the neverending med pass

I am a new Lpn grad & just began working 1 month ago in LTC . I am disgusted at how many pills these doctors have these poor residents on. I have 32 patients & I am "the nurse of the floor". I know I cannot give each patient the real superior care they truley deserve. I have many patients that say to me no , no , no when they see me coming. Yet I am suppose to talk them into how important they take their medicine. If I did not convince them , then our policy is to notify the PCP same shift. I would be on the phone with the Docs all day & never get anything done.
Also to make things even better , this facility has a rule :no overtime " you will get written up if you cannot get your work done on your shift .
I love the patients & feel so sorry for them , but believe this facility is creating an environment for errors, and nurses to take many short cuts to get out on time . I need to get my 1 year of experience in & then I will be looking for another job. But from the sounds of it , so many nursing homes are ran the same way.
I always dreamed of being a nurse & feel so disappointed that this is how it really is. When I was in school they sure did not talk about this ! The teachers said, you will be a great nurse . I dont feel like a great nurse . I too feel like a pill pusher & it sure makes me feel powerless . There has got to be an answer .... I have wanted to cry everyday as I absorb that this is the "real world " of nursing . I see many burnt out nurses who now seem to hate nursing & ask me ... honey are you glad your a nurse now.... one this is for sure I am now a DNR !

Have you looked at the meds given? Perhaps some of them could be moved to the 5pm pass, or may be some of the meds could be discontinued. Many times we continue to give meds that no longer are needed, and you would be surpised at the number when you evaluate the med themselves. Our facitily routinely looks at the meds and the times they are given. Just because a med is daily does not mean it has to be given at 8am, and twice a day meds if they are not ordered every 12 hour can be moved to 5 pm. I know this has helped our problem with the never ending med passes

I don't see how any of you get any nursing responsibilities done passing meds! All our meds are totally passed Med Techs. The nurses have more than enough to do in 8 hours WITHOUT passing meds. She literally never stops (I'm the ADON) and if she had to pass meds no one would ever get any care.

Massachusetts doesn't allow med techs. Anyone who can read can hand the pills out, but it takes the skill of a licensed person to monitor for effect, side effects and the rest. Some of our patients are very compromised and it takes skill to determine what meds are having an adverse or positive effect.

I am so glad that I took the time to read this thread. So many of you expressed how I feel most of the time. All I do is pass pills and try to do everything else (assessments) between these horrible med passes. I am sorry, but there is more to nursing care than passing 20+ pills to 30 or more residents. I feel like a horrible nurse because I am not able to assess all of the things that need to be assessed, I am not able to monitor the CNAs work like I should, not able to follow up on the thousands of things that need to be followed up on, or just take the time to comfort someone the way I would like to. This some of the reasons I hate being a nurse in a nursing home.

When I go to management to try to work out some sort of plan so that my residents are getting the kind of care they should I get shot down. I get told to make do and do my best. In other words No matter how much you work on a solution or complain we will not work with you to fix this problem. They say that they care about skin break down, falls, and med errors, but they do not want to make the changes needed to help prevent these problems. Instead they just want to point the finger at the nursing staff that is cut to the min. and say that it is your fault that this is happening. Excuse me, but all I have time to do is run around from one problem to another trying to keep things from getting out of control.

I do realize that part of the problem is the government, but really management does have to step up some time and accept some of the blame for the horrible way that these nursing homes are ran. I am tired being reactive to these problems. Why will the management not let us be responsible nurses and try to prevent problems? When will they stop placing impossible demands on us?

I have been a LPN at the nursing home I work at for a little over 2 years and I love working with the elderly, but I feel just like everyone of you that wrote a message in this thread about the neverending med passes, stresses of the job and noone ever listening to you, feeling like a pill pusher, being overwhelmed and etc...

Point is too many patient's to a nurse and too much medicine, too little time to do a really thorough job like we want to do and not enough TLC to these elderly people who need TLC now more than ever. The thread that mentioned about when resident's pass how they just roll another resident in quick as they can to replace the former resident> it's really getting to be like a assembly line of resident's for the money.

I am scheduled to work a 8 hour shift, but I usually don't clock out until 9 sometimes 10 hours. I have anywhere from 30 to 35 people at a time and it is hard to get all the meds out on time, residents wanting their meds and you going hard as you can, tube feedings, hoping to be able to get to tx, residents wanting to talk but you don't have the time, someone falls-fill out incid. reports-call dr and family, a resident's condition changes you have to call the doctor, get paperwork ready if resident has to go to hospital-and you have to go to to give report, family members complaining or upset because you haven't gotten to their family yet and you have 30- 35 other resident's to care for on top of their loved one, or something else goes wrong it's impossible to be organized with so much chaos. It's overwhelming and so stressful then everyone wonders why there's a nursing shortage!

LTC should work with the nurses and listen to the nurses, so that by working together we can find a way to make the resident's daily lives better and the nurse's job less overwhelming and stressful so that we can give our resident's the best care possible. Sorry post was so long!

I'm an LPN student, likely will end up in LTC, should I try some other area?

You won't get a hospital job in Massachusetts as an LPN. I'm not sure about the other states but I've heard most hospitals elsewhere won't hire LPNs.

I have had to give meds to fifty patients on day shift. What eased it some for me would be that I would give the patients that were in bed or tube feeders there meds first and them I would park the carts near the elevators and catch the walkers and those in wheelchairs when they first returned to the floor. In another factility we had the med pass times changed to 9-1-5-9. Another med pass time that seems to work is to give BID meds at 8 & 8 or TID at 8-2-8. We have changed tube feeders meds to 12-6-12-6. When I run long with first med pass, I start the second med pass with the ones I got to first with the first med pass. You can always ask pharmacy to evaluate for unnecessary meds and make recommendations. Can some meds be changed to long acting or time released. Instead of tylenol every four hours can the tylenol arthritis be used that is given every 8, etc.

You could try LTC and see how you like it as you'd never know unless you worked in it to see and then decide what you want to do. It can be hectic job and you will stay busy from the time you clock in until the time you clock out and the med pass is busy busy, and you never know when something is going to happen to add even more to the list of things to get done, but all in all it is about caring for and making the resident's lives as comfortable as we possibly can and giving them a smile and asking how they are doing can make all the difference in the world to them even though we don't have a lot of time to talk with them for long and get our job done. But always remember this: always treat each resident as if that were your family member or you there being cared for.