Is giving meds early common??

Specialties Med-Surg

Updated:   Published

I just finished my 2nd week off orientation as a new grad and feel that all I'm doing is running around giving meds ALL DAY. I work 7a/7p and have been staying until 9:30 to do charting. I don't have time to look at labs, orders, do dressing changes...nothing.

Last night a slightly more experienced nurse told me she gives ALL her morning meds at ONE time (as long as it's safe). She even gives antibiotics early (due at 10 given at 8). I do full assessments and she told me she does focused assessments only. She said she used to stay that late catching up, but was griped at for OT so she had to do something.

Is this common and acceptable??? Last night I had a new admission which took me forever right before shift change and I missed two antibiotics, dressing change, and my 6 p.m. feeding to unconcious PEG tube pt. I did them all, but was there until 10 p.m. :bluecry1:

Everyone says things will get better with experience, but by experience do they mean you learn you HAVE TO cut corners in order to get everything done in 12 hours????

Specializes in none.
Bonnie86 said:
I just finished my 2nd week off orientation as a new grad and feel that all I'm doing is running around giving meds ALL DAY. I work 7a/7p and have been staying until 9:30 to do charting. I don't have time to look at labs, orders, do dressing changes...nothing.

Last night a slightly more experienced nurse told me she gives ALL her morning meds at ONE time (as long as it's safe). She even gives antibiotics early (due at 10 given at 8). I do full assessments and she told me she does focused assessments only. She said she used to stay that late catching up, but was griped at for OT so she had to do something.

Is this common and acceptable??? Last night I had a new admission which took me forever right before shift change and I missed two antibiotics, dressing change, and my 6 p.m. feeding to unconcious PEG tube pt. I did them all, but was there until 10 p.m. :bluecry1:

Everyone says things will get better with experience, but by experience do they mean you learn you HAVE TO cut corners in order to get everything done in 12 hours????

You do have to cut corners in these days. With the med passes of today, I would take a very long time. I found a way. Give the medicine at the time they are ordered. This may seen a stupid answer but hear me out. Now this is only for 3-11 in long term care but I would give all of the 3's together then all of the 4's then thew 5's and so forth I found that after about a half year doing the 3-4 5-6, doing the meds when they were ordered gave me enough time for things like lunch, nd charting. Maybe this will work for you.

1 Votes

I dont know how it is in america but we generally try to put all our meds on the same time, so you can expect you give meds at 6, 12, 2, 6, 10 and during the night, of course there are always exceptions. As for giving meds early, ive seen nurses give meds 30 minutes before and 30 minutes too late...I try to be on the dot when giving meds, but i think our system is a bit easier, less multi tasking.

1 Votes
Specializes in I/DD.

Our computer charting gives us a 1 hour window (my AM med pass goes from 8-10). It is a pain in the butt to give meds early because the program makes you explain why you are giving it early, so I usually stick with the window. Prioritize your important medications first, on our floor that would be IV abx and BP meds. I try and give the antibiotics as close to the due time as possible due to SCIP measures. I usually go to see all my patients first thing in the morning, sometimes before report if the last shift is busy (I won't wait around to do an assessment). By the time I am done with assessments it is 0800 and I can start meds. I figure out when meals are coming for each patient, and pass morning meds with insulin. When I am done with meds I will worry about dressing changes and other tasks. If it is a time consuming patient I do them last, it can be overwhelming to get stuck in a room for 30-45 minutes when you know you have countless little tasks to do. I prefer to finish the little tasks so I can feel free to focus on the big ones.

1 Votes

Thanks for all the tips. I work 7A/7P in a hospital on Med Surg floor with five patients who 90% of the time are very elderly. That means the 8 and 9 a.m. med pass usually includes all kinds of BP, heart, vitamins, stool softeners, etc. They have a TON of meds. Going to work on speed. Another question, if a patient is NPO do you give the meds or not? Half the nurses hold meds while the others give meds with just a tiny sip of water. Are there hard and fast rules about this? Thanks!

1 Votes
Specializes in I/DD.

Our cardiac surgery patients have a protocol, we give them their beta blockers only, but hold all other pills. For other patients I might give some BP meds, I definatley give pain meds, and depending on the patient/medication I might give a psyche med. However, check with your providers! Some will change to iv BP/pain meds. The providers I work with don't bother, but everyone is different.

1 Votes
Specializes in pediatrics, public health.
Bonnie86 said:
Another question, if a patient is NPO do you give the meds or not? Half the nurses hold meds while the others give meds with just a tiny sip of water. Are there hard and fast rules about this? Thanks!

When I was working in a pediatric hospital, I always contacted the doctor with this question, and would have them write me an order if they wanted me to do anything other than holding all meds while NPO. Generally speaking, they wanted anti-convulsant meds given but most others could be held. If the pt's only scheduled meds were something that could very obviously be held with no problem, such as daily vitamins, I would hold them, but anything else I would ask the doctor.

1 Votes
Specializes in Med Surg.

Our rule of thumb on holding meds is if they're cardiac we give them, if not we hold them. Some docs specify, but usually that's what we do.

1 Votes
Specializes in Hospital Education Coordinator.

Nursing in a hospital is 24 hours, so if you missed the meds or feeding the next nurse can do it. Won't like it, but can do it. Look at facility policies regarding when meds can be administered. Remember Maslows---safety first (including meds) then worry about the rest. You will get faster as time goes on, but there is no such thing as dallying around

1 Votes
Specializes in Trauma Surgical ICU.

Check your hospital policy re NPO status. In my hospital, they have made it pretty easy. If the doc writes NPO, they are NPO. If they want them to get meds they have to state that. It is very clear to everyone. My last hospital did not have such a policy so we called all the doc with a NPO order for clarification.

1 Votes
Specializes in ER, progressive care.

If the patient is made NPO, clarify with the doctor if they want the patient to be strict NPO or "NPO may give PO meds." For cardiac patients, typically none of their cardiac meds are held. Sometimes providers will change the route of meds from PO to IV.

1 Votes
Specializes in med-tele/ER.

I reschedule their meds to make sense, one of my biggest pet peeves as a night nurse is when nurses start q12 or q8 hours at strange times not allowing care to be clustered while patient is awake. Starting a q12 heparin SQ at 3pm makes no sense to night shift nurses.

I also look at the drug, if it is IV antibiotic or pain med I give on time, but if it is prozac due at 10am and I have a ton of 8am meds, I would just give the prozac regardless if it was given day before at 10am.

1 Votes

At the risk of sounding ignorant, (I've never worked acute care) why on earth would meds be scheduled at 0800, 0900 and 1000? Why dosent the pharmacy or nurse entering order or whoever schedule all those for 9am? I mean Ok, I can see ABX or meds explicitly ordered q12hrs having specific times. Don't nurses in the hospital have the right to use their own judgement to change med times?

1 Votes
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