LPN passing meds all over the place!

[KarynicaRN]

Talk about a scary situation. I work for a community college and take nurse aide students into a wonderful state owned facility. I have the biggest concern and no one else seems bothered by it and I am just an instructor USING their facility, so really I have no voice, or do I?

There is an LPN who passes the morning and noon meds. She has the meds lined up on the med cart, hands the medication to MY students and the cna's who work there to give to the residents. In my wonderful state only nurses can give medications unless they are med techs who have had an approved med course. This is usually only people who are med techs who work with the developmental disabled. Not this case.

Anyway, this LPN leaves medicine cups all over the tables, some still full of medicine! Anyone of the residents could pick the medicine up and take it at any given time. I have never encountered this type of med pass in my 12 years of being a registered nurse. I have worked in many long-term care facilities and I always stood with my resident and made sure they took the medication and I cleaned up my mess! I always took my med cups to the trash.

Am I just too picky? :uhoh21:

[OgopogoLPN, LPN, RN]

70 patients for a med pass is an insanely dangerous situation!!!

However, she needs to be reported, or at least reeducated or something. She desperately needs help. There should be at least 3 LPN's for that many patients!!

I don't know what advice to offer. I feel for her as I will be an LPN and if I work in LTC, I will be doing a lot of med passes, but no way to 70 residents!! However, lining up all the med cups, with no ID and leaving them on the table is a fatal med error waiting to happen.

[jenn-jenn]

I am a cna in pa and I work in a skilled nursing facility. And I know we are not allowed to pass meds to anyone. I think it is a definitely a good think to be concerned with and nothing you should think you are too picky about. Maybe the director of nursing or someone needs to be told that this is going on. At the facility I work at they are not allowed to leave the resident until they take the pills in front of them.

[november17, ASN, RN]

WIthout reading any of the replies, Im giving my honest opinion. That LPN is an unsafe moron. I can understand having to cut corners to get productivity up and all that jazz, but this is completely unsafe practice. She should have her license revoked. I'd write a letter to the BON and have your nursing students sign it as witnesses. That situation is completely 100% ridiculously unsafe.

[november17, ASN, RN]

we had a night nurse who would pull up 6am meds and put them in the drawer in the cart

at 5 am one morning state surveryers walked in..she was in trouble and ltc facility was written up, i know what being pushed to the wall is like but there really is no excuse when you get caught

I don't understand how

pulling all the meds at once --->putting them in little cups---->passing them

vs

pulling them meds one at a time---->putting them in little cups--->passing them

is any faster? you spend the same amount of time checking them, putting them in little cups, and then passing them?? maybe it just makes the nurse feel more efficient??

I remember as a CNA questioning an LPN about that, and she said, "Once you're a nurse you'll understand"

I've been a nurse for a year now, and I still don't get it. How does setting all the meds up at once speed things up?

You still open and close the same amount of drawers, you still look at the same amount of paperwork, you still pass the meds to the same patients. It all takes the same exact amount of time.

Can anyone answer this question, what part of the process is speeded up?? It doesn't make any sense to me.

[morte, LPN, LVN]

I don't understand how

pulling all the meds at once --->putting them in little cups---->passing them

vs

pulling them meds one at a time---->putting them in little cups--->passing them

is any faster? you spend the same amount of time checking them, putting them in little cups, and then passing them?? maybe it just makes the nurse feel more efficient??

I remember as a CNA questioning an LPN about that, and she said, "Once you're a nurse you'll understand"

I've been a nurse for a year now, and I still don't get it. How does setting all the meds up at once speed things up?

You still open and close the same amount of drawers, you still look at the same amount of paperwork, you still pass the meds to the same patients. It all takes the same exact amount of time.

Can anyone answer this question, what part of the process is speeded up?? It doesn't make any sense to me.

because you only have a two hour window, if your med pass is set for 9am, you "cant" give them until 8 and no later than 10.....but if you set up the first 10-15 of them from say 730-8 those will go much quicker, especially if they are the crushes/gt/jt patients

[Valanda]

I can be a little evil at times, but if other avenues don't work, I'd suggest a "planned accident". Bump into that cart good and hard and watch the meds go flying. The nurse will quickly learn that her practice is unsafe and can possibly cost her alot of time instead of saving it.

As far as the CNA's administering medication, at least in my state, it is sometimes acceptable. I have had a few times where a resident trusted one or two CNAs, but none of the other staff. In these cases, I have prepared the meds, handed them to the CNA, stood near the CNA and the resident, and watched to make sure that every bit of the med was given. I am talking about direct line-of-sight and full attention. Not handing the med to the CNA and preparing meds for another resident. This was acceptable even through 4 state surveys in LTC.

[linzz]

Seventy patients is a lot and if these pills need to be crushed and the residents coaxed to take them, it is just too many for LTC, assisted living has these numbers but the residents are less acute. She should not be giving them to aides to give out unless they have med certification. Many facilities here in Canada have these numbers but often the RN assists with the larger passes such as the breakfast pass in order to stay in compliance. I have passed meds to this number of people and not for long as I felt it was unsafe but I never left pills or cups out, meds were pulled ahead of time but left in their original package and if away from the cart, I would lock it. One resident, liked

to leave her pills out all day and didn't like it when I told her to take it when given or I would have to waste them, however my licence is more important than resident whims.

[girlr6RN]

That is the reason I got out of LTC. I feel aweful that the elderly are in places that cannot possibly give adequate nursing care to them. Things need to be changed. There needs to be a stricter and smaller nurse to patient ratio (I had about 60 pts +/-). I was there for a month and I was still handing out 8 am meds at 12. I'm a pretty quick learner, and don't fool around with anything. I don't smoke, didn't take breaks (my 15 min or lunch), and was completely overwhelmed. I know those nurses don't check MARs, or most other "safe" nursing practices. There's no time to.

Those that work LTC- I feel for you. You're willing to put your license on the line to provide care to those that need (and deserve) the most caring and comfort. Hats off to you. And I"ll state this: I will NEVER work in LTC again, untill nurse to patient ratios are reasonable, unfortunately.

[KarynicaRN]

lol valanda. you have me in stitches with your post about bumping the med cart. i have thought about the insanity that would insue if something like that did happen. you should see her med cart. it is covered with med cups and liquid meds and crushed meds, and i could go on and on.one little bump and the whole group would go flying into the floor and all over the mar, etc. today she gave a lady 12 medications in one suffle cup and walked off! i was always told to stay with the resident and make sure they take the meds. man, i do feel for the lpn, but what is going to happen when state comes in and see's that? what a nightmare!