I too work for a nursing home and have learned how to efficiently pass meds. I work the PM shift and have about an hour to prepare for my med pass before meal time. I just prioritize. Who needs to be medicated first (pain, diabetic, bed/chair bound, etc.), then I move on to my ambulatory residents (It's hard to keep up with them while they are wandering about. When I clock-in, I get report, count NARC's, make my rounds to assess my residents so I know who needs meds first. Then I start my hour of prep restocking my med cart with my essentials and checking my charts for any treatments or issues that need my attention. It used to take me about 2 hours to pass meds and now I have narrowed it down to an hour and a few minutes depending on the residents that evening. When you learn what your resident likes and requires you will be able to make it happen faster, as well as build a relationship with them. I love it now when my residents tell me "Good night, I love you!" or when the ones who don't speak just want a hug. I know that I have done my job right.
Organization is key. Each shift makes sure the cart is stocked for the next...that helps a ton! Might need to get fresh ice or supplements etc but the basic supplies are there. Still...I will check it over and make sure I have everything I need...iv supplies, otc meds, syringes etc.
Find out what the general pattern is for most of the residents. I work 3-11. Get report, do a general check/ scan of the residents, check the fax machine for labs/ order and get started. With you general scan, you can get an idea of any problems that need addressed like pain, change of conditions, dressings that might need changed sooner than later in the shift etc. You also get an idea of where the residents are or where they might be going (therapy, activities etc) and can give them their meds accordingly I will also eyeball and ask the residents if they are going back to their rooms for dinner etc.
For me..I get the folks around the desk first and the ones coming and going to activities/ dinner. I try and get the diabetics in this time too. Next, I start down the hall since those people will be staying in the rooms. I do the ones with feeding tubes last.
Keep a list on your cart of any issues that you need to address after the med pass, bring along a reorder sheet for meds and add to it as you go along. Try to minimize distractions (not always able to..call bells, doc and family calls)
Ask the other nurses what works best for them..might not work for you, but it gives you an idea.
More of the same: Organize the needs of your patients. I also work 3-11 and the first med pass (supper) is the most trying. There are the doc calls, getting res up for dinner/activities, etc... As in earlier posts, I do those in pain first, and diabetics then tube feeders are last. It does get easier. Have patience and have a cheat sheet with you so you know who takes their meds crushed or whole, etc...I wish you luck!