skills that they are using in the process are not controlled in the own hands of the registered nurses who are supervising them. Because of this, there is still a chance of incompetencies and this concludes that the use of the unlicensed personnels, however competent they are, should be limited only to the safest task that they can do with the most minimal risk of having errors. Because of this issue, the public which are the primary clients of health care, are alarmed of the possible errors that may happen to them especially in receiving medications. In this scenario, it is possible that the clients may have a reduce trust to the medical facilities and hospitals because of the prevalence of this unlicensed personnels which are performing professional nurses task. A continued effect of this is the drop on the willingness to submit to medical attention of the clients of health care because of fear of malpractice. Such scenario should be avoided as soon as possible for it will increase the morbidity rate of the population. Recommendations: Evaluating the different side of the issue, it is proper now to recommend that first, the scope of practice of the unlicensed personnels should strictly be followed even though the personnel is very competent and is capable of task above his job description like the administration of medication. The license that a registered nurse holds plus the training, education, experience, and competency makes them very different to unlicensed personnels and this personnels will never be able to fit the place of registered nurses, legally and competency-wise. Secondly, the hospital administration should be advocate of the client’s welfare and should assure the full health care that they will receive is from the hands of professionals. It is not recommended to disregard the help of the unlicensed personnel for they are very useful as patients advocate, it is just recommended that they stick to the scope of their practice to ensure maximum effectiveness and accurateness of the health care delivery system. The continuous hiring of the unlicensed personnel in place of the registered nurses should be stopped because this will deteriorate the image of the health care delivery system in the face of the public. Another recommendation I have derived is that the registered nurse should be really cautious in delegating the task of giving medication to the clients, especially in situations wherein the condition of the patient is not predictable. It is because nursing judgment and assessment is highly needed in these kinds of situations for medications in critical care. To sum it up, administration of medication to the client should be handled with utmost care and supervision if it is to be done by unlicensed personnel and if possible, delegating such task by the registered nurse to the unlicensed personnel should be avoided as much as possible and be reconsidered for the possible situation for the safety of the client. Reference: ANA. (1997). UNLICENSED ASSISTIVE PERSONNEL LEGISLATION 1997 [Electronic Version] from http://nursingworld. org/gova/hod97/uap. htm. Texas Administrative Code [Electronic (2003a). Version]. DELEGATION OF NURSING TASKS BY REGISTERED PROFESSIONAL NURSES TO UNLICENSED PERSONNEL FOR CLIENTS WITH ACUTE CONDITIONS OR IN ACUTE CARE ENVIRONMENTS. Retrieved April 2007 from http://info. sos. state. tx. us/pls/pub/readtac$ext. TacPage? sl=Rapp=9p_dir=p_rloc=p_tloc=p_ploc=pg=1p_tac=ti=22pt=11ch=224rl=7. Texas Administrative Code [Electronic (2003b). Version]. DELEGATION OF NURSING TASKS BY REGISTERED PROFESSIONAL NURSES TO UNLICENSED PERSONNEL FOR CLIENTS WITH ACUTE CONDITIONS OR IN ACUTE CARE ENVIRONMENTS. Retrieved April 2007 from http://info. sos. state. tx. us/pls/pub/readtac$ext. TacPage? sl=Rapp=9p_dir=p_rloc=p_tloc=p_ploc=pg=1p_tac=ti=22pt=11ch=224rl=6.