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Hello Everyone,
Well, I've read all your e-mails and first I want to clarify that I DID NOT
participate in developing the CRMA recert curriculum or manual. In Sept of
2003, I DID call Peter to discuss concerns and to give constructive feedback
regarding the CRMA manual and was rudely yelled at over the phone. I was asked to
put my concerns in writing (which I did - several pages, and sent them) but
NEVER heard about them again. I do appreciate that my suggestions were kept and
reviewed. Since then, I have had to e-mail both Peter and Carol and they have
always answered my questions promptly and professionally.
Second, I truly appreciate all the effort that people invested in developing
this curriculum, it shows much time and effort. I would have loved to assist
but could not fit that commitment into my already overbooked workload. I am
sure they put together a product that they felt was best and that must not have
been easy.
Third, I want to say that because there are various levels of assisted
living, some aspects of the curriculum are more pertinent to some facilities then to
others. For instance, some facilities care for elderly people, some for
people with intellectual disabilities, others for persons with mental illness, and
lastly, some children homes. Facilities range from 2 beds up to much more than
that. Some facilities employ nurses; many do not, so the CRMA needs to be
able to work independently without an RN oversight. Unfortunately, the
certification is not specific (I imagine that would be a nightmare). Hence, the
curriculum needs to be universal. A CRMA should be able to function in any assisted
living facility safely!
Next, I agree that CRMAs should have basic knowledge to pass medications and
note orders, but as Betsy said, knowing how to use their resources is a much
greater tool to memorizing lots of hardly used facts. I too see many CRMAs who
are caring and conscientious, but will struggle when they need to note orders
at 100% - especially with the pressure of knowing they only have 1 chance and
their job depends on it. Many of my students rarely note orders (due to their
position) and do need a review. Isn't it ironic that in reality, when orders
are noted, they are checked by 2 CRMAs to insure accuracy, but only get 1
chance in class. Also, CRMAs are encouraged to ask for assistance, call a nurse or
pharmacist or consult a drug handbook in the real world for questions.
I believe the majority of the test questions are basic and fair. I agree that
equivalents are not necessary to test, they can be looked up and are rarely
used (I personally have never used "drams"). Since CRMAs should never calculate
dosages and metric is the only accepted measurement on an MAR in assisted
living, I discourage my CRMAs from converting any dosages. Instead, I refer them
to the experts - nurses, pharmacists, doctors. The graduated med cups have all
the liquid conversions on them anyway.
I have provided my students in our agency with the manual, minus the
exam/orders and a study guide with worksheets. Perhaps a review workshop can be
scheduled for those who need assistance or a refresher class offered prior to taking
the recert class. (After all, when I recert my PALS or ACLS, I get the manual
and a review prior to testing my skills.)
I have always told my students that my goal is to insure they can pass meds
safely and I will do whatever I can to help them succeed. Scaring them will not
accomplish that goal, but supporting them and helping them through this will.
I wanted to end with a question for instructors: how do you handle students
with hearing deficits when checking their blood pressure monitoring skills? I
have many group homes that rely heavily on automatic machines as well as staff
with difficulty hearing. I can foresee a problem and wanted your feedback…………
Thanks for listening and wish me the best, my first recert class is next week
……
Best Wishes,
Linda Reed, RN
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