Is This Even Possible?

[kalikare8]

I work in a LTC facility. More than 1/2 of our patient populous suffer from Alzheimer's or some other type of dementia. I would even say that the majority of our patient's suffer from some psychological or mental disorder, whether they're at the facility on a short stay, or they're their long term. On the day and PM shift the average amount of patients you are responsible for is 24. You are responsible for the med pass, and treatments on your 24 patients. We ( sometimes ) have a treatment nurse to do the heavier treatments, for example the resident's that have wound vacs, or Stage 3 and 4 decub's. What's considered lighter treatments are done by you ( the charge nurse ). In the mix of your patient load, you may have anywhere between 1 to 7 G-Tube patient's. You may not have any patients with a GT. It all depends. There is no treatment nurse at all on the PM shift. Dayshift typically has the heaviest med pass. I have witnessed nurses, whether they're a seasonal, less than 2 years experienced, or even a new grad do a med pass in less that 2 hours. Is this even possible? The majority of the cardiac meds are due on dayshift, so you have to do blood pressures, and or apical pulses. They have to be taking short-cuts in order to do this. To me this is a feat that is totally impossible. By the way, you get a heck of a lot! IMO this cannot be done. Some nurses are done in less than 1 and a 1/2 hours. I need feedback from my fellow nurses out there.

[kalikare8]

In the above reference I spelled "their" instead of "there". I should have proof read my topic before I hit the submit section. Thanks.

[TriciaJ, RN]

I would want to shadow one of the fastest nurses to see how it is done. In my limited LTC experience, I found G-tubes very time-consuming because each med has to be crushed, mixed with water, administered, then flushed separately. Do people just crush the whole wad together? Since I was agency I got no orientation and no help and still have no idea how I could have been any faster unless I cut corners, which I don't do.

I would love to have been able to shadow someone seasoned to get some good pointers.

[NOADLS]

I would want to shadow one of the fastest nurses to see how it is done. In my limited LTC experience, I found G-tubes very time-consuming because each med has to be crushed, mixed with water, administered, then flushed separately. Do people just crush the whole wad together? Since I was agency I got no orientation and no help and still have no idea how I could have been any faster unless I cut corners, which I don't do.

I would love to have been able to shadow someone seasoned to get some good pointers.

You bet they're shoving everything in there in a single (sometimes 2) goes.

There is no secret that the fastest nurses are taking shortcuts. Some of them don't even check what they're giving.

As for blood pressure readings or apical readings, some of the medications have parameters set on whether you give the medication or not on a per dose basis. Some of them only require that you take the reading on a weekly basis.

I would also like to point out that if you ask to shadow one of the faster nurses, they will not be pulling their shortcuts in front of you. They'll end up taking longer and make up an excuse for taking longer.

I've basically written the LTC playbook.

[calivianya, BSN, RN]

I found G-tubes very time-consuming because each med has to be crushed, mixed with water, administered, then flushed separately. Do people just crush the whole wad together?

Not LTC, but I always do. What's the logic behind crushing them separately, anyway? They're all going to mix together in the stomach regardless. If they are things that are going to interact, they could still interact in the stomach unless you are going to give them 30 minutes apart.

[loriangel14, RN]

They won't be doing BPs and pulses daily and yes tube meds will all go in together