[feisty_lpn]

mimi - That was a big issue for me too when I first started agency. Then I figured out a system that works well for me.

1] I make sure to ask the previous nurse during report who takes their meds whole, crushed, or tube.

2] I go through the MAR book. I write on my report sheet beside each pt's name... med times, insulin times, accu-check times, narcs, aerosols, BP and P checks, etc. I love MARs that have tabs to pull because I can just use those and color code my times (7am = red tab, Noon = green tab, etc). But I still write everything else on my report sheet and I take that with me EVERYWHERE. It lays on the top of my med cart during the med pass for easy reference. When that pt's meds are passed, I either cross the time off my sheet or push in the tab.

3] I start my med pass at the beginning of the MAR book. If that patient is not in their room, I go to the next one. After I get all the 'roomed pts' finished, then I concentrate on the AWOLs (thats what I call them, to myself of course, if they're not in their room). They're generally in the dining room. I am not shy about asking an aide or dietary where I can find the person I'm looking for. Once in a great while, someone will be in PT and I'll have to go to them or wait for them to get back.

I know that sounds like alot of work, especially at the beginning of the shift. But honestly, its a time-saver. I spend roughly 30 secs on each pt's MAR, making my notes. The 10-15mins I spend doing that saves me a whole lot of frustration/confusion/headaches throughout my shift. Before I started doing this, a med pass for 24 patients I never met before that shift would take me nearly 3 hours. Now, even double-checking the MAR to make sure I don't miss anything, an HS med pass for 26 patients takes me about 90 minutes.

The med cart usually is labelled with patient names or room numbers. I have yet to have a med cart that was "naked".

HTH

[kiszi]

fiesty-- You worked only in LTC before agency? Was it difficult to transition to hospital work? I plan to go agency after first year is up, and I was wondering about that. Did the agency mind that you didn't have hosp. experience? I think I can do well in the hospital, but I don't know since I haven't been in a hospital since clinicals! Fiestylpn or anyone, any insight?

[feisty_lpn]

kiszi - Hospital work is definately different from LTC. The only hospital experience I had was from nursing school clinicals. When my agency asked me if I'd be willing to do acute care, I absolutely jumped on it and I LOVE IT! I admit the 1st 3 or 4 shifts kicked my butt and I felt like a brand new nurse thrown to the wolves. I left the 1st two shifts in tears... from bil feet pain and frustration. I seriously had thoughts that nursing is not for me, what the heck was I thinking, etc. I was ready to quit nursing altogether. It didn't help that the charge RNs treated me like crap... rolling their eyes when I had a question or let them know pt needed an IV push, etc. But I toughed it out and now I beg for hospital shifts. LOL

Now, when I leave a hospital shift... I feel like I've done 'real nursing'. LTC is nursing, don't get me wrong. Its just a different kind of nursing and not one I want to do for the rest of my career. Although it is nice that I can take a LTC shift after doing a few hospital shifts... slow down a bit and enjoy the calm. And not leave with a sore feet and back too. LOL

I dont recommend that you accept hospital shifts from the start since you don't have experience. Being agency is hard enough the first few months. At least it was for me.

HTH, GL