Do you give your 10 AM meds at 8 AM?

[FireStarterRN, BSN, RN]

Hi, yesterday I took over a patient at around noon from someone, and then the patient was to be discharged. So, I wanted to review her meds with her as to what or what not she had already had that morning, so I went into the computer, we chart with a scanning system and it shows the exact time the med was scanned.

The nurse who had had the patient all morning gave all her 8 AM and 10 AM meds together. I was surprised because I've always taken the administration times quite seriously and figure they are there for a reason. I asked another nurse what he usually does and he told me that he tries to adhere to the correct times too.

I assume she does this for her own convenience and efficiency. Our ratios were very good yesterday. She wasn't sick or anything, we switched patients for another reason.

What do you think of this practice? I saw it done on another floor before when I've floated and have picked up some patients and noticed that the previous nurse had given all the 8 AM meds and 10 AM meds together.

[pagandeva2000, LPN]

Depends on the drug, I guess, the patient load and what else is happening during the day. I have given 1 and 3pm drugs together at 2pm, so, I guess it is the same thing. If I see colace and an antibiotic that was just ordered, I've done it, because I may forget later.

[lpnflorida]

I am more apt to give 0900 med and 1000 med together if I am on the last of my patients and it is 0930.

Would I give them at 8am. No, I would not. Usually it is levaquin which is ordered for 10am and it has strict administration of either 1 hour before or two hours after a meal.

[chicookie, BSN, RN]

I've done that. Given both at 9am but they usually are some sort of drug that doesn't really interact with anything. I haven't given it much thought as its the one hour before and after rule here. I try to do only 30 minutes though. That is my goal; doesn't always work though.

[psalm51]

Most meds (with few exceptions) go BEST

[Piki]

Honestly, who has the time?? I know at that time I am busy making first rounds and assessments. If they have a 7:30 (usually something like insulin or maybe a protonix drip, or PO) or 8 a.m. meds I usually give them first rounds. Luckily our daily meds are scheduled at 9 & 2100. Like someone else mentioned I wouldn't have a problem giving 9 & 10 meds together - we do have the window of an hour before and hour after. But as a rule, I don't have the time to be giving out all daily meds first rounds unless for some strange reason I only have one or two patients that have meds in the morning.

[Ivanna_Nurse, BSN, RN]

I agree with the poster who said she gives meds that are due at 1300 and 1500 together at 1400. If it were me, i'd probably give all at 0900 and save a trip, because I would forget also. Ivanna

[Chaya, ASN, RN]

Depends on the meds. In general I would aim to give both at 9 AM if they are given daily or BID. If one is Q4 hr or Q6 I would adhere to that time more strictly and keep the times spread out if needed-ie; a Q4 hr antibiotic due at 8 AM b/c it would be due again at 12N. I would give other meds with it if they were officially due at 9 but if there was also, say, an Q6 hr antibiotic due at 10 I would do that at 10.

[wooh, BSN, RN]

Depends on the meds. And it's not always for MY convenience. Sometimes it's for the patient's convenience. I've seen home meds scheduled at all sorts of times when at home they take them all at once. I trust my judgement more than an automatic time a computer comes up with.

[RNperdiem, RN]

Giving both meds at 0900 would be okay for me unless we are dealing with hourly meds like eye drops or something.

I have worked in settings where the temptation to cut corners is almost overwhelming.

I wonder what that nurse's previous job was like. Did her preceptor train her to consolidate and give lots of meds together?

[CoffeeRTC, BSN, RN]

Why are they scheduled that way in the first place? Are they q X hr meds? I would think it would make better sense to have them timed within a certain window so that they can be given on the same med pass?

This is unless they need to be given at certain times.

No wonder we are all running our butts off.

[Straydandelion]

A lot depends on the meds, where I work, the meds at 8A are usually q4hr, I would not give them too early/late even with a policy and procedure stating can give within an hour of the time. I have rarely seen a med for 10A except one specifically certain times after meals. A lot of this depends on what else is happening on the floor with my other patients, IF I have time, I would prefer to give at the exact time prescribed.