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| Advertisement Sponsored Links | | | | No. 11 | 
Jan 06, 2009, 09:19 AM
 Re: Leaving meds at bedside in LTC
I have never left a med at a patient's bedside and rarely pre-pour, but my biggest weakness is taking too long to do a med pass. This in itself is a med error because you are supposed to give meds within an hour either way of the prescribed time. No matter what, you can't win.
I have worked floors where it is expected, even by residents, that two med passes will be combined since there is literally not enough time in an entire 8-hour shift to give everyone their meds at the right time. In theory, we should call the doctor to change the times of as many meds as possible to reduce the med passes. In reality, that could take a shift in itself to go over everyone's meds, call the dr's, and try to make things more efficient. No one has time (and management will not make the time) to do this.
 | | No. 13 |
Jan 06, 2009, 06:27 PM
Re: Leaving meds at bedside in LTC Originally Posted by systoly  I always worry about the folks who get their med pass done way faster than me, it's just like the ones who say they can drive 85 miles in an hour..
It does make you wonder how they get done so fast - if they're giving ALL of the prescribed meds. I mean, it takes 20 mins to give 3 different types of eye drops & 2 different puffers. I was never the speediest med passer, but when you know how heavy of a med pass another nurse is doing & they are sitting down an hour later saying "I'm all done"......can't help but think the worst.
| | No. 14 |
Jan 06, 2009, 07:10 PM
Re: Leaving meds at bedside in LTC Originally Posted by systoly I always worry about the folks who get their med pass done way faster than me, it's just like the ones who say they can drive 85 miles in an hour. As far as the one hour before and one hour after rule is concerned, I don't really pay much attention to it. First of all, condition always supercedes time. Second, I've been followed by state inspectors several times during a med pass and nobody ever said anything about time. They know it cannot always be done. Nobody on any state board (I believe) would fault a nurse running behind during a med pass when everything else was ok. Of course you have to be mindful of meds that are given four times a day, etc. I do believe that some DONs encourage short cuts, but they will also be the ones to cast the first stone.
I agree that one cannot pay strict attention to medication pass time. What most nurses do is they always start at patient #1, so that when it is, in fact, 4 hours later, at least it is around about the same time. If we paid strict adherence to that, meds would never be given; and depending on the circumstances of the day, one is fortunate to be able to give anything at all on a real, bad day.
| | No. 15 |
Jan 06, 2009, 10:45 PM
Re: Leaving meds at bedside in LTC
Last night I took some po meds and a neb tx to a lady, and she said "nope' I don't need them tonight. Two hours later when I was busier than heck she sent a message out to say that she wanted her neb tx then. Guess what, she didn't get it. She was right, she didn't really need it.
| | No. 16 |
Jan 07, 2009, 09:42 AM
Re: Leaving meds at bedside in LTC
as a new LPN on the search for employment,I know this happens all the time and I always thought"what if the Pt does not take the meds??"but after watching a movie about a woman who kept all her meds untill she had enough to commit suicide and the nurse was responsible then I had a whole new look on this!!!!I forget what the name of the movie was???
| | No. 17 |
Jan 07, 2009, 12:25 PM
Re: Leaving meds at bedside in LTC
I used to float evenings in a facility, and the day nurse always left meds at the bedside. When I started my 5 pm med pass, I had to pick up little bins of meds that were left behind - antibiotics (hey, why isn't that pneumonia clearing up?), antiglycemics, psych meds, even narcs. When I asked a senior nurse about it, she said, "honey, this is long term care. It isn't that deep". The day nurse is one of those golden nurses who has been there forever, and can't be touched. *sigh*
I just chat with the resident while they take their pills and if they demur, I tell that I once had a patient choke on their pills and I don't ever want that to happen again - so they gotta swallow in front of me.
e
| | No. 18 |
Jan 07, 2009, 01:03 PM
Re: Leaving meds at bedside in LTC Originally Posted by catlvr I used to float evenings in a facility, and the day nurse always left meds at the bedside. When I started my 5 pm med pass, I had to pick up little bins of meds that were left behind - antibiotics (hey, why isn't that pneumonia clearing up?), antiglycemics, psych meds, even narcs. When I asked a senior nurse about it, she said, "honey, this is long term care. It isn't that deep". The day nurse is one of those golden nurses who has been there forever, and can't be touched. *sigh*
I just chat with the resident while they take their pills and if they demur, I tell that I once had a patient choke on their pills and I don't ever want that to happen again - so they gotta swallow in front of me.
e
When I look at the deductions from my paycheck and think about the cost of meds, I'd like to say Oh yes, it is that deep. |
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