LTC has changed-How do you give out 5pm meds now? - page 3

by Blackcat99 | 5,334 Views | 26 Comments

In the old days, we use to go inside the dining room and give patients their medications. Now I have discovered that it is against the rules now. I am always hearing that is is always best to give medications with food. At my... Read More


  1. 1
    what happens if the doctor specifiically orders a med WITH meals?
    Quote from NamasteNurse
    If we called the doc because a res refused meds, we'd get out ear bitten off and handed to us. He barely wants to hear about falls that have no injury. Generally we save those incidentals for one big call, or write it in his book for rounds. However if a med is refused two days in a row or if we had to hold it for parameters twice, then of course he has to be called.

    As to the med pass issue, NYS law says you cannot give meds in the dining room, period. Do some facilities allow it informally? Yes. I have worked in a place that DID allow us to have our cart outside the DR and run back and forth, since a nurse has to be in the DR during meals, this was 'killing two birds with one stone'. That's only on the floor DR not the main DR. Absolutely no meds in the main DR.

    Generally, I start my 5PM pass as soon as I get to work, count and get report, which is around 345. I do all insulins first, then everything else. Generally I try to be done with the meds by 5 which is dinner time, because where I work now, everything stops when the trays arrive and everyone helps pass trays and feed. AFter dinner I do sennas, and the 'lesser' important meds and any people I couldn't find before.
    Blackcat99 likes this.
  2. 1
    Quote from NamasteNurse
    If we called the doc because a res refused meds, we'd get out ear bitten off and handed to us. He barely wants to hear about falls that have no injury. Generally we save those incidentals for one big call, or write it in his book for rounds. However if a med is refused two days in a row or if we had to hold it for parameters twice, then of course he has to be called. As to the med pass issue, NYS law says you cannot give meds in the dining room, period. Do some facilities allow it informally? Yes. I have worked in a place that DID allow us to have our cart outside the DR and run back and forth, since a nurse has to be in the DR during meals, this was 'killing two birds with one stone'. That's only on the floor DR not the main DR. Absolutely no meds in the main DR. Generally, I start my 5PM pass as soon as I get to work, count andget report, which is around 345. I do all insulins first, then everything else. Generally I try to be done with the meds by 5 which is dinner time, because where I work now, everything stops when the trays arrive and everyone helps passtrays and feed. AFter dinner I do sennas, and the 'lesser' important meds and any people I couldn't find before.
    This seems absurd to me. I park my med cart right in the DR during supper. Best time to get everyone all at once.
    Blackcat99 likes this.
  3. 1
    I sure wish we were allowed to park our med carts outside the DR at mealtimes.I think it is always best to give meds with meals. However, we are not allowed to bring our carts off our unit period. So what usually happens is that our 5pm meds are given very late.
    spiderslap likes this.
  4. 1
    If the evening meal is served at 5 pm the times need to be changed. depending what meds we are talking. If you are talking prevacid or such they need to be ~ 1/2 hour before meal, CA++ can be after. etc.
    Quote from Blackcat99
    I sure wish we were allowed to park our med carts outside the DR at mealtimes.I think it is always best to give meds with meals. However, we are not allowed to bring our carts off our unit period. So what usually happens is that our 5pm meds are given very late.
    Blackcat99 likes this.
  5. 4
    Isnt it ridiculous sometimes? I feel like i can hardly do anything without being interrupted constantly. Patients asking for things, unlocking doors for aides, keeping people from falling, and of course the phone, among other things on the infinite list. Contradictory rules, like not interrupting med passes, but having to do just that at all times. Or the rule about no meds in halls or dining rooms, but they give me 28 pts, no med tech, multiple ivs or feeding tubes, and many fall risks who should have a one to one. How can this be done on time or safely? I wish i knew how ltc nurses could speak up for themselves. I know a lot of ppl are afraid to admit they dont always play by the rules, but it needs to be addressed. Im a new nurse working per diem with new pt assignments every shift. I follow the rules and end up waaaayyyyyy behind. Then forced to try and give txs and do basically all my charting for an hour or two after my shift. Unless theres a highly guarded hack i still need to learn, i sincerely hope some force sheds light on the impossible list of responsibilities of ltc nurses.
  6. 1
    "No meds in the dinning room" is sheer stupidity. It is the most natural time/place to take them.

    Stupid rules are meant to be broken.
    Blackcat99 likes this.
  7. 2
    Stupid rules are meant to be broken? Do you want someone interrupting YOUR meal? Probably not.
    We have lots of residents who request to have their meds with their dinner...so we write the order that way and put it in the care plan. I have people who will NOT leave an activity when it's time for a blood glucose check so we care plan it. It should be what the resident wants...not about what the company wants or what the nurse wants.
    Long Term Care is a rapidly changing industry, especially in buildings where there are short term, skilled residents. On one hand, it is supposed to be a homelike environment. On the other it's a med surg floor without the same number of nurses on a med surg floor.
    My facility is pushing to start a CHF program and a cardiopulmonary program. I can't get the marketing/admissions liaison to get it.....anyone who has training can push lasix...that's not the skill. The problem is, the patient (not really a resident since they are short term) is quite ill and needs to be monitored and assessed. So while I'm in there pushing lasix and assessing the effect, the rest of my 22 patients are on the call bell needing pain medication or falling or complaining about the dinner. The government needs to reassess the reimbursement rates so I can have more RNs to take care of the sicker patients they want us to take.
    kiszi and morte like this.


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