So I'm a new grad, recently landed a job at an LTC/short-term rehab. They gave me about 7 days of orientation (one where I walked off midshift crying ... I know it's very unprofessional of me, but I just couldn't breathe & was about to pass out if I continue). The whole 7 days, all I did was passing meds and hoping to memorize them all. The unit capacity is 31, with the census at the moment being at 22.
So I've been on my own for 2 weeks now (6 days) and it still takes me from 7:45-12:30 to pass all meds. Is this normal for a new grad? To take 5 hours to pass meds? Of course there are interruptions in between... discharge, appointments, residents calling out for narcotics... but it shouldn't take that long right? I only got 1 FSBG at the moment. Then when 12:30 comes around, 1PM meds are around the corner. Good thing 1PM meds are light... I only got to pass out to about 10 residents, so the leftover time: from 2-3P I can do tx and charting (but that's only if I work through my lunch). So of course I gotta take my 30 min lunch otherwise I can't get back on my feet. Seriously, I only got to use the bathroom once the whole shift and now am planning to wear a diaper to prevent going to the bathroom.
So sometimes I don't get out til 7PM. Since I stayed back for that long... I got to see an experienced nurse passed meds (3-11 shift) and she only took 3:45-5:30 ... not even 1 1/2 hrs o_0. I don't know what I'm doing wrong. Does she not take BP before giving blood pressure medications?
& they did not train me properly on admission & discharge, hospice patients, how to document correctly, T.O order etc=[ . One day I was on my own and one of the residents was getting discharged. Good thing I found the medical records lady walking down the hall... so I grabbed her to show me where the discharge paperwork is at b/c I had no clue what to do. The other day a resident's IV got infiltrated so I had to remove it... & the supervisor helped me put another IV in the other hand. Well, she was unsuccessful, so she grabbed the other nurse from the other unit in to help. Anyways, stupid me documented that I did it. I also didn't say that MD was notified, and responsible party was notified... well because I thought it was a standing order to put a new IV in whenever it gets dislodged or infiltrated. I don't know how deep of a trouble I'm in with that now.
It took me about 3 hrs to chart as well. Help me out on time management! Please, someone here!
Jun 12, '12
what you are experiencing is not uncommon. You will get the hang of it. Everything is brand new and please do not be so hard on yourself. 7 days is not long enough for a new graduate. hang in there!
Jun 13, '12
Med pass is an unavoidable grind that you just gotta push through. You'll get faster. It's sad so many new nurses don't stay in LTC long enough to find their groove.
As for tips:
why do you wait till 745 to start your med pass? Tell chatty Cathy on nights to hurry up with report and then get started asap.
Be firm about keeping interruptions to a minimum as much as possible. I don't care what anybody says, a
discharge can wait an hour until you're caught up with meds.
It's unfortunate that you work in a facility where you apparently got to check a BP before every freaking coreg or lopressor or whatever. That is 100% unnecessary. Maybe the doc can modify the order? Franky, a weekly BP/pulse can monitor the therapeutic effect of most BP meds. If no dice on that, go through and check everyone real quick before your med pass with a wrist cuff.
Do what works for YOU. My preceptor kept giving me crap cause I didn't use those little flag thingies in the MAR. I hate using those. For me, it's a waste of my time to pull a yellow flag for blood sugars, green flag for noon pills, pink flag for pts to go back to, etc. All that reeks of OCD to me. All Ive EVER neede for any med pass is a "cheat sheet" with a list of pts where I make half an "X" when I give them their 8ams and finish the X once I give them their Noons.
Last edit by BrandonLPN on Jun 13, '12
Jun 13, '12
Thanks yall! Today was my day off & I went in to try to memorize all the meds for each resident (since I can't write it down). Honestly I got confused even more... esp w/ the OTC meds...so I decided to leave and pray to the Lord that as time goes on I'll have it down. Memorization is not the way to go =[
Thanks for the encouragement mombabyRN96 & BrandonLPN (also thank you for your medpass tip Brandon. I have the same method as well. Yea I hate flagging things too. OK I'm going to try to focus and minimize interruptions to as little as possible. & I'm thinking of buying an electronic BP cuff so I can measure their BP while preparing their meds =] )
Thank you all!
Jun 15, '12
Why are you struggling to memorize the meds? The MAR is there to help you give the pill. Memorization is not required HOWEVER I would definitely know what the pill is used for.
As for disruptions--> Use Priority on those like... Is a resident complaining of bad gas? Do you need to go there right away or can you wait till you get to their room.. Stuff like that...
Jun 16, '12
Please don't even try to memorize the meds. It's an unsafe practice since meds change frequently. I agree with the others who've said to keep the interruptions to a minimum. And get the doctors to bet rid of those parameters. It might make sense to check the blood pressure IF the medication is new, but certainly not every shift or even every day.
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