the sacred med pass - page 3

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   CapeCodMermaid
    Well,Sanakruz, I don't know where you're from, but here in Massachusetts, even the homes which are "organized" fare no better. The nurses aren't better, the patients don't get better care...what does happen is the union takes the dues and they are the ones laughing all the way to the bank. Change has to start with the regulatory agencies. We need to educate our patients and their families so they see as clearly as we do that one nurse can't care for 40 patients. In Massachusetts there is push by the MNA for a law that would limit the number of patients a nurse has in an acute care setting to between four and six....WE, as nurses who work in LTC, especially sub acute units, need to have the same sort of support for our concerns.
  2. by   agnewRN
    I've worked in LTC for 10 + years first as STNA then as RN. I look back now and wonder how I did what I did as charge nurse with 25+ residents and actually visiting and talking with families and residents. I use to feel like part of the "family". I left that for a Supervising position and eventually a Unit manager position in SNF. Working as a manager I felt I was always defending my nurses and staff to my DON. I was the first to defend them if it was felt they did something wrong. Everything always came down to the budget or family complaints . I know shortcuts are being taking to complete the med pass as soon as possible so they can get started on the treatments, wound rounds, attend the mandatory inservices ( that are conveniently scheduled at times of med passes and are way too long for floor nurses to be away), the skilled charting, the doctor calls, restarting IVs, trying to calm pissed off families ( so they wouldn't go to the DON ) and try and thoroughly assess any one of your unstable residents and maybe send them out. Oh and lets not forget attend care conference where the DON expects the nrses and STNAs to attend since they know the resident best. This of course was also the time when families released their attacks on nursing and you're left with feeling like you have not done anything right. This will all continue untill the States set safe staffing ratios for LTC- instead of leaving it up to facilities to do this.
    By the way I left the manager's position after suffering extreme burnout and attacks from my DON that left me in tears questioning any ability I had. I was told I focused too much on the clinical and patient care . Kudos to the nurses who still hang in there on the floors.


    :angryfire AgnewRN
  3. by   debRNo1
    Originally posted by agnewRN
    By the way I left the manager's position after suffering extreme burnout and attacks from my DON that left me in tears questioning any ability I had. I was told I focused too much on the clinical and patient care . Kudos to the nurses who still hang in there on the floors.
    WOW I could have written that post myself. Defending my staff, kissing butt with the families ect ect. The families depended on me to do the right thing and I tried my best to keep everyone happy and safe. I was burnt out and attacked too by my DON who I considered my mentor. I know she was grooming me for ADON position and I really pulled the rug out from under her when I resigned. She harrassed me from the minute I handed her the letter and it continued for the next 3 weeks. She kind of made it easier for me to go with her behaviors.

    I was so very burnt and a little angry when I thought about how many hours I worked without compensation. I too say Kudos for the nurses who hang in there because being a nurse in LTC regardless of the position you hold is NOT EASY.

    deb
  4. by   sanakruz
    It's not easy god bless you!
    If you are organized you can at least speak with one voice about changing the regs. Many unions have paid lobbyists in the state capital pushing their membership's concerns into the forefront.(A reason dues are charged;lobbyists make the big bucks!!!)This is how the political process works. And this is indeed a political issue make no mistake.
  5. by   Shiraz
    Sanakruz, I believe the organization thing works...for a while, anyway!!
    I usually work 3-11 so after I got report...depending where I am...theres one unit where I have to wait for the nurse to sign off her MAR which she religiously starts at 2:30. Didn't we learn to do that after the med was given??
    Then I go and check the TX book and gather up stuff for some tx's and clean some G-tube sites. I'll also try to pick up a couple charts and document some of those "required" blurps about why Mrs. Jones was depressed last week. Or why Mr. Smith smacked a CNA. By the time I do some of these It's time to stick a couple fingers. How about some of those new glucometers?? I still go to a facility that has one where you need a blob of blood the size of your keyboard "O". Then it says "WAIT" Don't they know we can't!!!
    Then you start the almighty med pass....and the interruptions start!!!
    Needless to say I felt good at the end of my shift when I picked up a chart that I have already documented on or when I went through the tx book ...Wow!! I already did that!!!

    Stay focused, be happy and smile!!
  6. by   WeSignificants
    Regarding the two hour med pass time limit: Some facilities are now scheduling half the med pass at 8am and the second half at 9am. You have one hour before to one hour after the med is due to give the med. So if you do this you actually have 3 hours to do the morning med pass which is traditionally the lengthy one. You can also give all the vitamins at another med pass which speeds it up. What patient in long term care doesn't get a vitamin! Many are giving Digoxin either at noc shift last med pass or on the evening shift. Coumadin should also be given later in the day after the PT/INR results are in, in case the dose needs to change. Just some suggestions to bring to administration. As long as it is in your policy that med times are 8, 12, 4, 8 for some rooms and 9, 1, 5, 9 for others it is okay.
  7. by   sueb
    Hi everybody, I'm new to this board (actually I've been lurking for awhile..nice board!) but I felt compelled to register and post my feeling here. I am an agency nurse working in geriatrics for most of my 22yr career. I've been working in for the same facility for several years. You MUST take shortcuts...and learn to live with them, if you want to survive in this type of nursing. I can honestly say that 100% of my patients get 100% their meds 99% of the time. But if the sh-t hits the fan and I must choose between giving a Colace or helping a patient, I'll take the patient everytime. I know someone else will come along and give that Colace.( or vitamin or whatever!) Sue
  8. by   Disablednurse
    I'm with you Sueb, but have you ever noticed that all of the nursing assistants disappear when med pass starts and you can never find them if you need assistance.
  9. by   Simplepleasures
    Bumped up to the top , these are such good examples of how a typical med pass in LTC goes.Still the same three years later if not worse.
    Last edit by Simplepleasures on Dec 28, '06
  10. by   adrienurse
    deleted
    Last edit by adrienurse on Sep 17, '08
  11. by   bethin
    I'm going to guess here, but if she's DON wouldn't that mean she has a nursing degree? If she has time to come over and chide you for being late then she has time to help out a little. She doesn't have to pass meds, but would answering a call light, redirecting a resident, etc too much to ask?


    Ooops, what was I thinking? Seeing a NM or DON work the floor is like Haley's Comet - happens about every 500 years.
  12. by   jill48
    Quote from cargal
    We always run over. I find it uncanny that the smoking nurses can finish the med pass by 10A. I take until 11 with out fail. I put up shades, put sweaters and glasses on residents and talk to them, and their families. Miss my break, too. Cannot work overtime due to exhaustion. Most days I am too tired to make dinner.
    As far as what caliotter3 describes, why am I not surprised? Nursing shortage, no shyte!
    It is ironic that it is the state that regulates the time perameters on the med pass, but also regulates the poor staff ratios. Are the ratios that are in place outdated from the 60's and 70's? Now residents live longer and are less stable, and more dementia.
    I am a nurse who smokes and I do get my meds passed on time. Do you know why? Because I'm not sitting around gabbing or complaining. I get in their and organize my time to get everything done. And instead of a 30 minute lunch break, I will take 3 ten minute smoke breaks. And my being gone for ten minutes when it's not as busy is alot easier to take than other nurses' being gone for 30 minutes in the middle of the day. Don't hate on smokers. And don't insinuate that we are not getting the same things done that you are. :angryfire
  13. by   adrienurse
    Quote from jill48
    I am a nurse who smokes and I do get my meds passed on time. Do you know why? Because I'm not sitting around gabbing or complaining. I get in their and organize my time to get everything done. And instead of a 30 minute lunch break, I will take 3 ten minute smoke breaks. And my being gone for ten minutes when it's not as busy is alot easier to take than other nurses' being gone for 30 minutes in the middle of the day. Don't hate on smokers. And don't insinuate that we are not getting the same things done that you are. :angryfire

    K you know what, we don't need to get into pointless debates about who's lazier than others.

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