When I was nursing in a RH, we had lost a couple of our long-term RPNs. As many know, we have experienced a nursing shortage for some time and were having difficulty filling these positions. The owners of this RH also owned numerous others and had began introducing Med-Techs (PSWs with additional training in medication administration) as part of the care team to fill this void. It was at this time that this concept was introduced to our home as it was being used in others. Leadership’s goal for the Med-Techs was to provide additional assistance to the RPNs and build the RPNs’ skills in delegation and leadership. Our leadership team introduced this to the neighourbood I worked on first. This decision had a dramatic impact on our RPNs’ day to day roles and responsibilities. There would now be 1 RPN for 2 neighbourhoods (approx 100 residents) with 1 Med Tech on each neighbourhood. In looking at the readings this impacted both the structure and human resources within the organization. At the time I feel I was between the Early Majority and Late Majority in accepting this change. We had a nurses meeting where we were encouraged to voice our concerns and it was sometime after this that I felt more comfortable with the idea. I worked with some incredible Med-Techs but unfortunately still feel this change was not for the better as many of my (and my fellow RPNs) concerns were realized. There is much more knowledge and critical thinking needed in medication administration and connecting why those medications have been ordered and monitoring their effects. There was unfortunately a noticeable increase in medication errors and poor medication optimization as this created a gap in nursing care and knowledge of the residents. Our RPNs were no longer having as many interactions with each resident so were not assessing them as often for changes a Med Tech may not be trained to observe as concerning.