Pre-pouring meds

Specialties Geriatric

Published

Be honest now...how many LTC nurses out there pre-pour their meds??? You know that anything you can do to save a little time helps. I am 1-11 nurse with 42 residents, 3 CNA's and a 3-9 float who does treatments. I am responsible for all meds, MD calls, paperwork...just about everything else...I love my job and I love my residents, but there is just not enough time to do things by the books. :crying2:

BobL....I also agree with the number of meds ordered. We had one little old lady who, yes we had to "fight" on occasion to get her nitro patch on. Guess what Doc did, in his "infinite" wisdom? :uhoh3: Yup.....put her on a pill, which she will not take.

And, yes, I would label the meds I pulled. I should have mentioned that. Also, I did not prepour all the meds. :p

Specializes in Inpatient Acute Rehab.

I have been a nurse for a total of 20 years--19 yr as an LPN and 1 yr as an RN. I have never pre-poured. It may save time, but is very unsafe. Case in point--- One of the LPNs where I used to work pre-poured her meds. On the med cart, each room number is in a separate drawer, but there are 2 people in one room, so two people have LABELED meds in one drawer. This nurse gave the wrong meds to the two ladies that shared one room-- she gave them each others meds.As I said, she was rushed and just grabbed the pre-poured meds from the drawer. Well, the one lady was okay-- she just got lasix and a couple other meds. However, the other little ladie got what was meant for her roommate--which was 100mg Oxycontin. The nurse did not even realized this; she had to ship the lady out with a respiration of 5. The lady died enroute to the hospital because it was not discovered that she got the Oxycontin meant for her roommate until after she died.

Pre-pouring can lead to death.

sagarcia and cotjockey - I agree with you.

Our facility has rules against pre-pouring - why violate the rules?

The times I worked LTC if I didn't have time to get all the meds out in a timely manner, I just charted that. If you are late on a consistent basis it means something is wrong with the system. Why continue to work with a broken system?

I'd definitely work on getting less meds and more help.

steph

Either way, most facilities have policies against pre-pouring your meds. I just don't understand why people don't do things the way they are supposed to be done. I certainly wouldn't want a doctor who takes shortcuts...I wouldn't want my nurse to take shortcuts either.

Either way, 99% of nurses working LTC don't give a rats butt about assinine policies (this is the damn truth too).

Here's one policy at my hospital:

Never take medication from another resident to give to another resident.

My take on this? whatever! if my resident is due for DIGOXIN @ 5pm and his/her meds aren't there, I'm going to "steal" from another resident supply and give it to him/her until I can replace it.

Quit being self-rightious and get real! There's no freaking way a human being can pass meds (within 1 hour..what a joke), do treatment, AND PAPERWORK without cheating a little bit. All you people that go by the book would never survive in the hospitals I work at. These hospitals would eat you alive and steal your soul.

You can go by the book in acute care, but not LTC.

I had a registry nurse work at my LTC hospital and she pre-poured her meds. And guess what? she didn't even go home in time.

Also, if I came across pre-poured meds and they're not labeled, you can bet that they'll end up in the garbage. You'e not supposed to pass meds you didn't prepare yourself. That's one policy I follow.

Either way, 99% of nurses working LTC don't give a rats butt about assinine policies (this is the damn truth too).

Well I might be the one percent? Not sure how else to asnwer this one. :uhoh3: Do all acute care nurses follow policy 100%? Lets not get into a LTC vs hospital discussion.

I really don't think I am being self-righteous...I am just saying that it can be done. Sometimes things happen and meds are late, but I would much rather do the job right and be late than take shortcuts and go against policies and safe practice to be on time. When I did LTC, my meds were on time a majority of the time and where I worked, no one was going to fault you for having late meds if something came up.

Either way, 99% of nurses working LTC don't give a rats butt about assinine policies (this is the damn truth too).

Well I might be the one percent? Not sure how else to asnwer this one. :uhoh3: Do all acute care nurses follow policy 100%? Lets not get into a LTC vs hospital discussion.

Listen. I work acute and LTC and you know what? I've notice the habits of both types of nurses the past 14 years.

That's 14 years! I know what I'm talking about it. What? you think I'm a post-dot.com nurse?

I really don't think I am being self-righteous...I am just saying that it can be done. Sometimes things happen and meds are late, but I would much rather do the job right and be late than take shortcuts and go against policies and safe practice to be on time. When I did LTC, my meds were on time a majority of the time and where I worked, no one was going to fault you for having late meds if something came up.

Duh...of course it can be done. But you try doing everything by the book 5 days a week (excluding overtime and doubles) and see if you can keep that up.

Don't work hard, use your brain. What? you believe is killing yourself slowly physically and mentally? I've been around alot of burnt out nurses WITH YOUR MENTALITY and I'm getting there.

When I first started in LTC, I worked for a facility that still used the old ticket system for meds. I thought that it worked great! You would pre-pour meds and the tray had holes in it for the med cups with slots behind each cup for the ticket with the pt. name and drug.

I agree, that you leave room for error by prepouring. It is definately a challenge to get those meds out within the prescribed time when you have so many patients. A patient falls, a new admit rolls in, short on CNA's and have to help feed etc..... Our system surely is flawed. I agree with one of the above posters. Get them off so many meds! Really, do you think that at 80 years old, it is time to be starting someone on meds to lower cholesterol! If I took 17 pills in the morning, I wouldn't eat breakfast either!

We have to stop and consider the cause or reason some feel compelled to pre-pour. What is the reason? Too many meds for too many people to be passed in too short a time. Who gets blamed if in a rush a med error occurs? The nurse, yet the rush is caused by management's poor planning for safety and care; instead the profit motive wins. Too much to do in too little time is due to the lack of fair nurse to patient ratios which afford good quality care throughout the shift as opposed to a mad rush to get it all done with less than your best effort due to the time constraints. And if you lose your license over an error, well they can have a new LPN in just 12 months! It's sorta like a ferris wheel, nurses on, nurses off.l

I have been a nurse for a total of 20 years--19 yr as an LPN and 1 yr as an RN. I have never pre-poured. It may save time, but is very unsafe. Case in point--- One of the LPNs where I used to work pre-poured her meds. On the med cart, each room number is in a separate drawer, but there are 2 people in one room, so two people have LABELED meds in one drawer. This nurse gave the wrong meds to the two ladies that shared one room-- she gave them each others meds.As I said, she was rushed and just grabbed the pre-poured meds from the drawer. Well, the one lady was okay-- she just got lasix and a couple other meds. However, the other little ladie got what was meant for her roommate--which was 100mg Oxycontin. The nurse did not even realized this; she had to ship the lady out with a respiration of 5. The lady died enroute to the hospital because it was not discovered that she got the Oxycontin meant for her roommate until after she died.

Pre-pouring can lead to death.

The lack of an appropriate amount of time allocated to the care of the patients/residents was the root cause of her death. That's a mangement decision, yet I doubt they were wrote up or :angryfire fired for this.

I really don't think I am being self-righteous...I am just saying that it can be done. Sometimes things happen and meds are late, but I would much rather do the job right and be late than take shortcuts and go against policies and safe practice to be on time. When I did LTC, my meds were on time a majority of the time and where I worked, no one was going to fault you for having late meds if something came up.

I must speak up. Where I work overtime is forbidden. You somehow, (haven't figured out how yet), must get pre-approval for all overtime, quite difficult on the off shifts, since management isin't there. Yet, when you are already sooo busy, and something happens, e.g. a death, an accident, etc. You just got alot more to do with no extra time allotted. So you take the extra time (OT) to get it done, and then get counseled for working OT. It's a no win situation. It adds unnecessary stress, and is just plain wrong! How and why do nurses put up with this?

I know almost every nurse has done it! But, it is really not neccesary if you manage your time wisely. I have worked in LTC being the only nurse on shift for 80 people, 60 of them were twice per shift med passes. I never had to

arrange meds early. I truly have found in my experience the nurses that have a hbit of this practice are the ones who like to take very frequent "smoke" breaks. In an eight hour shift I was lucky to sit down for 20 minutes to grab a quick bite to eat, and I never pulled my meds early. Not, to mention if your company had a suprise state inspection your facility is not going to be on your side of this matter! I understand the time cruch, but it really is not nessecary.

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