Are there any LPNs that find 40 person med pass workable?

ButterflyNurse30 · Dec 20, 2010

I am in the same boat. I skip my lunch break almost everytime I work. I am a floater so I never work the same hall which makes it hard to get a routine. I try to stay ahead but if one thing goes wrong then I get so behind. It's so hard to get done what I should in 8 hours. To make things worse they are now very strict on overtime so if we stay and finish we get in trouble for overtime and we don't finish all the paperwork, we get in trouble for not finishing. There are a couple of nurses that clock and finish the paperwork, but to me it doesn't seem right to work off the clock.

tainted1972, ASN, RN · Dec 20, 2010

I Have 22 residents In 2 different Homes .. I know it is a far cry from 40 but I have to drive to and from each house at least 2 times. And if there is an emergency I have to drive more.

Anyway I have learned a couple of things.

First I chart as I go, Sometimes I am just standing there watching someone swallow pills, I can chart while they are doing that.

I do my treatments while I am passing meds so I am visiting each patient once.

I do the difficult/time consuming patients FIRST.

I have discovered many opportunities for multitasking. For example while patient A is drinking whatever concoction, I am pulling the meds for patient B.

or when I am taking a blood pressure (automatic) I am getting the blood sugar on the other side.

I try to make sure that I have everything I need for each patient before I start my med pass.

I am sure it is much different in a SNF especially if they are in private rooms.

If I come across something Like a missing med, cream, or anything that require a trip to the supply room... I skip that patient and move on making a list of things I need as I go, That way I am making ONE trip and not 20.

I hope this helps.. even if it is just a little.

caliotter3 · Dec 20, 2010

I worked night shift and did med passes for 80 in one place, 52 in another, and 40 in a third (total number of residents responsible for). I made certain that I had everything organized before I started and tried to have as much charting done as possible before starting the AM pass.

Finallydidit · Dec 20, 2010

I have 30 residents, 16 of which are diabetics, work 3-11 so I have the 4p and hs finger sticks, as well as 2 med passes, It absolutely takes me all 8 hours to complete everything, and thats with no mishaps along the way. I couldn't imagine doing this for 40, in an 8 hr shift.

I try to get my finger sticks done first thing, just in case something unexpected happens. Then give the injection with the meds. Plus it gives me the chance to check on over 1/2 of my Res. first thing.

I don't sign my MAR as I go, just look over it to see new orders or changes. Then will sign after about 6-8 passes. If I am behind, I will pull 4, (place them in cups in their drawer),pass 4, sign 4, Don't like doing that, but it does help if you need to make up lost time. I go to lunch at 7 and try my best to start charting at 7:30 and be finished by 8 to start the 9p med pass and finger sticks.

If I am lucky I have 2 aids, on a good night it is 2.5 but most nights it is 1.5 especially with the holidays coming.

At times I feel like it is impossible to do my job!

apatt2 · Dec 20, 2010

It is almost impossible to take care of 44 residents by yourself. I too am a float nurse. I stay on my feet until about 2-3 pm getting all the hands on work done and then I sit down at about 2 or 3 pm to complete paperwork. I can't believe the government say that we can do this. Patient care is getting neglected. The supervisor likes to talk to everyone that walks by and not help. God forbid, the supervisor get mad at you, she really won't help. I have recently gotten my RN and I will not be working with 44 patients very long. I am looking for another job. I have too much to lose!

apatt2 · Dec 20, 2010

I have 30 residents, 16 of which are diabetics, work 3-11 so I have the 4p and hs finger sticks, as well as 2 med passes, It absolutely takes me all 8 hours to complete everything, and thats with no mishaps along the way. I couldn't imagine doing this for 40, in an 8 hr shift.
I try to get my finger sticks done first thing, just in case something unexpected happens. Then give the injection with the meds. Plus it gives me the chance to check on over 1/2 of my Res. first thing.
I don't sign my MAR as I go, just look over it to see new orders or changes. Then will sign after about 6-8 passes. If I am behind, I will pull 4, (place them in cups in their drawer),pass 4, sign 4, Don't like doing that, but it does help if you need to make up lost time. I go to lunch at 7 and try my best to start charting at 7:30 and be finished by 8 to start the 9p med pass and finger sticks.
If I am lucky I have 2 aids, on a good night it is 2.5 but most nights it is 1.5 especially with the holidays coming.
At times I feel like it is impossible to do my job!

FYI!!!! Be careful!! You are suppose to sign the MAR as you go! If licensure come in on you, the facility will get charged for every blank ($2500 approx.) you have. You should do it the right way because if your facility get fined for you having all of those blanks on the MAR, :crying2: you won't have a job anyways!!

systoly · Dec 20, 2010

I've done lots of 50+ residents med passes without breaking a sweat. But I've also done 30 residents med passes and felt completely defeated. What slows me down the most are liquids, eye drops and of course having to crush. Throw in a bunch of g-tubes and insulins and the nightmare begins. Working SNF, I'm sure you have all of the above. At best, you have 2 hours to complete your med pass and still be in compliance. That translates into 3 minutes per resident. Is that enough? Not on this planet.

NurseLoveJoy88, ASN, RN · Dec 20, 2010

I've done 45 residents in ALF and it was hard and my boss wanted me to do 60 and I refused. I told him why don't he try it. Enough said. I have a new job and I have 19 -20 residents and it still gets busy at times... especially having lots of diabetics and tube feeders.

To help with time. I sometimes give pm meds and hs meds at the same time if there are no interactions. I'm sorry but I refused to wake some residents up at 10 oclock to give artifical tears, or a calcium pill or something like that.

NurseLoveJoy88, ASN, RN · Dec 20, 2010

I agree some residents take forever !!! Sometimes I have to spend 10 minutes just trying to encourage them to take their medicine. One resident I have to promise a story to and popcorn just for her to take her meds.

I have to get icecream for some. Don't even get me started on the boosts and resource, and benefiber power, pro stat and uti stats. Whoo !! overwhelming.

tokidoki7, ASN, RN · Dec 20, 2010

I agree some residents take forever !!! Sometimes I have to spend 10 minutes just trying to encourage them to take their medicine. One resident I have to promise a story to and popcorn just for her to take her meds.
I have to get icecream for some. Don't even get me started on the boosts and resource, and benefiber power, pro stat and uti stats. Whoo !! overwhelming.

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Forever Sunshine, ASN, RN · Dec 20, 2010

I have 30 residents, 16 of which are diabetics, work 3-11 so I have the 4p and hs finger sticks, as well as 2 med passes, It absolutely takes me all 8 hours to complete everything, and thats with no mishaps along the way. I couldn't imagine doing this for 40, in an 8 hr shift.
I try to get my finger sticks done first thing, just in case something unexpected happens. Then give the injection with the meds. Plus it gives me the chance to check on over 1/2 of my Res. first thing.
I don't sign my MAR as I go, just look over it to see new orders or changes. Then will sign after about 6-8 passes. If I am behind, I will pull 4, (place them in cups in their drawer),pass 4, sign 4, Don't like doing that, but it does help if you need to make up lost time. I go to lunch at 7 and try my best to start charting at 7:30 and be finished by 8 to start the 9p med pass and finger sticks.
If I am lucky I have 2 aids, on a good night it is 2.5 but most nights it is 1.5 especially with the holidays coming.
At times I feel like it is impossible to do my job!

Its sad that we have to do things the way we do them but its the only way we will get done and get to go home before 1am.

3-11 is the busiest shift in my opinion. We have 2 hours to count narcotics, recieve report, do CNA assignments, fingersticks, start the meds, call drs before 5pm comes around and its time to babysit the dining room. We can resume the meds after dinner. Now its 6:15. Finish up 4:30 meds, hang GT feedings, give any 8:30pm meds if able to, answer the phone, put out fires, look at this skin tear/bruise, Mary is on the floor. Call the MD. Some of the meds still aren't done from 4:30. This blood pressure is low. Jane is refusing her shower. Finally finish 1st med pass at 8:30 and sneak off the unit to go eat dinner before something else pops up. Return at 9pm. Do everything else that still needs to be given in the MAR. HS fingersticks. Treatments. Oh looky here... nothing in the treatment carts that I need to get treatments done. No scissors. No tape. No gauze. No saline. Time to hunt all that down.. its 10pm. I still need to sign out narcotics, chart, and do MD orders. Finally finish treatments at 10:30. Clean up the nurses station because I can't work when things are messy. Its 11pm Count.. Give report. Finally its 11:20 and I start charting. Finish documenting the MD orders in 8 different places. Its now 12:30am(and that's what time I put when I sign out) and I can go home

I sign my MAR before I give the med.. or else I will forget.. and come in the next day to a love letter about all the boxes I need to fill in lol. If I have time at the end of the night I flip through the MAR and check over to see if I missed any boxes.