Two med carts, three halls, to many patients

Specialties Geriatric

Published

Specializes in Med-Surg, Home Health, LTC.

I think patient count on my team 36.

But the main question I have is ....has anyone here worked out of two carts before?

Patients scattered in three halls. New system, I was first on this new design. Agency nurse.

mars missing, no report on two pts or mars! did not know until around noon I had them.

I think it was the two carts and finding things ( my second shift at facility, my first time on this team.

Meds not all in one drawer, split in two drawers in each cart. one must have been the overflow meds.

I am simply and honestly trying to see if the experience I had is common or was it just pure and simple

dysfunction I walked into.

14 hrs straight no break and no one seemed to care or offer.

Asked one nurse to help with something and she said she would have to count narc drawer if she got into cart and

did not have time.

Asked the aids to do some BP's for me for meds and they refused.

Just wondering thoughts on this arrangement from those of you doing this all the time..

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Specializes in LTC, Med-SURG,STICU.

That sounds like a dangerous situation to me. Missing MARS and no report on two pts is dangerous. That facility put pts at risk, you lincense at risk, and themselves at risk for a big lawsuit if something should happen to one of the pts.

Since you are an agency nurse you should be able to not return to that facility and if it was me I would not return. If I was you I would talk to the DON or whoever is in charge and tell them of the way things are. They may or maynot be aware of it and at least if you tell them they have the chance to make things safe for their pts.

I have worked in 2 LTC facilities and a hospital as an RN and none of them was that dangerous. I have seen my fair share of bad management and bad nursing but nothing like that. My best advice is get out and do not look back.

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Specializes in LTC,Hospice/palliative care,acute care.

We went to 2 med carts on our 40 bed units several years ago because it was impossible for one nurse to perform a compliant med pass.Sounds like you showed up before they worked out the kinks in their system. I usually work with 3 nurses on my unit-a charge nurse and 2 med nurses.When there are only 2 of us we both get report and are responsible for everything involving all of our residents on each side of the unit. Our building is round so it was easy to divide the units-I worked in a home that had short halls radiating out like spokes on a wheel.Hated that -it was tough because you did a lot of "back and forthing" during the med pass. We keep our back up meds in the med room-we have so many residents on more then 12 that we just don't have enough space.We constantly have to move around the contents of the drawers to accomodate but we keep the drawers well marked.

Our cna's do not do vital signs-every facility is different.

I would not allow anyone to access the cart I am responsible for during my shift because of the narcs,nor would I access another's cart

Don't go back to that unit until they perfect the system-you have that choice

.

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Specializes in LTC.

At my facility the med nurse pass meds for 64 residents out of 4 med carts. we dont have missing mars but i still think the situation is unsafe

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Specializes in LTC.

My facility has 2 med carts per unit. On my shift theres 2 nurses. Sometimes the charge nurse will do half of the floor and that leaves you with only 1 med cart and treatments. Other nights I have 2 carts but no treatments.

It is very very very difficult to get 50 patients medicated in 1 shift on your own. Forget about the time frame. Because its just not happening. I can get it done but half the meds are out of the time frame.

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Ah- the tricks of the trade we have to perform, the cutting of the corners, the consolidation of the meds, the missed BS, the making like everything runs perfectly. All because no one listens when you say -ITS TOO MUCH.

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Specializes in LTC, Med-SURG,STICU.
Ah- the tricks of the trade we have to perform, the cutting of the corners, the consolidation of the meds, the missed BS, the making like everything runs perfectly. All because no one listens when you say -ITS TOO MUCH.

More like nobody cares.

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Specializes in Acute Spine, Neuro, Thoracic's, LTC.

I work evenings at my facility. I am responsible for all meds, dsgs, BGM's, orders, families, everything( i am the only nurse) for 30 Residents from 4:30 - 7pm and then from 4:30 - 11pm I am responsible for all meds, EVERYTHIng for 50 Residents ( only nurse). It is very very difficult to complete everything to my satisfaction. Doing HS meds on 2 separate floors for 50 residents while constantly being interrupted by various problems, families, care aides, falls, etc is very difficult to say the least.

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Having worked LTC with 30-33 residents is no easy task to say the least. On most days the residents were lucky if they saw me once or twice a day and that was to give meds. LTC is not for me, I did not feel like I was doing a good job of taking care of my residents. The biggest part of my shift (7-3) was passing meds. The DON was strict in the med pass time frame. She would make rounds and check the MAR to see where you were in your med pass. I was appalled at some of the shortcuts nurses would take, but I understood why. Some nurses would give all of the meds at one time, even the 12 & 2 o'clock. Having 30 or more residents is to much. It's no wonder nursing homes have a bad rep. As nurses we do the best we can do under the circumstances, unfortunately I found myself taking the shortcuts I was appalled at for time management. I got out of LTC and am now unemployed, having a hard time finding a job. The job market here in north Fl is not to good. In LTC a nurse has to many patients to care for with everything that goes with it.:nurse: I need to add that before I went to LTC I worked on a med/surg unit. LTC very different.

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Specializes in Med-Surg, Home Health, LTC.
Having worked LTC with 30-33 residents is no easy task to say the least. On most days the residents were lucky if they saw me once or twice a day and that was to give meds. LTC is not for me, I did not feel like I was doing a good job of taking care of my residents. The biggest part of my shift (7-3) was passing meds. The DON was strict in the med pass time frame. She would make rounds and check the MAR to see where you were in your med pass. I was appalled at some of the shortcuts nurses would take, but I understood why. Some nurses would give all of the meds at one time, even the 12 & 2 o'clock. Having 30 or more residents is to much. It's no wonder nursing homes have a bad rep. As nurses we do the best we can do under the circumstances, unfortunately I found myself taking the shortcuts I was appalled at for time management. I got out of LTC and am now unemployed, having a hard time finding a job. The job market here in north Fl is not to good. In LTC a nurse has to many patients to care for with everything that goes with it.:nurse: I need to add that before I went to LTC I worked on a med/surg unit. LTC very different.

Our work history sounds very similar...med surg to LTC, except I still have this agency job, been with them on and off 11 yrs.. I am with so with you at feeling appalled over the shortcuts. I posted a thread titled something like "dirty little secrets" to managing LTC..there are many replies but obviously no one is going to say what theirs are. but you have to. and it is appalling! I believe this will become worse!! With "health care reform" , economy, profit driven facilities....it will become worse. I am looking for something else to do..feel like I would even clean offices if it would pay the bills!! But for now will just try noc shift and see if that is improvement. Good luck on your job search!

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Hey Kashia, I did read the thread of "Dirty Little Secrets", and there are a lot of replies with a few of the "secrets". What I was told by some of the nurses in LTC was to skip through some of the QD meds such as colace, vitamins, ect., don't sign off in the MAR, and the next day sign off. That is one example. I did not do this as it is false documentation. Another example is BP & BP meds. Was told by another nurse not to take BP everyday, give the med and make-up BP for MAR documentation. By not taking these two shortcuts, I was always behind. DON did not understand why I was always behind. Since these nurses told me these shortcuts in confidentialy, I did not feel like I could give a good reason to the DON. I do not feel like LTC is safe practice. However, I do understand why the shortcuts. I too am thinking of doing something else, but don't want to waste my education. On the other hand, if I can't find a job, what good is my education doing me? Right now I am very discouraged. I feel like the new healthcare bill, and a bad economy will make things worse. I feel for the new grads, all that time in school and no jobs! Thanks for listening.

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Specializes in LTC.

I work in a combo assisted living nursing home facility. Currently I am doing evenings covering the 2 assisted living floors. 54 residents to give meds to and about 10 treatments. Add in the "not feeling good" complaints, MD phone calls and whatever else comes up my med pass takes 7.5 hours!!! I am getting more anxious with every shift because I am seeing more that makes me nervous.

We have a new DON starting soon and the nurses hope that we can get at least a 11a-7p nurse or even a 3p-7p. I just pray at the start of every shift that nobody has any real issues.

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