state survey question

Super_RN, BSN, RN · Dec 2, 2005

In my opinion your work load is unsafe. 75 residents to care for by yourself?! It sounds absolutely ridiculous! Is it hard to keep staff there or is this normal for staffing? It is unfair and unsafe to the residents! As for passing meds in the dining room, I'm not sure. I don't see why it would matter as long as it is to the right resident. Then again, I don't work LTC so I'm not sure of the policy. I hope everything goes well for you.

Super

ktwlpn, LPN · Dec 2, 2005

I work in a local nursing home and we are expecting state any time now. I've been threw a few survey's before but never had to pass as many AM meds as i do now. I am the only nurse at my station and I take care of 75 residents myself , all with quite a few morning meds. I need to know if anyone knows if not being able to meds in the diningroom at meal time is a state policy or just possible a facility policy. My facility tells me its a state thing but i've also heard otherwise. I start at 6am, have two med carts 75 residents and all AM meds at 8 am.

It is a "state thing" How in the world do you get that number of meds out within the mandated time limit? I can't believe the surveyors have not made an issue of this..We now have 2 med carts with a nurse on each for all of our units of that size.In order to avoid a large portion of the med pass interrupting the resident's meals we have also changed the medication administration times.We are also looking closely at each resident's meds-especially important with the ever changing medicare guidelines...It's always been so much easier for the docs to "just give them whatever they want" We'd have residents with a dozen or more meds,p.o.,eye gtts,nasal sprays,etc.....Our charge nurses have done a great job with this working hand in hand with a new pharmacy and the docs....With 2 med carts we generally pass meds to 20 to 22 residents.....We can actually spend a little time with them...It's a good thing

donmomofnine · Dec 5, 2005

ohmygosh!!!

Mandylpn · Dec 5, 2005

Not sure, I worked at one place where we did give meds in the dining room as that is how the residents wanted it, I mean the cart was in there and everything. Another place I worked at we could not bring the cart in the dining room, but could walk in with meds for one rez at a time to give while they were at the table (in case you did not catch them on their way in). I think it is a "privacy" issue. :chair:

suebird3 · Dec 5, 2005

i work in a local nursing home and we are expecting state any time now. i've been threw a few survey's before but never had to pass as many am meds as i do now. i am the only nurse at my station and i take care of 75 residents myself , all with quite a few morning meds. i need to know if anyone knows if not being able to meds in the diningroom at meal time is a state policy or just possible a facility policy. my facility tells me its a state thing but i've also heard otherwise. i start at 6am, have two med carts 75 residents and all am meds at 8 am.

i have 60 people max...and that is a stretch.

our state policy is that eye gtts, bgm's, and insulins are done in the rezzie's room, d/t privacy issues. of course, most of the insulins are done on the 11-7 shift (all but one).

we have some meds set at 9 am; others, like gt's or people who go to program are 8 am passes. kinda gives us a bit of leeway.

suebird

Joan1199 · Dec 5, 2005

I work in a local nursing home and we are expecting state any time now. I've been threw a few survey's before but never had to pass as many AM meds as i do now. I am the only nurse at my station and I take care of 75 residents myself , all with quite a few morning meds. I need to know if anyone knows if not being able to meds in the diningroom at meal time is a state policy or just possible a facility policy. My facility tells me its a state thing but i've also heard otherwise. I start at 6am, have two med carts 75 residents and all AM meds at 8 am.

Joan1199 · Dec 5, 2005

I would ask where in the State Regulations it states we can not pass meds in the dinning room. It may be under their privacy regs. You must inform them it is impossible to pass those amount of meds in the time allowed for the medications. I would put this in writing and give it to your supervisor with copies to Head of Nursing. Boad of Nursing, and Health and Human services. This puts the onus on your supervisor

kadokin, ASN, RN · Dec 5, 2005

i have 60 people max...and that is a stretch.
our state policy is that eye gtts, bgm's, and insulins are done in the rezzie's room, d/t privacy issues. of course, most of the insulins are done on the 11-7 shift (all but one).
we have some meds set at 9 am; others, like gt's or people who go to program are 8 am passes. kinda gives us a bit of leeway.
suebird

i have always had a problem w/passing insulin before breakfast. sometimes people refuse their meals. what do you do then if the insulin has already been given? anybody else have any insight/experience on this subject?:uhoh21:

nursedawn67, LPN · Dec 6, 2005

where I work our med pass times are during meal times, most receive them before the meal actually comes, but other do get them while eating. But we also finds this frees up the residents time after meals to nap, go to PT or to attend activities without being interrupted.

Bird2 · Dec 6, 2005

I have always had a problem w/passing insulin before breakfast. Sometimes people refuse their meals. What do you do then if the insulin has already been given? Anybody else have any insight/experience on this subject?:uhoh21:

It would depend on when the insulin would peak. They might need a mid morning snack or a good lunch.

tlrochelpn · Dec 7, 2005

Thank you for all of your responses, but I need to clear up one thing, I miscalculated my resident I have 55 not 75 and a few do self medicate. but it is still hard to follow the policy and stay within time frame. I thought of something but not sure if it will work. I wrote up a paper for my rcf resident to sign stating they know about the state policy but what to exercise their residents right to have meds given with meals. All i can do is try, right?