Unit Dose Woes

Nurses General Nursing

Published

Specializes in Psychiatric / Forensic Nursing.

Is it just me? Does anyone else out there spend WAY to much time just opening the Unit Dose packs sent by the pharmacy? I understand the need for hospital pharmacies to save money (like all of us) but JEESH! For example; I work on a Geriatric Psychiatry inpatient unit. One of my little old folks gets 17 pills and/or capsules at bedtime. Her meds are in no less than 4 separate types of packaging. It took me 10 minutes to pull and extract all the meds then crush them to powder (dysphagia). Multiply that by the 18 patients on the unit, we're talking some serious Nurse time ( 3 hours). Did any body, or does anybody even look at the nurse time needed to open the lowest bidder package? My favorite is the tiny little scissors shown on a couple of the packages. How cute when I am at the bedside and the nearest scissors are back in the med room.

Specializes in critical care ICU.

I have a penlight, hemostat, and scissors in my pocket at all times! It is really the best way to make sure I'm well prepared. :yes:

I have a penlight, hemostat, and scissors in my pocket at all times! It is really the best way to make sure I'm well prepared. :yes:

I'm not so sure I'd be carrying scissors in my pocket in an inpatient psych floor. Some places have protocols against it.

Specializes in Emergency, Telemetry, Transplant.

I always thought that unit dosing was more of a safety issue that anything else. I would think (?) it would be cheaper to send fifty Metoprolol pills in a pill jar than to send fifty unit dose packs.

I do agree, that some of the unit dose packages are difficult to open, but I think they serve a purpose.

Specializes in critical care ICU.
I'm not so sure I'd be carrying scissors in my pocket in an inpatient psych floor. Some places have protocols against it.

Ah I saw geriatric but my brain skipped psychiatry. I mean, I guess it depends on your policy protocol. I've never worked psych, and in my psych clinical it was court ordered patients. So many had very violent tendencies. Obviously there meds were handed out through a glass window.

Is it just me? My favorite is the tiny little scissors shown on a couple of the packages. How cute when I am at the bedside and the nearest scissors are back in the med room.

I've found scissors don't work well on those packages even if you do manage to have scissors around.:bored:

Our pharmacy started packaging pills in the single dose packets and would get really annoyed when we called them because half the time the meds were not in the dang packet! You'd get a string of empty packets and someone, somewhere would have one packet with 5 pills in it.

Ativan breaks easily. We have packages that don't have that nice little pull tab. I have to struggle popping that stupid little pill out of its tight little nesting spot. Then the pill breaks apart and crumbles.

Well, this has caused issues for me in psych. The worst/funniest was the psychotic lady who got super angry when her pill snapped in half! Her eyes bugged out in indescribable anger as she called me a "b", pushed the full water cup I was holding into my chest, and then chased me down the hall :up:

Specializes in Psychiatric / Forensic Nursing.

Oh, yeah. Another fun day in Psych. How about the Zyprexa Zydis that dissolves while you are trying to get it out of the package.... The L.O.P.'s (Little Old People) get fixated on "my pills" and they will not take any that are not the exact size, shape and color. Of course, the hospital pharmacy caters to these folks, NOT ! When I worked Prison Psych the inmates frequently had their meds change size, color and even shape for the same generic meds, depending on the current contract; sometimes as often as monthly. That was always fun to explain.

Specializes in Geriatrics.

I find when I try to rush opening the med packs, pills fly everywhere...-_-

Do you have access to the pill crusher pouches? If I have to crush 10+ pills I try to do them in one go with the pouches.

Specializes in IMC, school nursing.

EKUGRAD, you read my mind. These blister packs are worse to open than before. Most make you push them through and they break. My wife keeps telling me to clip my nails, but I really need some length to my fingernails to work with these hideous packages. Thanks for validating my belief.

Specializes in Psychiatric / Forensic Nursing.

I know it doesn't fit safety protocol but I carry the small Swiss Army knife "Executive" at work, deep in my scrubs pocket. Knife blade and little bitty scissors are a life-saver.

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