the sacred med pass - page 2

Got a spanking today from my DON and am I steamed! God forbid that we run over the legal time limit for our med pass...ever......We have always been in compliance during our assorted inspections but... Read More

  1. by   Mkue
    I don't know how you all do it, working in LTC, passing meds, getting everything done within regulations, putting up with ppl who don't show up on purpose, unsafe conditions.. it's really sad being a student and knowing these problems exist.
  2. by   canoehead
    If the DON has a problem with not finishing on time some of the "daily" meds can be staggered throughout the day so everything doesn't have to be done in the morning. Daily meds could safely be given at lunch or supper.
  3. by   Nursula
    This is my first post, but I have been lurking for almost a year, and would like to say that this is the most supportive board I have ever come across on the Net.

    I felt compelled to respond to this post. I graduated in June, and passed PN boards in September. I now work in LTC. I work part-time, and got a total of 14 days orientation, spread out over the course of 5 weeks.

    I love my job, but the med pass is killer. I have 40 residents, and do the 9am and 1pm med passes, all the treatments, and what seems like a ton of paperwork. A big problem is that each time I work, I am on a different unit and don't know any of the residents. The few times I have been lucky enough to be assigned to the same unit for a few consecutive days, I felt so much more comfortable. At least I knew who the residents were, and that in itself saved me a lot of time.

    Every time I go to work, it's like my first day. New residents (or residents I worked with one time a few weeks ago), new meds, new RN Supervisor, new CNA's, new places to look for supplies and forms...you get the idea. I graduated #1 in my coursework and clinicals, and consider myself a quick learner, but feel like a complete moron every time I go to work. A med pass that takes all the other nurses 2 hours, takes me 4 hours. I never take breaks and usually take a 20 minute lunch. I try to take shortcuts, but am afraid of making a med error.

    Thanks for listening.
  4. by   Nursula
    This is my first post, but I have been lurking for almost a year, and would like to say that this is the most supportive board I have ever come across on the Net.

    I felt compelled to respond to this post. I graduated in June, and passed PN boards in September. I now work in LTC. I work part-time, and got a total of 14 days orientation, spread out over the course of 5 weeks.

    I love my job, but the med pass is killer. I have 40 residents, and do the 9am and 1pm med passes, all the treatments, and what seems like a ton of paperwork. A big problem is that each time I work, I am on a different unit and don't know any of the residents. The few times I have been lucky enough to be assigned to the same unit for a few consecutive days, I felt so much more comfortable. At least I knew who the residents were, and that in itself saved me a lot of time.

    Every time I go to work, it's like my first day. New residents (or residents I worked with one time a few weeks ago), new meds, new RN Supervisor, new CNA's, new places to look for supplies and forms...you get the idea. I graduated #1 in my coursework and clinicals, and consider myself a quick learner, but feel like a complete moron every time I go to work. A med pass that takes all the other nurses 2 hours, takes me 4 hours. I never take breaks and usually take a 20 minute lunch. I try to take shortcuts, but am afraid of making a med error.

    Thanks for listening.
  5. by   Nursula
    Oh jeez. Sorry for the double post. I'm still not sure what I'm doing with this thing. :imbar
  6. by   CapeCodMermaid
    LOL...Nursula...They all show up twice the first time. Sorry you're having such a horrible first job. All the administrators like to sit around and ask why they can't keep help..seems they don't have a clue. Give yourself some time...better to be slow with the pass and do it the right way...
  7. by   Shevalove
    I have to say I feel the same way. I love where I work, but being the only RN for 32 patients and with no med tech is hard. I feel like all I do is pass meds from the start of the shift until the end..I am scribbling notes at 11:00pm so I can leave. I am the only RN in the building with two cna's..NO one else..so that makes me charge. I don't think it's right or fair. I truthfully do not understand how the other nurses at my facilty have time to do anything!
  8. by   jones58
    When we run short on time we are suppose to ask the sv for help. Hah hah, if I ask for help she spends 15 minutes telling me how to do things faster. I'll muddle through alone, thank you.
    Reasons it take so long to finish med pass:
    1. Interruptions from the telephone that no one else can answer but the nurse.
    2. Too many pts, too many meds.
    3. A request for a pain pill from the other end of the hall.
    4. A pt. who has to go the bathroom right now, and has been asking for 20 minutes and her family is looking at YOU.
    5. A 5 minute discussion over every pill that is in the med cup. "What is it?" "What is it for?" "Should I take it?" "This pill makes me feel sick".
    6. The wrong temperature water. "Too cold".... or "I hate water".
    7. The drawer for that med is empty. Look around and borrow the right med.
    And the list goes on.
    It's just a big race, every night.
    ON your mark, Get set, Go!
    Last edit by jones58 on Nov 21, '02
  9. by   sassynurse78
    Those times are crazy. I am very rarely done in the time limit. Not enough nurses to do it in a timely manner. This gets me thinking about something else to: I called the state once, asked them about staffing ratios. I was told there aren't any. (I am in IND) They told me it is up to the facility to adequately staff the building, and unless something happens they cannot do anything about low staffing. Which makes no sense! They set ridiculous time limits on med passes,tx's but then they don't specify how many staff it takes to do this????? ktwlpn:you have more strength then I do, I would have told my DON that I would like for her to go with me and show me the correct way of getting meds done on time, because obviously I am doing something wrong and would like her input to correct it.
  10. by   debRNo1
    Originally posted by Nursula

    Every time I go to work, it's like my first day. New residents (or residents I worked with one time a few weeks ago), new meds, new RN Supervisor, new CNA's, new places to look for supplies and forms...you get the idea. I graduated #1 in my coursework and clinicals, and consider myself a quick learner, but feel like a complete moron every time I go to work. A med pass that takes all the other nurses 2 hours, takes me 4 hours. I never take breaks and usually take a 20 minute lunch. I try to take shortcuts, but am afraid of making a med error.

    Thanks for listening.
    Nursula, you are NOT a moron

    My first position as LPN was floating in SNF- they had 8 units/40beds and the stress/confusion can be overwhelming. I kept a list of the names and rms on each unit. Alot doesnt change so at least I knew who had TF, insulin,who wants crushed or only OJ to drink ect. and just jot down stuff. You have to really hustle and sweat it out just to get done and one med pass just rolls right into the next.

    The nurses who finish these horror med passes are NOT giving all the meds and Ive gotten some phony textbook VS too !! Short cuts abound and they will just skip a few pills and go sleep well at night !!?? My last unit was 51 beds and the med pass was disgusting and honestly not doable "in time". I took a charge positon that let me off the med pass (gave me tx's !)and then became manager of the unit that was to say the least unmanagable. I resigned last month after 8 yrs there.

    They should call any LTC nurse a JUGGLER instead because all the crap you deal with is mind boggling and it just about sucked the life out of me thats why I left........

    good luck CYA :kiss

    deb
  11. by   CapeCodMermaid
    In my facility we have 3 units...one is a 60 bed long term care unit. There are 2 nurses there who are expected to do EVERYTHING....meds, treatments, MDS,care plans.....They never get done with the med pass on time. It is a physical impossibility. What they do is give the right med to the right patient etc with as much care as they can. The patients do not suffer from getting a QD med at 11am instead of 9am. If the administration doesn't like it. let them come do the pass...or hire more help
  12. by   Shiraz
    I'm an agency nurse who frequents local LTC facilities. Last evening 3 nurses from my agency filled shifts at a facility that requires 5 nurses on 3-11. I'm still amazed how the staff nurses can get done 2 hours before we do and manage to find time for smoking breaks and even take their 30 minute dinner break.

    We find Pole Bags not even opened from day shifts.

    The thing that really gets me is when a double amputee patient can't even get a pain pill because someone is too lazy to sign out the med or document a few words of why he needed it.

    I also commended one of my co-workers telling her I was amazed to see her bring the med cart down her hallway because when the regular nurse is on staff I never see him with his cart. How do you give meds without the cart??

    My husband says I care too much...isn't that what nursings all about???
  13. by   sanakruz
    This thread has revealed the black heart of nursing homes. You all realize some ****er is laughing all the way to the bank while we care and juggle and lose sleep? Ever wake up bolt upright in a cold sweat and remember you forgot to do such and thus?
    ORGANIZE NOW.
    You owe it to yourselves and your patients.
    No one can safely care for 40 people, no one.
    The nurses that appear to breeze through are part of the problem not part of the solution.
    Yep the regs are outdated.Here in CA they were written in the 70's when the average SNF pt was a little old lady with a pacemaker, not a vent in sight.The owners/corporate dicks know the antiquated regs work in their favor and hey it's all about the money right? "You're not happy move on" Heard that too any times.
    I feel for you all and your pts.What a sucky way to live in one's twilight.
    How many of you have wanted to tatoo DNR on your chests?
    There is no such thing as caring too much.
    ORGANIZE

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