Medication Aide Certification Exam Cram: The Roles and Responsibilities of the Medication Aide

This chapter reviews key issues related to your roles and responsibilities as a member of the healthcare team and the importance of establishing a caring and ethical relationship with clients. A brief review of principles of effective communication as well as residents’ rights follows.

Your Roles and Responsibilities

The National Council of State Boards of Nursing (NCSBN) accepts responsibility for developing standards of nursing care and education that protect the health and welfare of the public, thus serving as a guide for state laws addressing nursing practice. The Nurse Practice Act of each state determines what licensed nurses—Registered Nurses (RNs), Advanced Practice Registered Nurses (ARNPs), and Licensed Practical/Vocation Nurses (LPN/LVNs)—can do, also known as their scope of practice (or a description of what licensed nurses can do according to their level of educational training and experience). The Model Nurse Practice Act also outlines the role and responsibilities of nursing assistive staff, known by the NCSBN as unlicensed assistive personnel (UAP).

As part of the UAP category in most states, your title is that of Medication Aide-Certified (MA-C). In other states, you may be referred to as a Certified Medication Aide, Certified Medication Technician, Medication Aide, Trained Medication Aide (TMA), or other similar distinction. You must hold the Certified Nurse Assistant/Aide (CNA) credential, complete a state-approved Medication Assistant program, and meet all other state requirements to become registered, which include a written competency examination and may, in some instances, include a clinical competency evaluation. An alternative route to MA-C certification may be through equivalent education in an approved program leading to LPN or RN licensure.

Your role (or function) as a Medication Aide is to assist the licensed nurse (RN or LPN/LVN) in providing safe and ethical care for clients—that is, administering prescribed drugs (also called medications or medicines) and completing other delegated nursing tasks allowed by state law. Medication Aide employment settings vary (for example, skilled nursing homes, residential settings, or assisted-living facilities; hospitals, long-term care facilities; correctional centers; home health agencies, schools, group homes, and daycare centers). For purposes of this publication, the care setting for the Medication Aide is the skilled nursing center or assisted-living facility, and your clients are referred to as residents. You must adhere to all laws and regulations of the state licensing/accrediting agency.

Roles and Responsibilities of Other Nursing Team Members

The following is a synopsis of the role of licensed nurses in healthcare facilities:

• Registered Nurse (RN): RNs are responsible for carrying out both the medical plan of care prescribed by the physician and the nursing care plan developed by the nursing staff. They assess each resident and modify their nursing care as needed to help meet residents’ needs. RNs also work with other therapists and staff to ensure the well-being of each resident. They may assign you, the unlicensed assistive staff member, to assist in administering medications and directly supervise your work. RNs work under the supervision of the director of nursing and are accountable for their practice according to the state’s Nurse Practice Act, which outlines RN practice competencies and limitations of their scope of practice. They may supervise other RNs, LPNs, or other UAPs.
• Licensed Practical Nurse (LPN): LPNs carry out the medical and nursing plans of care for assigned residents, but work under the supervision of RNs. LPNs give treatments, administer medications, and document care given according to a prescribed scope of practice set by the board of nursing or other licensing agency. LPNs may also supervise UAPs. Their duties may be expanded with additional training and credentialing. Where allowed, LPNs may assign you to assist with medications while supervising your work.

The Role of UAPs

Certified Nursing Assistants/Nurse Aides or Patient Care Assistants/Technicians (CNAs, PCAs, and PCTs) carry out duties under the supervision of RNs or LPNs. As unlicensed assistive personnel, they provide personal, hands-on care and other tasks required to meet residents’ needs. CNAs are also responsible and accountable for their duties as defined in their position description and as proscribed by the standards of care by the state accrediting body. CNAs cannot delegate duties to other UAPs; this includes delegating medication administration tasks to you.

You, the Medication Aide, must perform your duties according to national standards as follows:

The Standard Job Description of the Medication Aide-Certified (NCSBN):

• Functions as a healthcare team member
• Carries out delegated nursing assistant tasks
• Assists the nurse in providing care to clients, which includes observation and reporting of client needs
• Recognizes and performs tasks according to level of education and training
• Accepts responsibility and accountability for own performance according to state laws and regulations regarding MA-Cs
• Performs tasks in an ethical-legal and caring manner
• Communicates changes in client status according to level of training and experience
• Documents care according to agency policy and procedure
• Performs tasks safely and effectively to assure client comfort and welfare
• Respects client rights
• Protects confidential client information unless otherwise required to promote client safety and welfare
• Follows federal, state, and agency regulations to protect own health and that of others
• Seeks guidance from the nurse as needed to perform tasks safely and efficiently

Similar standards apply in the state in which you become certified; it is also your responsibility to adhere to them.

Your position description or job description outlines your duties, responsibilities, and other expectations of your employer. It also documents the chain of command, or supervising personnel, to whom you report. It will note education, experience, and licensure requirements as well as desirable physical and mental abilities. Physical abilities include walking several miles during a work shift, standing for extended periods of time, lifting and moving abilities, and so forth. Mental stamina is needed when working under stressful conditions while modifying resident behaviors.

Exclusions to the MA-C Role (Legal Limitations)

According to the NCSBN, the nurse shall not delegate to the MA-C any of the following acts:

• Giving medications that require dosage conversions or calculations
• Assessing the client’s need for, or response to, medications, including PRN medications
• Giving medications via parenteral, nasogastric, gastrostomy, or jejunostomy routes
• Regulating IV fluids, program IV pumps, insulin pumps, or giving drugs to unstable clients or patients

This list shows just a sampling of role limitations; state law and administrative rules as well as the employing agency may further limit your practice. Remember, also, that the employing agency may not expand your practice beyond state law and regulations. This includes, for example, assigning you any duties not included in your position description. If you have any questions or conflicts related to your functions or job limitations, consult with the supervising nurse; or, if the situation involves the nurse involved in the assignment, contact your employer’s human resources officer before you act. In any case, do not perform any duty not included in your position description.