All experienced nurses need some advice.

Scottishtape · Feb 23, 2017

Yes, many of us have held a position like that.

What are your questions? What are you struggling with?

Kjohns16 · Feb 23, 2017

It's just new to me and a little different than what we learned in the school. I'm the only nurse and I come three days a week and set up medication for a few days. I just want to make sure that it's ok and that it is allowed under my license.

COtoLPNstudent · Feb 28, 2017

Wow I never just sat up the meds in the assisted living facility I worked at. I was on a med cart daily passing medications to 80 something residents by myself for 12 hrs a day. I did treatments, accuchecks, insulins, ordered meds, and was on call after leaving at 7p...there was no 7p to 7a nurse, just the CNAs. Honestly each state has different regulations as it relates to nursing in a assisted living facility. The facility I worked at was just a step below a nursing home due to the number of residents with dementia and behaviors. The Only difference is that the residents can leave and go as they wish. No such thing as a 24 hr report, charting, or Skilled nursing care......you lose what you've learned after a while.The work load of 80+ Residents with only one nurse was brutal and eventually I quit after management refused to get another nurse to help out.

minerwife927 · Mar 1, 2017

I would NOT be comfortable with that at all. Who is giving the meds on days you arent there? Are people getting them? Are you pulling narcotics? I pull the med, I give the med.

NotMyProblem MSN, ASN, BSN, MSN, LPN, RN · Mar 1, 2017

It's just new to me and a little different than what we learned in the school. I'm the only nurse and I come three days a week and set up medication for a few days. I just want to make sure that it's ok and that it is allowed under my license.

As a nurse investigator in my state, your facility would face heavy fines and the board of nursing would definitely have something to say about your nursing practice. If someone gets hurt or worse, which is bound to happen in your situation, you will be thrown under the bus, fired, and crucified by your employer and they will develop an instant case of amnesia to cover themselves. That's in my state. I haven't a clue about yours..

But in presetting medications, how will you know which pill to remove if the blood glucose is low or the blood pressure is low? What if the patient is taking Coumadin and physician calls and says to hold the dose for several days due to PT/INR results? How do you know that others have not come behind you and tampered with what you've done, or mixed up the meds period?

Even in our personal care homes in this state, weekly dispensers are not allowed...leaves the door to possible harm standing wide open. If you are the LPN/LVN, I'm assuming your title is that of Wellness Director. You might strongly consider having a discussion with the Administrator. Pull a copy of your state's scope of nursing practice for review, and if this practice is not allowed, show this documentation to your Administrator. If he or she continues to require this of you, resign and report them to your department of community health (THE STATE)!

RainMom · Mar 4, 2017

But in presetting medications, how will you know which pill to remove if the blood glucose is low or the blood pressure is low? What if the patient is taking Coumadin and physician calls and says to hold the dose for several days due to PT/INR results? How do you know that others have not come behind you and tampered with what you've done, or mixed up the meds period?

This is a problem my family ran into the first time we gave ALF a try with my mother. The nurse set up the med cart (not sure if it was daily or less often) & medication aides would pass them to the residents. Most of these aides were very young, at least one was still in HS. Mom was on Coumadin & her INR levels were volatile with minimum of weekly checks which we did with our own machine. Her INR at one time was 4+, we informed the staff nurse & informed the MD office (via a system with the INR monitoring unit). Typically, the MD would call my sister, the POA, regarding any dose changes as well as a faxed order to the ALF. Well, the order didn't arrive timely or misplaced or who knows what, but the Coumadin wasn't stopped. Two days later, INR was 6+. It was at this point that we discovered that the nurse had not stopped the Coumadin because she didn't get an order from the office, although she was aware of the elevated INR & had been told that it should be held (nursing judgment anyone?).

Also, the counts on almost all mom's meds were off (some too many, some too few including her tramadol) when we moved her back home after just 6 months. Unfortunately, I didn't learn about that from my sister until several months later; a little late to file a complaint.