I'm a Medications Menace

dcnballmom, ASN, RN · Apr 24, 2007

to the writer that said dining rooms were a good place to pass meds - in my facility you are not to pass meds during a meal - my med pass starts at 7am and breakfast starts at 8 - thats not including doing the routine fingersticks and answering call bells while my GNAs are passing out trays - and when i have to cover 2 units that includes 12 FSBG with a 30 second glucometer and covering two halls before i even get to start with the pills for the morning - and yes we have that hour before hour after - but when the med pass takes almost 3 hours somedays - well thats just a little much for me

SuesquatchRN, BSN, RN · Apr 29, 2007

Just wanted to let you all know that the tips worked, and I thank you for the time you took in typing this stuff out.

I'm reading left to right, times first, and using a ruler for the check. No med errors!

Another new LPN keeps making the same kinds of errors I was and he was doing the same things WRONG. The excat same things. I told him scan times, forget looking for initials, you'll be looking at blanks when new orders come in, and his face lit up. He was doing exactly what I was! So you helped two for the price of one.

And again, thanks a whole lot.

Sheridan80 · Apr 29, 2007

Hi Sue, Just a question,do you really enjoy what you do? I mean working

LTC and specifically working with the elderly. you sound frustrated and

although I know we all have been there, you can only work so long in

that area without becoming frustrated. Do you take time for yourself

outside of work? ie; exercise, meet with friends, go out with hubby.

even considering you work pt. time, you sound like you need a break.

rehab nurse · Apr 29, 2007

hey sue,

i worked subacute attached to ltc, and this issue is a biggie. we have constant orders being written, then it goes to the rack to wait, then a PT/OT or MDS will pull the chart for something else, and forget to put it in the rack. they end up shelving it, and an order gets missed. huge problem.

youve gotten tons of good responses, but i didn't see one mentioned that i used to do.

we had permission to highlight med times. pink for midnights, green for afternoons. days was just plain. we have loose leaf mar's like you. the problem with this is that, nurses forget to highlight when writing out orders, or they highlight the wrong time. it's very easy to make a mistake with the process in LTC.

just something we did to help cue the nurses to "their" med pass times. good luck to you!!

Home Health Columnist / Guide · Apr 29, 2007

Good to here our allnurses members tips worked.

I was teaching a new staff member how do do our referral statistics: with 100 colums to tally was near impossible without ruler which was MIA from desk. Promptly ordered 2 more for office along with another calculator.

Having the right tools and developing a system crucial for time sensative tasks.

Keep on truckin with that error free medpass.

SuesquatchRN, BSN, RN · Apr 29, 2007

Hi Sue, Just a question,do you really enjoy what you do?

Most of the time I love it. I had come off a really bad couple of weeks of "orienting" to new units without an orientor, that kind of stuff, and lots of dumb med errors.

As to the p/t, that depends on the pay period. Sometimes it's 12 out of 14, others, 6.

hey sue,
we had permission to highlight med times. pink for midnights, green for afternoons.

Yeah, we do that with red for nights, green for evenings. Some of the nurses don't bother using the right pen, but even when they do, I could manage to miss it.

And Karen, thanks again. Details, details. You know, the small stuff.

crawlyberry · Apr 30, 2007

I have a question...student here...When working in the hospital, how often do you recommend checking the charts for new orders? Is there a system that anyone could share? With all of these responses about medications and new orders, time management is weighing heavy on my mind. I appreciate everyone's input. Have a nice day. :specs:

SuesquatchRN, BSN, RN · Apr 30, 2007

I have a question...student here...When working in the hospital, how often do you recommend checking the charts for new orders? Is there a system that anyone could share? With all of these responses about medications and new orders, time management is weighing heavy on my mind. I appreciate everyone's input. Have a nice day.

Crawlyberry, don't even start thinking about this yet.

I work in long term care - a skilled nursing home with chronically ill people. That is very different than a straight med/surg ward, which differs from ICU, which differs from PACU, which is not LD, and on and on.

First, pass the NCLEX.

:)

Daytonite, BSN, RN · Apr 30, 2007

i have a question...student here...when working in the hospital, how often do you recommend checking the charts for new orders? is there a system that anyone could share? with all of these responses about medications and new orders, time management is weighing heavy on my mind. i appreciate everyone's input. have a nice day.

when i was first working in the acute hospital the charts were checked for orders by the charge nurse. that was part of their job. they often made rounds (in the older days) with the physicians so they knew when the docs were in and what orders they were writing. they would sign off the orders and notify us team leaders of the new orders that had been written. later, when i worked other shifts, i would check the charts on patients of doctors i saw on the unit because nowadays doctors don't expect you to make rounds with them and a lot of times they are like magicians--now you see them, now you don't--in and out of the unit before you know it. i often would inquire of my patients how things were going during my shift and if any of the doctors had stopped by to see them. if they said yes, that was a cue to go to their charts to check for orders. occasionally a chart waiting for you to sign it off "walks" away and get put back in the rack instead of where it was waiting for you to sign it off. for sure, however, the charts are always given a final go through at the very end of the shift and checked for orders before you leave. if you have an efficient unit secretary they will also make sure that the orders are getting transcribed. still, as the rn, you are responsible for making sure that they were transcribed correctly and you still need to put your john hancock on them to show that you did verify it. i had a failsafe system in place for myself. i used my "brains" (report sheet) to help with this order sign off business. as i got down to the last hour of my shift i started checking charts for orders. if all the orders on a chart were signed off i put a big slash mark through the patient's room number on my brains. by the time it was end of the shift i could easily see if i had missed a chart. as you start working and gain experience i'm sure you'll come up with a way of keeping track of checking doctor's orders.

MelodyRNurse · May 13, 2007

I recently started my first nursing job... in LTC, I have come to the conclusion that I must have been very confused or possibly on the verge of insanity when I took the job. I have already made a couple of really stupid mistakes that have severed my confidence in being a good nurse. I was floated to a different unit almost everytime I came to work, I never even got the chance to get comfortable. It has been a nightmare...Those of you that can do it (work in LTC) and do it the right way are amazing.

SuesquatchRN, BSN, RN · May 14, 2007

I havenb't had a med error since I took all of the advice here.

And thanks again!

My pass took two hours this morning, with a couple of breaks because it's Mother's Day, and I had their children up the wazoo.