Large med pass at 6 am!!!!!!

Nurses General Nursing

Published

Specializes in Med/Surge, Psych, LTC, Home Health.

One of the reasons my new job went from being, eh, pretty tolerable... to being miserable... is because management decided that night shift would start passing *AT LEAST* half of all of the patients' morning medications at 6am. So, instead of being able to wrap up all of my charting, wrap up I+O's, and generally get off work anywhere near on time... I have to do this big med pass at the end of my shift.

Management did this to make things easier on our day shift... right now our day shift is WAYYYYYY understaffed and MANY things do not get done that should be done on day shift. However, this idea of lightening their 9 am med pass is so far not working. They are still slammed out the rear and not able to get things done; the lighter med pass is not making a difference.

But, we have the type of management team that doesn't care to listen to what we have to say.

Anyway, I was wondering if anyone else has this type of system on their floor or in their hospital?

discretely consult with the ombudsman and pharmacy...this may be against patients rights, and not good pharmaceutically

Specializes in Nursing Home ,Dementia Care,Neurology..

:yeahthat: Many meds should not be given on an empty stomach e.g. aspirin ,and who's going to get it in the neck if they have a gastric bleed........you are for giving it!I don't see the point ,time management -wise giving them some meds then having to go back and give others with their breakfasts!Yes it's good if shifts can help each other but is there anything else you could take off the day shift so that they can do the meds?

Specializes in geriatrics.

In my facility, on one hall, the day shift nurse arrives at 6am to get the 3.5-4 hour med pass started. (no, that wasn't a typo, it takes that long). On the other halls, night shift has a good sized med pass, then when day shift comes in at 7am, they turn right around and do more meds. I am also interested in finding out other's ideas. I'm not a doc, but I believe a lot of our LTC patients take waaaaayyy too many meds.

I don't know what could be taken off of day shift's load.....the majority of the time, we are dealing with doc's, phone calls, pharmacy and families, and assessments while trying to catch the patient before the therapy dept. does.......

That doesn't sound like it will lighten the load much at all. If they have more meds to pass at 9 am, what's the point? My hospital has crazy med pass times. The pharmacy times out our meds based on the type of meds, but they will have things timed at 0600, 0630, 0725, 0800, and 0900 on the same person. Do they really think nurses have time to do five med passes in three hours? I work nocs, so I'll do the 0600 and the 0630 (usually between 0530 and 0600), but I hate waking people up to shove pills in their mouths. It seems like most of our patients are up until 4 a.m., so at 0600, they are just getting to their deep sleep.

Specializes in Operating Room.

As a lowly student I can only comment on what we are taught in lecture and clinicals, but it has been drilled into our heads that if the med is ordered for 0900 you have an hour on each end to pass it, so you'd have from 0800-1000 for your meds. I'd fail clinicals if I passed meds 3hrs off schedule... Anyone know if this is right? like I said, I only know what we're taught

Specializes in Acute Care Cardiac, Education, Prof Practice.

We pass a few meds in the am, ie omeprazole, levothyroxine etc however it sounds like your management might:

1) Actually be trying to see if this helps the days shift during this time of shortage and will probably run it, evaluate it and see if it should be kept that way.

2) They are trying to compensate for a need that may need to be addressed in terms of agency nurses (which is a lot less cost effective than the original idea)

Either way make sure you look at it objectively. Is management "really" not listening to the staff, or is this just a sign that the day shift has finally expressed their frustration effectively?

My suggestion, compensate. I work 12 hour nights on a busy, fast turn over cardiac floor. I know that the day nurses can sometimes deal with a floor that has a 12-16 pt turn over between 11 and 6. Before 11 they have to pass meds, assess, chart and teach d/c info before they even start to deal with more critical issues that may set everything back. If I was told I had to pass a large chunk of meds that early I guess I would just factor it in. Finish up major charting and chart checks by 0200 and then start passing meds at the earliest available time (0500) by whomever was already basically up.

My biggest beef with this system is that our patients generally are already awake a lot of the night with VSS checks and beeping pumps let alone a med pass, however meds are usually pretty quick and painless. (Unless its Lovenox! Yeowch!)

Best of luck, and may an objective eye save you some frustration.

Tait

As a lowly student I can only comment on what we are taught in lecture and clinicals, but it has been drilled into our heads that if the med is ordered for 0900 you have an hour on each end to pass it, so you'd have from 0800-1000 for your meds. I'd fail clinicals if I passed meds 3hrs off schedule... Anyone know if this is right? like I said, I only know what we're taught
Depends on the policy of the facility. In LTC, a nurse may be passing meds for 30+ patients, making it impossible to fall within the 1 hour before or after window.
Specializes in Acute Care Cardiac, Education, Prof Practice.
As a lowly student I can only comment on what we are taught in lecture and clinicals, but it has been drilled into our heads that if the med is ordered for 0900 you have an hour on each end to pass it, so you'd have from 0800-1000 for your meds. I'd fail clinicals if I passed meds 3hrs off schedule... Anyone know if this is right? like I said, I only know what we're taught

You are not lowly, you are learning! Stop mixing your "L"s up!

Yes you are right, one hour, however medications can be scheduled at many different times and the trick is getting them schedule at at consistent intervals. Be this 9 and 9 or 6 and 6. I believe a lot of times meds are scheduled in the hospital for 9 because this means the patient can go home and keep that schedule.

Specializes in Acute Care Cardiac, Education, Prof Practice.
Depends on the policy of the facility. In LTC, a nurse may be passing meds for 30+ patients, making it impossible to fall within the 1 hour before or after window.

At my last facility (small rural hospital) they had implemented a 1/2 hour window before and after meds instead of the standard hour, talk about riotous day nurses!

They do it at the LTC I work in part time. I work nights, either 7p-7a or 11-7a, and we are expected to help with their morning med pass in addition to what I have to give. I have all the blood sugars and insulins, which I try to do as close to 7a as possible, I don't like doing them too early, so it's really alot on me. And I have both ends of the hall to do, when they come in they have 2 nurses. So some days I don't get done what they would like for me to do, and I just tell em, I didn't get it all this morning.

I have to go home at 7am and I'm not staying there unless it's an emergency, such as a fall or something. I'm not staying there an hour over to do their work.

We are doing this more and more now on night shift. I find that I am often giving just one med to every patient I have and I have to wake them up for it. Some patients really don't appreciate being woken at this time for one pill. Then I end up taking them to the bathroom, finding all kinds of things for them, giving them a snack depending on the med, and it seems that all the other things add up to about 15-20 minutes in their room sometimes. If I have 12 patients, that's a whole lot of time being eaten up.

I don't mind doing whatever to help them out but it quite often makes me late out as the med pass is scheduled for 6am when I am supposed to be off and giving report.

+ Add a Comment