Endless Medication Administration....

veegeern, BSN, RN · Dec 8, 2005

I will be licensed 2 years in Feb., and I still have vivid memories of

feeling like I was "dispensing pills" and wondering if "this" is what nursing is all about. Especially when I looked around and saw that the other, more experienced nurses, had made their pass to 6 patients in less than 1 hour. Hang in there. It gets better. Your med passess will take less time (most days :) ) once you do it for a while. It took me 6 months to a year to become more organized and to have enough confidence in myself to move a little faster. I got to the point where I was no longer having to tell myself "alcohol, pull back, flush, roll the clamp...hmm not dripping...no too far" Now I just do these things, and I am able to talk to my patient in such a way that I am getting info from them at the same time. On most days, I can even remember what they told me:chuckle.

Simba&NalasMom, LPN · Dec 8, 2005

Boy, do I hear where you're coming from! My first job in LTC was day shift with 35 residents. 90% of my time was spent pushing pills. Too much to say the least.

Lord knows I'm going to be flamed for this because after reading all the anti-med tech posts, I know I am in the minority; but I recently moved to a state that utilizes med techs and I do have to say that having them does make my job much easier; I'm at the point where I can't even remember what it was like to have to pass my own meds cause even without having to do so I'm still overwhelmed.

Hang in there, it will get easier with practice, but it does take time. And don't let anybody push you to be faster; much better to get the right drug and dose to the right person.:)

christvs, DNP, RN, NP · Dec 9, 2005

Oh wow, can I ever relate to you! I've been an RN for 5 months now & take today for instance: I work on a med/surg unit in a hospital & today I had 5 post-op patients who all had either abd or lady partsl hysterectomies & all I did all shift long was see who had pain or nausea and who couldn't pass gas or poop and then I'd go grab the appropriate pain or anti-nausea meds, simethicone, sennoket, etc...and then all the IV pushes, IV antibiotics, etc.! I feel like the only other thing I did today besides give meds & do my initial assessment on each pt was that I kept checking them all for lady partsl bleeding, since they all had the same surgery. So yes, I agree with you that it's very frustrating to spend 90 % of our time giving meds. I was just thinking the same thing you said in your post that I feel like half the stuff I learned in nursing school I have forgotten, cuz who has time to sit and discuss labs, tests, etc? Although I wish very much to become more involved in all aspects of their care. That is why I applied to grad school to become an NP. But you are definitely not alone in how you feel! I feel like I'm getting faster and more confident in what I do, but sometimes the day is so stressful cuz of the acuity of the pts, that no matter how fast you move, it's still so busy! Like today, I noticed I wasn't the only nurse who was stressed out. All the other more experienced nurses were saying how busy it was and that they barely had time to sit down to eat. It''s probably cuz we had so many post-op pts who all needed something at the same time, all the time! Geez!

-Christine

MackNJacks mom · Dec 10, 2005

I can definately relate. I just got off orientation and it is a huge wake up call. You probably needed to get that off your chest. It is hard to have any time to spend with your patients. I get maybe one slot of time per day to discuss concerns and dx's with my patients and families. It is funny because most people say, you work 12 hour shifts? That's a long time!! But the truth is it feels like 3 hours, and you still have things that could have used more time. They say it gets better with time. I sure hope so. It is nice to read these threads and know that other new grads feel the same.

Jenn

AtlantaRN, RN · Dec 15, 2005

if you feel like the people in the circus that keep the plates turning on the bamboo sticks, yep, you are a nurse, especially if you are a medical/surgical nurse, I've worked at facilities that have 6-7 patients on day shift...

hang in there

that is nursing

I'm in the IMCU and max out at 4 patients, and it isn't as bad, usually

linda

chachh, BSN, RN · Dec 17, 2005

I have been working for 6 months now on a tele unit, and I feel totally overwhelmed at times with med passes.

My last shift consisted of an ICU appropriate pt who was quickly sliding down hill (they shipped the pt to the unit on the following shift of course!). Constant needed suctioning, was in isolation, venti mask, fs, IV's, two drips, and was starting to bleed out when I was getting ready to leave! 2nd pt was post heart cath who had restraints w/ short term memory loss who ended up running down the halls naked and urinating, threatening to beat us all up (got punched once and had to go through this twice when the dtr untied the pt). Then had another GI bleeder constantly getting up to bm but needed assist because the pt vagaled and fell before. 4th pt another post heart cath who arrived with chest pain, had do go through the whole protocol with that. Luckily 5th pt was a walkie talkie that just needed pain meds all night, but gosh, the way my night went I barely spent 3 minutes w/that pt.

Needless to say I had to rely on my charge to do my chart checks, and I still needed help just passing meds. Never got a lunch and only went pee once! I felt guilty because I couldn't spend more time trying to critically think about my first pt because I knew the pt was going down hill. Would call the dr and feel like an idiot because in report my history was so shady on him, but who had time to go through the thick 2 volume chart when you needed to assess and get the situation taken care of stat, and then of course be told you are an idiot because you didn't know blah, blah, blah. And then feel like an even bigger idiot because what you were originally calling about was in fact actually happening and did you really explain the situation accurately when you called the dr the first time?

Gosh, will it really get easier? Will we actually be able to critically think as well as just run around and pass meds?

But I must say, venting does help!

jsixxerrn · Dec 17, 2005

I am a pediatric nurse of 2 yrs. i remember how you guys feel. it will get better you're time mgmt skills will improve. you will learn to teach while giving meds and assses while teaching while giving meds. and answer the other call light while assesing while teaching while giving meds. it will all come together you will still have those nights where you arre not able to do all you want to no matter what. welcome to nursing

patwil73 · Dec 18, 2005

Just like to second the encouragement, it does get easier. One ting I do that really helps me is I write down the meds and times on my "brain" sheet. If I have a lot of meds I start combining times such as ...

2030 x, y, z instead of 2000 and 2100

I also check for times prn meds were given and write for next due times and questions on prior meds passes

ex:

2000 x, y IV (ask about nausea - due at 2100)

2100 nausea prn (ask about pain - due at 2200)

I will also write what order I want them to go in (if I have a very critical they go first, but otherwise it goes in who can takethe med the quickest, so for the long ones I have more time to spend with them)

I find if I take just a couple of minutes at the start of the shift to write things down my day go much better and I am much more organized.

Hope this helps

Pat

Indy, LPN, LVN · Dec 18, 2005

Yeah, that few minutes to begin with can make a world of difference. Finally, after 4 months I find I'm starting to actively look for pieces of info in report, instead of just trying frantically to scribble everything down that the other person said on tape. When that's done and I know who my patients are, I spend a minute or so going back to those pieces of info and making sure that they make it to my brain, so I actually know what is going on with the patient when I go into the room.

It's weird to say, but last week I felt like I did this for the first time. It makes me wonder what the heck I have been doing the last 4 months. It's also a VERY good feeling walking into a room and after the intro, telling the patient what I'm gonna do to get them ready for their procedure, outlining the strategy for surviving their nighttime portion of fluid restrictions, why they can or can not shower and etc, it gets a lot done in a little bit of time. What it really did was free up the next hour after assessments for med passes without people bugging me for all kinds of stuff that I didn't have time for right then. (Ok maybe they won't always do that but it worked on a full moon so yippee!)

So to the OP: Relax. You're probably doing a wonderful job, just have to keep in mind what things you do that are right so that you don't always focus on the negative.