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the neverending med pass



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No. 10
from FROGGYLEGS
Old Oct 23, 2005, 09:29 AM

Default Re: the neverending med pass
I have 30+ residents on a locked unit and another 20 ICF/skilled. Unfortunately this isn't the worst ratio I've worked.

I really know where you're coming from with the comment about Aricept. The vast majority of all my Alzheimers patients have been on it regardless of how severe there condition had became. It seems the only way it is DCd is if the resident ends up on hospice.

In the brief instances that I actually have time to talk with my residents and to actually be their nurse I am happy and proud of what I do. Unfortunately most of the time I feel like a professional pill peddler and that is not nearly as rewarding. As far as the facility is concerned I think the only use I have is to get those meds out. I wonder what would happen if the talk of medication aides did come to pass, but that is an entirely different can of worms.

I thought LTC had a lot of problems when I entered it, but I swear it gets worse every year. I think the assignments I once hated would seem really good at this point.

The lawsuits and threats are sickening. I can't even count how many times I've had families and/or residents tell me they were going to sue. The first time I had a resident tell me they were calling Johnny Cochran I thought it was a bit funny...then I started seeing the Cochran firm nursing home abuse ads on tv and realized that their imagination wasn't running wild.

Thanks for the replies everyone. I really enjoyed reading them.

Oh and Nightowl.....you may be the official urine collector, but I am the magical insulin fairy.
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No. 11
from doodlemom
Old Oct 23, 2005, 10:27 AM

Default Re: the neverending med pass
My first nursing job was in LTC, but now I go into facilities as a Hospice nurse. A few years ago, in between jobs, I worked for an agency. I tried to work in a nursing facility and found it impossible to pass meds on a 3-11 shift. By the time 8 pm came around, I was passing 4, 6, and hs meds all at one time. There was only one working accucheck in the building and none of my patients had their blood sugar checked before dinner. Their were 12 tube feeders and 16 accuchecks. This was a different experience than I had years ago and it was a nightmare. I decided at that point that I would never work in a nursing home again - unless I was not working on the floor. I felt like my nurisng license was on the line. How does the state not come in and close these places down? Now I see mostly medication aides passing meds in facilities. I guess they figure they can pay 2 CNA's for the price of a nurse.
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No. 12
Old Oct 23, 2005, 05:02 PM

Default Re: the neverending med pass
I got a kick out of the responses because it is SO TRUE!! the med cart does feel like 200lbs and my feet feel as if they are going tofall off at the end of the shift. Thanks for making me laugh and it is good to know that we are all in the same boat. I am glad i am not the only one sick of LTC and nursing in general and i have only been in 4 yrs. dont know if i need a change in nursing or nix nursing all together. Good luck on your decision...
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No. 13
Old Oct 23, 2005, 05:20 PM

Originally Posted by johnson001
I got a kick out of the responses because it is SO TRUE!! the med cart does feel like 200lbs and my feet feel as if they are going tofall off at the end of the shift. Thanks for making me laugh and it is good to know that we are all in the same boat. I am glad i am not the only one sick of LTC and nursing in general and i have only been in 4 yrs. dont know if i need a change in nursing or nix nursing all together. Good luck on your decision...
That is unfortunantly exactly what I've been thinking. I an LPN of 4 yrs. ( I haven't even been working solid those 4 yrs.) and I'm thinking what have I got myself into????? I'm currently working toward my RN with excelsior and I'm wondering if I'm wasting my time, money, and memory. On the one hand I love being a nurse & on the other hand ir is soooooooooo mentally & phsically exhausting to have soooooo much responsibility & excessive work in my 8 or 12 hr shift which is always more than 8 or 12 hrs. Wonder what the health care facilities will do when alot of us quit nursing ( I'll go back to doing hair) and the older nurse retiring, and schools unable to fulfill the needs with new grads. Maybe at that point they will be ready to work with us(nurses). Ofcourse at that point they will be a day late and a dollar short. Sorry to rant, I love nursing but it just wipes me out.
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No. 14
from dekatn
Old Oct 23, 2005, 05:40 PM

Default Re: the neverending med pass
Oh nightowl, I think we must work in the same place and pull the same 250lb. med cart. I have already been to doc with my shoulders, impingement syndrome bilaterally. Painful just doesn't begine to describe what I go through. I've done PT til I'm blue in the face. I wish the doc had to go 3X weekly and pay for it to do absolutely nothing. I eat naproxen sodium like m&m's. I can't get any rest at night if I don't. LTC what a joke. Anybody got any ideas on how to start making major changes in this crazy broken down system?
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No. 15
Old Oct 23, 2005, 06:49 PM

Angry Re: the neverending med pass
Hi, I have worked 20 yrs. total in LTC, 14 yrs in one & 6 1/2 yrs in the one I'm at now. I can relate to everything you said in your posts. My usual wing, with 44 beds, is between the self care wing & those who need the most care, O2, g-tubes, neb txs. This last wing has 44 beds, also, but that's where Medicare & skilled care is, so there are 2 nurses. My wing has just one nurse - my residents wander the most, fall the most, request prn's the most. I work 3-11, when, historically, there are more falls on that shift, d/t sundowners, & less staff around, res. are tired & want to go to bed right now ! ! ! This is the wing where they put the agency nurses when needed. Now I know agency nurses are great & do fill a need, but you can't tell me someone coming into a strange place, knowing no-one , is able to get everything done when even the regulars, like me, can't do it all. We've tried for a long time to have another nurse, even one to work 4=5 hrs, to do one of the med passes. Oh, this wing has TWO med carts, also. There are also a lot of treatments, often d/t those darn falls. I'm close to retirement, would like to work PT, maybe I could be that nurse?????? Thanks for letting me vent.
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No. 16
Old Oct 23, 2005, 07:06 PM

Good grief! ! ! I didn't know they show your age ! You can bet it won't be on my next post.
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No. 17
from jkaee
Old Oct 23, 2005, 11:04 PM

Default Re: the neverending med pass
These are all the reasons why I left LTC nursing after 10 years.

I love the geriatric population. They are my people, and I love caring for them. However, like it's been stated, it's just a pill pushing fiasco anymore. These poor residents are put on up to 50 pills a day.....and all it does is make the pharmacutical companies richer. Why does a 90 year old need to be on 5 different vitamins??? Why are they on Aricept when it clearly isn't indicated. It was gotten way out of control, and it's all so the big wig companies can get rich. It's such a shame.

I currently work in an acute rehabilitation hospital. Today I had 7 patients, and a tech. Funny, it takes me just as long to give out meds to those 7 patients.....but I'm also doing patient care, and interacting with them, doing assessments, etc.....instead of just pushing a cup filled to the brim with meds in their mouth. I really enjoy it.

I am not bashing LTC nurses.....I was one for 10 years. I'm bashing the system.....you just can't do the type of nursing you want to. We really need to learn as a society how to treat our elderly.

JMHO
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No. 18
from Daytonite
Old Oct 27, 2005, 10:41 PM

Default Here's an idea for you
One of the things we did at one of the homes I worked at was for the three full time charge nurses to put our heads together collaboratively and work this out. There is nothing that says you have to schedule routine meds for specific times although some meds, you know, you want given at certain specific times every day. What we did was that we took the huge load of am meds for the tube feeding patients who were confused or not otherwise aware of the time of day and change them to 4 and 5 am in the morning. That gave me time to crunch up all these pills and pour the liquids and get them down their tubes along with the tube feedings. That took a huge load off the day shift. I also took over giving a few of the early am meds at 6am. Those residents who were early risers and were generally up and dressed by 6am got their 9am meds changed to 6am as well. We made sure that the administration times for these medications were all changed on the MARS by the computer center. That way we were in compliance with the one hour rule of getting the meds given at the times specified. God! Things go so well when people work together as a team.

We ran into a slight problem with the nurse who worked on my two days off because we discovered she liked to spend a good amount of her night sleeping so our tube feeding patients weren't always getting their medications when she worked. When this was discovered it took about 2 weeks to run her rear end out the door. You come to work to work, don't you?
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No. 19
from night owl
Old Oct 28, 2005, 05:46 PM

Default Re: the neverending med pass
Last night I worked a palliative care unit and their meds are cut way back. I truly enjoyed working there and not having to push hundreds of pills and take 20 bp's before I gave each med for three straight hours. I was able to give all my meds out in 45 minutes and actually had the chance to feed someone his breakfast. AND it was so nice getting out on time for a change. :hatparty:
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