How do you safely pass meds on 33 patients?

[Kashia, ASN, LVN]

I am mostly acute care trained. But through an agency I may go to skilled nursing

facilities.

The times I have in the long ago past, some places I would have like 33 patients

and I found it very difficult. Add any treatments to be done, mind boggling!

Sure some of it was not knowing the patients, but for those of you

that have a lot of experience in skilled nursing...please pass on some tips! Thanks!

[SuesquatchRN, BSN, RN]

Kashia, head over to the Geriatrics forum. There are a whole bunch of threads on this.

:)

[Intern67]

I think you already know the answer to this. You don't safely pass meds on 33 patients.

You do what everyone does in these understaffed LTC nightmare scenarios : You do the very best you can. I would be interested to hear how your LTC experience as an agency nurse goes. The facility I worked at NEVER used agency anything. If staff was not available then people simply did not get cared for.

[Nurse Joey]

You can't safely give meds to that many people. All the treatments, peg tubes, finger sticks, and vitals, aside from the sheer bulk of meds will keep you from it, as well as trying to get the meds passed on time. Just hope you have a good aide to help point people out, or a mar with pictures. Try not to let the nurse giving report ramble on, those "gossip" minutes are precious. Overall just be really organized, my trick is to get each persons's meds together and labeled between passes. I've had nights of 40 patients and I pray no one falls. Good luck and best wishes.

[SuesquatchRN, BSN, RN]

I think you already know the answer to this. You don't safely pass meds on 33 patients.

That is simply untrue. If your med pass is timed properly it can be done safely.

When floor nurses are unavailable my facility pulls from management. I was scheduled to work as supe this weekend and discovered that we were short a floor nurse so I passed meds for a day and did it safely. In addition to my other duties managing a 122-bed facility. I will do so again tomorrow because finding coverage on Easter isn't even worth trying.

Run late rather than risk errors. And actually, you will get it nailed in no time.

[nursinger]

That is simply untrue. If your med pass is timed properly it can be done safely.

If it's timed properly and you DON'T GET INTERRUPTED 100,000 times, and no one FALLS, or BECOMES ACUTELY ILL, or the doctor isn't interrupting you to assist him/her in an annual physical, then it might be done safely. You were extremely lucky today and I hope you're lucky tomorrow too. Our Nurse manager tells us, "Do the best you can." And most days, that's all you can do, no matter what shift you work. Some days are better than others. I just pray prior to each med pass.

[SuesquatchRN, BSN, RN]

If it's timed properly and you DON'T GET INTERRUPTED 100,000 times, and no one FALLS, or BECOMES ACUTELY ILL, or the doctor isn't interrupting you to assist him/her in an annual physical, then it might be done safely. You were extremely lucky today and I hope you're lucky tomorrow too. Our Nurse manager tells us, "Do the best you can." And most days, that's all you can do, no matter what shift you work. Some days are better than others. I just pray prior to each med pass.

No, I wasn't lucky today. I work in a good facility in which we are a team. If my med pass is interrupted for a fall I simply do what needs to be done and resume passing meds after the crisis is averted. As I said, I would rather run late than be unsafe.

And if the doc is pulling you to help assessing during your med pass your DON should address that. And if she doesn't she's the biggest part of the problem.

[nursinger]

Giving meds to 33 residents alone is unsafe and should be addressed. We have 50 residents on our unit and we have three med nurses and brand new med carts. Come work for the VA our staffing is excellent.

[Intern67]

That is simply untrue. If your med pass is timed properly it can be done safely.

When floor nurses are unavailable my facility pulls from management. I was scheduled to work as supe this weekend and discovered that we were short a floor nurse so I passed meds for a day and did it safely. In addition to my other duties managing a 122-bed facility. I will do so again tomorrow because finding coverage on Easter isn't even worth trying.

Run late rather than risk errors. And actually, you will get it nailed in no time.

Fair enough. OP, if SuesquatchRN is your boss, then everything will be hunky dory.

Other than that, you're hosed.

[HBRNBSN]

I work in a 70 bed LTC unit and we had 1 med nurse to pass all meds on 70 patients. What a nightmare! We now have all of our CNA's med certified and now they pass 90% of the meds.

[Forever Sunshine, ASN, RN]

There are some nights when I have to give meds to 45-50 residents. It takes me the entire shift. I divide things up into two med passes. a 4:30.. and a 9pm. When you learn the residents, and how they like their meds or how to give them their meds so they take them.. it becomes easier. I use my judgement when giving all pills at once. Because time takes off when you have 50 residents and I need all the time I can get.

[ilovenursing2009]

YOU DON'T!!!! Run the other way! There is no way to be safe in those circumstances. My opinion is that working at a SNF as a RN is a great way to get sued or lose your license. It is always hectic, patients never get the care they deserve and you will be responsible. RUN! There are lots of other postions out there!