A new kind of worker in Michigan nursing homes could address staff shortage
- Michigan’s nursing homes have been hobbled by too few workers, including nurses
- As the state ages faster than most other states, the problem is likely to get worse
- Now, a medication aide — a position created between an entry-level nursing assistant and a licensed practical nurse — will be able to dispense medications
Faced with a staffing shortage that threatens resident care, nursing home industry leaders hope a new kind of worker could meet patient needs.
Two bills now in front of Gov. Gretchen Whitmer would create “medication aides” with responsibilities — and pay, one advocate says — that would fall between an entry-level nursing assistant and a licensed practical nurse.
A two-bill package, introduced with bipartisan support, would allow the new medication aides to dispense routine medications in skilled nursing facilities, freeing up licensed practical and registered nurses to do more patient care.
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One of the two lawmakers who sponsored the legislation said he is considering additional legislation that would expand the role beyond skilled nursing facilities in the new year, possibly to hospitals and other health settings.
“We’ll take another bite of the apple later,” Rep. Joe Aragona, a Clinton Township Republican, told Bridge Michigan.
He introduced the package with Rep. Donavan McKinney, a Detroit Democrat.
In addition to addressing staffing shortages, the new role would create a career stepping stone and greater pay for Michigan’s nurse aides, currently among the lowest-paid health workers, Aragona said.
Similar legislation in Ohio allowed nurse aides to train as medication aides, earning up to $6 more an hour, Shelly Berryman, director of operations at MediLodge, a chain of Michigan nursing facilities, told lawmakers of the House Regulatory Reform Committee in October.
Both unions that represent healthcare workers in Michigan, the Michigan Nurses Association and the American Federation of State, County & Municipal Employees, opposed the bills, but neither explained their reasons at the hearing. A spokesperson for the MNA said Tuesday that the union had concerns about “the impact on patient safety.”
The American Nurses Association, in a 2021 brief about medication aides, noted that dispensing medications safely is “much more than a technical process.”
A nurse’s “clinical knowledge, experience and understanding of the patient’s condition and indications for a medication serves as a safety valve.”
Still, the association also has noted that using such staff “as the result of delegation and direction by a registered nurse” is appropriate and safe.
The package being considered by Whitmer takes aim at a larger issue: a pernicious worker shortage throughout health care.
Across the country, more than half of nursing facilities report now limiting new admissions because of lack of staffing, according to the American Healthcare Association. Michigan’s nursing facilities have lost about 17 percent of their workforce since 2020, leaving about 9,000 jobs empty, Richie Farran, vice president of government services, told the committee.
“I have been working in this field for more than 25 years and I've never seen staffing shortages like this,” said Berryman, of MediLodge, who testified alongside Farran.
As it stands now, residents’ medications are prescribed by physicians and delivered, prepackaged, to nursing facilities, where they are stored in a medication cart. Only licensed practical nurses and registered nurses can administer medications.
Newly-created medication aides would train to deliver those medications and focus on medication administration, reducing medication errors and freeing up more highly-trained nurses to focus on other patient care, according to HCAM. Only nurse aides with at least 2,000 hours of experience in a skilled nursing facility in a two-year period would be permitted to train.
They would be authorized only to administer regularly-scheduled medications — “the day-to-day drugs that keep our seniors alive,” McKinney told lawmakers in October.
The aides also will not administer intravenous medications or controlled substances.
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