Do you hop around?

Before I pass med on a new unit, I sit down with the MAR and go thru it and prioritize who will get meds first....residents with insulin, residents with more than one med time for the same med, resident with HTN, residents who are sick and reciving antibiotics, etc. so when I pass my meds I zig zag around alot, giving meds to resident in room 445, then taking the cart all the way to room 433, then taking the the cart across the unit to 456, then going to this room and moving the cart back down the hall to this room....Does this happen to any on out there in LTC land? I know some nurses who start on one end of the unit and simply work their way down or they put the cart in the activity room and wait till the residents come to them, but how do you do it?

There is no way in this world I could ever get my med pass on 35+ residents done if I jumped around from room to room. I do check the MAR at the start of my shift and get all my fingersticks out of the way first (I work 3-11 usually). Then I start at one end of the hall and work my way down. If someone is not in their room, I skip them and come back. If someone on the next hall wants a pain med or needs an IV hung, I pull all of their meds due at that time, leaving the med cart where it is. I try to park my cart in a spot where I can easily access four rooms at a time, so I can hit eight residents without moving the cart. I've seen nurses schlep the cart from room to room, but my old aching thirty-something year old body complains if I abuse it in that way. Those carts are heavy!

[kbrn2002, ADN, RN]

Sounds about right. I jump around or I'd never get done. I leave the cart in the hall and walk the meds to the resident, I find it's faster than pushing that heavy cart around not to mention the laptop for the EMAR/ETAR just won't hold a charge for a full 8 hour shift so I just leave it plugged in. I try to get people with the same meds at more than one pass done pretty quick, and all the blood sugar checks before meals. For the rest it is just when I can catch them coming down the hall. Some will come to me, some the CNA will stop with them on the way down to the dining room. I usually can get well over half of my med pass done without leaving the cart.

I zig zag around, say when someone who will get meds, but wants to get ready for bed soon, and happens to pass by my cart as I make my way down the hall (that's the plan,but it changes sometimes)I give their meds as they pass through, depending on what's going on (prioritizing!). So, I start out in a straight line, but will zig zag as situations arise.

There is no way in this world I could ever get my med pass on 35+ residents done if I jumped around from room to room. I do check the MAR at the start of my shift and get all my fingersticks out of the way first (I work 3-11 usually). Then I start at one end of the hall and work my way down. If someone is not in their room, I skip them and come back. If someone on the next hall wants a pain med or needs an IV hung, I pull all of their meds due at that time, leaving the med cart where it is. I try to park my cart in a spot where I can easily access four rooms at a time, so I can hit eight residents without moving the cart. I've seen nurses schlep the cart from room to room, but my old aching thirty-something year old body complains if I abuse it in that way. Those carts are heavy!

Your way sounds less complicated.

Tomorrow I'm going try the straight line method

Some nights I feel like a ping pong ball bouncing from one patient to the next

[kbrn2002, ADN, RN]

The straight line go room to room method will take longer but until you really get to know your residents and their routines it will be easier, or at least less confusing. After a pretty short amount of time you will learn each residents typical daily routine and it is much easier to pass meds and get treatments done when you pretty much know where to find them!

[Salisburysteak, ADN, RN]

Your way sounds less complicated.

Because it is.

Just relax and stop making med pass harder than it is.

I get the people who go to sleep early first...then I go from one end to another. We have a few that expect their medication at a certain time, so I try to accommodate them. I am very thankful for the ones that will just take their medication whenever I happen to get there...

[Eleven011]

I do the HS med pass mostly. I start with the handful of presidents who go to bed super early and get them out of the way. (I leave the cart at the desk and just walk them their meds). Then I do the residents who are still sitting in the foyer. Then I take the cart and go up and down the halls, skipping the residents that stay up super late. Then I park my cart again and get those late ones. It works out pretty good.

I definitely zig zag all shift. At our facility, patients are rarely just in their rooms. They go to the dining room, appointments, pt, wander around, the salon, out with family, etc. I usually have 25 to 30 patients, many diabetics, tubes feeds, and the rest. After the first couple hours when many of the first patients are oob and everything is becoming situated i simply move my cart from the nurses' station to outside of the sickest patient's room and keep it there. Room numbers are arbitrary when it comes to the patients' schedules. I weigh about 90 lbs tops, dragging that cart around doesnt even occur to me.

On day shift (7-3) I park my cart outside of the dining room. I start by getting everyone who is already in the lounge outside of the dining room (mostly the total assists in their wheelchairs). I then start passing them out to the residents who come into the dining room. The home I'm in, we are allowed the pass out meds in the dining room but I know some places don't allow that. I do the same for lunch and dinner. When I work the evening shift and do the hs med pass, I start at one end are make my way around. If the person is in lounge when I go through, I give them their meds there. Sometimes I do have to go back to a resident if they weren't in their room when I went by.