There's a Mousetrap In My Med Cart - page 3

As some classmates in our RN nursing program gathered around in a small group this morning, I sided up and listened to a story that quickly carried me back in time when I was a newly licensed practical nurse (LPN) just learning... Read More

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    As I read this I have thought about how many times I have been in tears or near it passing meds. It is sometimes scary and difficult, but somehow we get it all done. Most of the time without incident. (By the grace of God)

    Kudos to you and all of us that try our best!
    spiderslap and cyndiangel13 like this.

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    I challange any nurse to actually pass 100% of the meds on days in +/- 1 hour in LTC. This is impossible. Especially the nurses that have never worked LTC and complain about their "impossible" load of 5-6 pts. Working LTC is the hardest work you will ever love, but this is but one of the millions of reasons that nurses are leaving the profession. Why is it that the state regulates the ratio of children to daycare workers (6:1 when I last looked) and they think that 25-50:1 for the elderly and frail is fine? Count me out of LTC, I've done my time.
    spiderslap, SE_BSN_RN, thatldo, and 2 others like this.
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    I can't adequately express my appreciation for both the article and the comments. I appreciate knowing I'm not alone in this. Thank you.
    spiderslap likes this.
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    Quote from Valerie Salva
    I think that there are tens of thousands of LTC nurses who are giving their meds outside of the time parameters every day. Some meds passes are so huge, there is no way humanly possible to get the meds out "on time."

    We pretend we give them on time, and mgmt pretends to not know how it really works- that is the reality of LTC.
    Where I worked we had 28, lots of diabetics with glucometer checks, lots of G tubes. I was PRN casual so I never had a good handle on the meds, and it took longer. I started at one end, went to the other end, went back to the first room and started again. Most of the shift was spent giving meds. I know I was out of compliance, but I tried to spread them out safely, and combine what I could to save trips. You are not supposed to give meds while they are eating, which adds to the problem. You either are out of compliance or you are taking dangerous shortcuts or completely ignoring any request for anything from a patient.

    I remember when I was a student. My instructor decided to have us practice giving meds for the whole team so we could get skilled at med passes. Well, that included 18 patients and with her there quizzing me and going back to the desk to check things, etc., I ended up still doing the morning meds at lunchtime. This was on an acute care med surg unit. I think she was so sorry that she ever thought this idea up that she never said a word about giving 9 am meds at noon.
    spiderslap likes this.
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    I've been an LPN for 3 1/2 short years and I've been employed at a LTC facility for those 3 1/2 years and my patient load is 28-29 residents. Yeah I'd agree with the Mousetrap theory!! However I do love my residents but due to the time issue often are in a "hurry" throughout the day and feel like I am not giving my residents the special love and care they so very badly need.
    vintagemother, azcna, catlvr, and 1 other like this.
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    I guess my first response is Why is a nursing student giving meds to 17 patients at all? This is almost impossible under the best of
    circumstances with a experienced nurse. Why are we trying to run nurses out of nursing before they're even out of school?
    SE_BSN_RN, Tragically Hip, and Brie80 like this.
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    Reality in LTC: residents do not wear name bands, so how do you identify them? And in this state, you can "legally" be expected to pass meds on up to 50 patients. How can thie be done in 1+/1- hours, when most have to be crushed and given in very small bites of applesauce? Doesn't happen. No way. Reality does not match law. Do the best you can.
    spiderslap likes this.
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    so, my question is: How do we empower ourselves to make changes...that seems to be the real answer that no one seems to address.
    NutmeggeRN, Spring_Peeper, Pat2012, and 3 others like this.
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    I agree, even the 1 hour before and after is a rat race with as many patients as a nursing home med nurse has to medicate. I work med/surg and they just determined we have had too long to pass our meds (TOO LONG!). CMS apparently has a 30 before and after standard and we have lost an hour of our med pass time. That doesn't sound undoable - except we all know how short staffed med/surg is, and I understand from nurses from other areas we have some very demanding patients in our area. So you always start out behind, try to catch up and can't.

    I suggested moving the BID's to 10 and 10 instead of 9 and 9 and was told that it was JAHCO (sp?) But I know other hospitals I have heard mentioned at a conference did make that change. I don't know who they were or I would call and ask them myself.

    Anybody know anything about this that could help me at our hospital?
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    Talk about giving nurses high blood pressure!! No wonder nurse's leave in their droves reading stories like this!!

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