I agree. Why are we so consumed with the time? Yeah the regulations talk about time, but if you do not give a colace within an hour of when it is ordered (before or after) is someone going to die? Time is basically for those medications that are ordered more than once a day so that you don't end up giving the too close together. I just don't understand though why at 88 years old someone needs 15 medications anyway....Medication orders should be for "in the morning", or "afternoon", or "evening", or "bedtime". That allows flexibility and takes the "time" thing" away. I have never written a citation because of "time"- mostly dumb stuff like not washing your hands or crushing something that should not be crushed- things every nurse should know that should be straight-forward common practice.
Antibiotics, B/Ps, insulin and narcotics are the meds I pay attention to the times... either way..the residents aren't going to die because their 4:30 pills weren't given until 7pm.
The 88 year little old lady probably won't give a damn about any of her pills and most of the residents hate all the pills they have to take.
I agree. I love working with medication aides. I was the "med nurse" for a couple of years before we switched to CMA's, mainly because we didn't have enough nurses. We had 54 residents then, and we worked 12 hour shifts so I had all 3 mealtimes. It was a hassle, but you quickly learn all the little quirks each resident has and what order goes best for you.
I now work mostly nights and we stopped waking people up about 4 years ago to give eye drops, nebs, inhalers, etc. The CMA starts meds about 6:30 am as people get up. One thing we noticed really quickly was the behaviors decreased when we stopped waking people up all the time.
"Sorry but I have to disagree. Most meds are ordered daily or two times a day. The actual time the medication is given is very arbitrary based on the med times the facility has chosen."
:yeah::yeah:
yes, the time can be changed to make medpass safer and to accommodate the residents. Many of them have been up very early and turn in early and they do not like to be awakened 2 or 3 times a night for meds.
JINKIES!!! Just reading your post made me nauseous. Nope, I never have, knowing my luck, I'm just too afraid something will go terribly wrong. I work with a nurse who seems to have no trouble cutting corners but is the first to point fingers at others even if they are not... especially if they are not. It's a nurse-eat-nurse world out there. Do what YOU think is right, it's your license after all.
I know this thread is kinda old, but I really enjoyed reading it. It is very hard to get a med pass done for 30-40 residents done within the allotted 2 hour time frame. I would big time :redbeathe it if we had AM, Afternoon, PM, NOC instead of 0900, 1330, 1700, 2100, etc times for meds. I can usually get my med pass done in a timely manner, and that's not usually in the 2 hour window.
I don't know about the CA rule or law about not having med aides/techs. Before I got this LVN job, I applied to be a med tech at an ALF. It paid half of what I make and was told in my interview that since I was an LVN, I could perform LVN duties while working there as a med tech. Yah, that's a HUGE money saver for facilities. But it won't help our economy if I did take that low paying position, doing LVN duties under the title "med tech"....I would have lost my house, my car, etc. Keep nurses nurses and instead of hiring lower paid "techs" or "aides" or hiring additional nurses, we should make changes within the system - take away the 2 hour window. Hell, I don't follow it for my own medication! I'm still alive and kicking! :w00t:
There are special circumstances in which times should be followed. I agree, those should be the exception. But the resident who is taking vitamins/supplements at 5 pm or 9 pm can take them sometime in that broad evening hour window.
I know this thread is kinda old, but I really enjoyed reading it. It is very hard to get a med pass done for 30-40 residents done within the allotted 2 hour time frame. I would big time :redbeathe it if we had AM, Afternoon, PM, NOC instead of 0900, 1330, 1700, 2100, etc times for meds. I can usually get my med pass done in a timely manner, and that's not usually in the 2 hour window.
I don't know about the CA rule or law about not having med aides/techs. Before I got this LVN job, I applied to be a med tech at an ALF. It paid half of what I make and was told in my interview that since I was an LVN, I could perform LVN duties while working there as a med tech. Yah, that's a HUGE money saver for facilities. But it won't help our economy if I did take that low paying position, doing LVN duties under the title "med tech"....I would have lost my house, my car, etc. Keep nurses nurses and instead of hiring lower paid "techs" or "aides" or hiring additional nurses, we should make changes within the system - take away the 2 hour window. Hell, I don't follow it for my own medication! I'm still alive and kicking! :w00t:
There are special circumstances in which times should be followed. I agree, those should be the exception. But the resident who is taking vitamins/supplements at 5 pm or 9 pm can take them sometime in that broad evening hour window.
The only time I did finish in the 2 hour window is when half the residents were out on Thanksgiving lol.
I've said this time and time again.. 2 hour window doesnt work for the 4:30 medpass.
I'm new to nursing and LTC and am quickly learning how wishy washy things can be. When I work another floor, I have residents looking at me very surprised when I walk in their room around 9pm to give them their 2nd med pass.
They usually reply " didn't I get all my medicine at 5 O'clock?" or they state that they are missing a few pills at 5 during first med pass. One lady didn't even know she gets eye gtts ???
The residents on my floor tell me that when I don't work, the nurse taking my shift gives them ALL their pills at one time. One particular lady (who is of VERY sound mind) tells me that she gets all her meds at 7pm after dinner the nights I don't work. This lady has medication that should be taken before meals and has pain narcs that are supposed to be spaced 4 hrs apart and "2".. count them "2" neb TXs that are to be spaced as well.
Don't get me started on BID DSG changes that are initialed in the books, but aren't done. How do I know they're not done you ask? Cause my initials, date, and time are still on the bandages from FRIDAY when I return on MONDAY!! REALLY!! BID DSG CHANGES PEOPLE!!!
I have several residents that tell me that they are so glad to see ME walk into their room after shift change and they hate it on the nights that I'm not their nurse.I have brought up the DSG change issue to the powers that be, but honestly, they seem more concerned about the books having initials stating that the task was done instead of the task actually being done.
Also, from time to time mysterious bandages without initials, date, or any documentation in the chart of an occurrence even happening will pop up on a resident and of course NO ONE knows what happened or who bandaged the resident. You gotta love those!
I'm new to nursing and LTC and am quickly learning how wishy washy things can be. When I work another floor, I have residents looking at me very surprised when I walk in their room around 9pm to give them their 2nd med pass.
They usually reply " didn't I get all my medicine at 5 O'clock?" or they state that they are missing a few pills at 5 during first med pass. One lady didn't even know she gets eye gtts ???
The residents on my floor tell me that when I don't work, the nurse taking my shift gives them ALL their pills at one time. One particular lady (who is of VERY sound mind) tells me that she gets all her meds at 7pm after dinner the nights I don't work. This lady has medication that should be taken before meals and has pain narcs that are supposed to be spaced 4 hrs apart and "2".. count them "2" neb TXs that are to be spaced as well.
Don't get me started on BID DSG changes that are initialed in the books, but aren't done. How do I know they're not done you ask? Cause my initials, date, and time are still on the bandages from FRIDAY when I return on MONDAY!! REALLY!! BID DSG CHANGES PEOPLE!!!
I have several residents that tell me that they are so glad to see ME walk into their room after shift change and they hate it on the nights that I'm not their nurse.I have brought up the DSG change issue to the powers that be, but honestly, they seem more concerned about the books having initials stating that the task was done instead of the task actually being done.
Also, from time to time mysterious bandages without initials, date, or any documentation in the chart of an occurrence even happening will pop up on a resident and of course NO ONE knows what happened or who bandaged the resident. You gotta love those!
I'm not saying your way is wrong but when you get stuff piled on you.. orders, admissions, charting. The trick of putting it all in 1 med pass is going to be your best friend. Of course there are certain meds you have to go back for. But if its 7pm and you are just getting to a resident for their 4:30 meds. Give them HS meds as well. Ex, zocor, senna, ambien(if they are in bed). The only things you don't play around with are antibiotics, bp meds, or narcotics.
Ok, this is so bad of me to admit, but we recently had a resident move to another facility. I was sad to see her go, she was amusing and nice. But I couldn't help thinking, there is one less resident to do a med pass and a tx for everyday.
Don't get me wrong, once I began doing my med pass in a "timely" manner (to my standards and took only a week or so), I was really able to get into true patient care. I'm not solely concerned about passing meds...I don't want to present myself as that kind of nurse.
Hopefully y'all will get my point about what I mean by a resident leaving seems to free up a little bit of time.
:yeah:
REALLY!! BID DSG CHANGES PEOPLE!!!
Forever Sunshine, ASN, RN
1,261 Posts
Antibiotics, B/Ps, insulin and narcotics are the meds I pay attention to the times... either way..the residents aren't going to die because their 4:30 pills weren't given until 7pm.
The 88 year little old lady probably won't give a damn about any of her pills and most of the residents hate all the pills they have to take.