Speedy med pass - page 5

by sbostonRN 24,842 Views | 52 Comments

I am a new grad and I've been working on a subacute rehab unit at a LTC facility for 2 months now. I really love it and I'm well supported by my coworkers. On a typical day, my unit has about 36 patients (up to 40), 2... Read More


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    Setting up miralax as mentioned previous is pre-pouring. You could also say if so many residents have colace or vit c why not just put all that in cups and stack; like the miralax? All that patient labeling of cups is a major no no...would you do that if state survey were there?
    ktwlpn likes this.
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    I've never found prepouring to save time, but it can get you in trouble. Other than the M&Ms, etc. I normally pass out with the other meds, I mean. I keep those in a prepoured cup.
    Forever Sunshine likes this.
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    Quote from sbostonRN
    Thanks for the tips! I am not able to pretty up the MAR (but that would be very useful as I'm a visual person) because we use computerized MAR. Basically when a med is due it highlights green, when it's past due it comes up yellow. I have highlighted my cheat sheet with med times and any 0730's, or other nontraditional med times. I work with the same group of pts for 2 weeks before switching so I do get used to their routines, but it still seems like I'm slower than all the other nurses.

    Also we are not allowed to write on the caps of stock meds...their reasoning is that caps can be switched too easily and a med error could occur. We can write on the side of the upper edge of the bottle which I might try with a red Sharpie.

    Thanks again!
    Apparently we have the same program at my facility. We also have computerized MAR due meds are highlighted in green and past due comes up yellow. Also, we are not allowed to write names in stock meds only the opened date.
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    This thread was started in 2011,I wonder how sboston is faring? I hope she is not pre-pouring ANYTHING-not even miralax....I don't even prepour glasses of water-if I do that then something WILL get spilled and then I have a big mess that takes even more time to clean up. BUMP
    Forever Sunshine likes this.
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    I currently work in a SNF with a patient census of 42 {there are 2 nurses}. I am taking up to 2.5-3 hours to complete the medpass. We have computerized EMAR. Shift starts at 7am, sometimes it is almost 8am before I can get report from the 11-7 nurse, so that puts me behind from the get go! I do my Diabetic patients first. Most of my patients are on ALOT of meds. There are constant interuptions despite the fact that I took the initiative to put a notebook on my medcart asking people to please write down the non-emergent issues for me. Our admin is huge on customer service, so he thinks that the nurse can be constantly interrupted during the medpass and it is ok! I have been a nurse for 7 years, and this medpass is something else!! I have only been working at this facility for almost a month, and everyday I get so frustrated. I have tried cleaning and organizing the medcart, but it is always in a shambles when I return. I seem to be the only nurse who restocks and orders meds. Anyone have any tips or pointers for me? They also leave narcs from discharged patients sitting in the cart too! On my 2nd day in orientation, a whole card of 30 Percocets went missing! I was on the first cart not the cart when the narcs went missing. The DON drug tested a bunch of nurses, so I don't know what became of it..... Although I was told by a nurse that this isn't the first time narcs have gone missing. So for the sake of my license, when I accept narcotic delivery from pharmacy, I have a 2nd nurse cosign with me when I place the narcotic in the narc box!
    Last edit by nicenurselpn on Apr 13, '13 : Reason: Just wanted to clarify something...
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    I have been a nurse for almost a year. 2nd career. I remember a nursing instructor saying it takes a year of full time work to begin feeling like you know what you're doing. I have never worked more than 2 shifts a week other than my initial orientation. I AM SO SLOW at my med pass...STILL. I rarely take a lunch break. Never a regular break. It's very frustrating and I worry that I'll get fired. I go home and think about what I can do differently. I have gotten better but I don't see how I can get it all done. I'm still 8 pts behind before my electronic MAR goes red as in late. I always leave late becuz I do my documentation at the end of shift. I only have 23 pts but they r on a ton of meds that need to be crushed. I waste a lot of time looking at the MAR and punching out the med one at a time. I'm afraid if I do it any other way that I'll commit a med error. I do everything by the book. When I try to delegate simple tasks I get resistance so I end up doing it myself. Often times meds or treatments r missing/out of stock so I have to go hunting. CNAs/therapy taking pts away before I've given them meds. Pts whom want meds at a specific time. I've tried going by room number, by time, by addressing the pts in my immediate vicinity, by giving meds to my pts with the least meds, the most meds, I've even tried getting all the vitals out of way first and I STILL CAN'T GET IT TOGETHER. So frustrating. Today almost all of my pts were on full vital signs! By the time I'm done with my 1st med pass it's 11. Then I start treatments. Then it's the second med pass which isn't too bad. I can't wait to feel good about my job
    spiderslap likes this.
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    I have 32 residents. I start pouring meds at 545 and have all my pills passed by 730am.
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    Quote from ADDISME
    I have been a nurse for almost a year. 2nd career. I remember a nursing instructor saying it takes a year of full time work to begin feeling like you know what you're doing. I have never worked more than 2 shifts a week other than my initial orientation. I AM SO SLOW at my med pass...STILL. I rarely take a lunch break. Never a regular break. It's very frustrating and I worry that I'll get fired. I go home and think about what I can do differently. I have gotten better but I don't see how I can get it all done. I'm still 8 pts behind before my electronic MAR goes red as in late. I always leave late becuz I do my documentation at the end of shift. I only have 23 pts but they r on a ton of meds that need to be crushed. I waste a lot of time looking at the MAR and punching out the med one at a time. I'm afraid if I do it any other way that I'll commit a med error. I do everything by the book. When I try to delegate simple tasks I get resistance so I end up doing it myself. Often times meds or treatments r missing/out of stock so I have to go hunting. CNAs/therapy taking pts away before I've given them meds. Pts whom want meds at a specific time. I've tried going by room number, by time, by addressing the pts in my immediate vicinity, by giving meds to my pts with the least meds, the most meds, I've even tried getting all the vitals out of way first and I STILL CAN'T GET IT TOGETHER. So frustrating. Today almost all of my pts were on full vital signs! By the time I'm done with my 1st med pass it's 11. Then I start treatments. Then it's the second med pass which isn't too bad. I can't wait to feel good about my job
    Did I take an Ambien and sleep write this? I feel your frustrations to the bone.
    spiderslap and psychgeribuff like this.
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    Quote from SuzieVN
    Second shift: Don't have to go to bed at night, don't have to get up in the morning. You have all day to work out, take care of personal business. And? The managers leaves at 5PM, so the pace is relaxed? Heavenly, if single. Hellish, if you are not?
    There are benefits and downfalls to PMs. Im married, so I have an extra downfall. With up to 40 residents of SKILLED Medicare residents, I don't get out before 2:30am. Get home at 3am. Cant unwind from a difficult day of admissions and numerous physician orders (oh yeah, then there is patient care...eye roll). Can't fall asleep til 7am ish (just cant unwind) wake up at 2 pm to do it all over again. Zero time for a personal life, zero time for my husband.
    spiderslap likes this.
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    Quote from wyogypsy
    I don't know any two nurses that do things exactly the same, they all find what works the best for them.
    I can't stand it when residents say to me "Nurse so and so does it this way....gives me my meds at 8:15.....always brings my tylenol at bedtime (prn, sigh...of course I'm not going to know.) I could go on and on. The main nurse for one unit just moved out of the country so all the residents are feeling me out. One guy was furious day one because I didn't have his 6pm meds ready for him right after report. "Nurse so and so always gives me my meds at this exact time!" Sure, I'm learning their routine pretty well now, but I want to say "Do I look like nurse so and so? No? Then back off.
    spiderslap likes this.


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