Are you often 2 hours late for meds?

[FireStarterRN]

At 4 PM yesterday I picked up one patient from a nurse during the the shift shuffle at 3PM. She was going to fill in on the monitor desk so I got report on the patient at 1600.

She gave me a rather disorganized report, and let me know that, by the way, she hadn't given her 1400 meds yet, sorry, but would I follow up on that. The meds were two IV antibiotics and a SQ heparin.

She had had 4 patients and was passing them on to various nurses. It was basically a 10 minute task to get the meds and hang the antibiotics and give the heparin. The patient had two pumps and two IV sites, and it was a quick job to run in there, and also do some teaching with the family on what I was doing quickly, in addition to doing a quick assessment and explaining who I was and how long I would be the patient's nurse.

The nurse seemed rather nonchalant about being 2 hours late. I didn't want to make her feel bad, but to me I would have to have another patient going down the tubes to be 2 hours late on meds.

What do you think?

[WahooRN08]

I was a little over 2 hours late on Friday. We had no nursing assistants, 5 patients per nurse on a busy Cardiac/Thoracic Step-down department. It happens... luckily none of the meds were critical to be on time with.

[stressgal, RN]

I was a little over 2 hours late on Friday. We had no nursing assistants, 5 patients per nurse on a busy Cardiac/Thoracic Step-down department. It happens... luckily none of the meds were critical to be on time with.

I think your statement says it all. Sometimes things happen out of your control and as long as you are aware of the critical timed meds I don't think it should be a problem. I guarantee that people do not take their routine medications at precise times when they are at home. However, iv antibiotics should be administered as close to schedule as possible and cardiac meds are generally pretty important to stay on schedule. We often are late administering meds when they are new orders and pharmacy enters them to be given earlier than the current time. I just document why it "appears" late in charting. It takes too much time away from patient care to call pharmacy, have them correct the times, re-confirm the order and so on.

[WalkieTalkie, RN]

I think she was being lazy. There's really no good excuse for this. I can see her being busy and not having time to do them when they were due, but she shouldn't have passed the patients on to you without at least taking the time to hang the abx and what not.

[SandraJean]

I probably would have just taken care of the meds and continued on with my routine. Sometimes things happen to throw the schedule off. If it were someone that chronically couldn't get the meds on time, that would be a different story.

[caringchic]

Two hours late happens, in nursing a million things can make a well scheduled day go haywire! Isnt that a characteristic of nurses is dealing w/ the unscheduled, unforeseen events. I have had RX not have meds available, meds not sent on time, IV sites blown, hunting for equipment for pt #1 while pt #2 "should" be getting his scheduled pacerone. Not to mention the pt whose bowel care has worked and resulted all over the bed and the CNA is no where to be found, or busy w/ pt #2 climbing out of bed. Then there is always the doctor who calls thinking that his pt's are the only pt's you have to be responsible for.... some days it is a good damn thing to have the pt's pink and breathing by the end of the shift!

I am amazed that people would say the are "never" two hours late could they offer some suggestions. .. obviously I am missing it in my 6yrs of bedside nursing...

[SunnyAndrsn]

I Have been that late with meds, but only in extreme circumstances. I'm in long term care, so I have 24 residents, lots of meds to pass. Sounds like she needs some help with organizing her day and her pt. care.

[FireStarterRN, BSN, RN]

I don't think this woman is lazy. I think she is disorganized. I noticed in report that she hadn't well prioritized her worries. She wanted me to follow up on something that had already been addressed, she wasn't up to date on what the current orders were, and then she hadn't hung the Zosyn and Cipro on time. Two hours late is quite significant.

She had 4 patients, a charge nurse signing off all orders, our best unit secretary who communicates new orders very well, and a tech to do all VS and blood sugars. None of her patients were having any dire issues, plus this hospital has IV therapy for IV restarts, so no need to get hung up with IVs.

I've worked side by side with this nurse before, both in my unit and in hers. She's a really nice person, but I think she's weak on time management.

[FireStarterRN, BSN, RN]

I was a little over 2 hours late on Friday. We had no nursing assistants, 5 patients per nurse on a busy Cardiac/Thoracic Step-down department. It happens... luckily none of the meds were critical to be on time with.

That sounds quite unwieldy.

[pagandeva2000, LPN]

I have been late with medication administration several times as a float/per diem. The computer was down, so, there was no pyxis access, other times working with horrible nurses that argued for over an hour about who will be in charge, setting patient care back entirely; then, I had to do catch up. Since I was a per diem, I was slower than most because I am not a regular (I work in the clinics as my primary position in the hospital).