Evening Med Pass Question

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Specializes in Med/Surg, Tele, Dialysis, Hospice.

I work part-time in a LTC facility on the evening shift. At the LTC facility where I worked previously, we had a few meds to pass at 5pm but had one big med pass at 8pm. At the facility where I work now, we have a huge med pass at 5pm and another one at 8pm. By the time I squeeze in my treatments and documentation, I am literally on my feet for 8 1/2 hours straight, which is beating my body up. This has me wondering: what is the evening med pass schedule in your facility? Do you have to do two huge passes every evening, or is it condensed into one? I have only worked here for four months but I am about ready to throw in the towel because I am so sore at the end of my shift from walking back and forth for 8 1/2 hours every time I work.

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Specializes in hospice, home care, LTC.

This was the same at every LTC facility that I have worked at, a heavy pass between 4and 5P and another heavy pass between 7 and 9P. I was also exhausted. I had between 25 and 40 patients. Just shoot me. And of course everyone wanted their pills at exactly the same time, NOW!:eek:

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Specializes in LTC.

We have meds scheduled at 4:30pm, 5pm, 6:30pm, 8:30pm(HS)

Realistically, we do an early medpass (4-6:30, 7). And a late medpass 8-10pm. If I have a resident who gets meds during 4:30, and another pill at 6pm. I'm give them all at once during the first med pass.

Also I try not to go back unless its a b/p med, antibiotic, lantus, ambien or melatonin. I hate waking people up for pills.

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Specializes in Med/Surg, Tele, Dialysis, Hospice.

Thanks for your replies. I do condense my 4pm-6pm pills into one pass, as well as my 8pm-10pm pills. If I didn't, I would never stop passing meds and I wouldn't get anything else done. And yeah, I hear you about everybody wanting their meds at the same time. Once in a while one of my patients will say, "You're late!", to which I reply, "Well, I do the best that I can, but they give me a lot to do." Our aides get the same thing, because they all want to get ready for bed at the same time too. It can be so frustrating working in LTC!

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Specializes in Home Health/Hospice.

evening med pass is hard, you have sundowners etc. Once you get to know the meds and the patients I feel it would be a lot easier for you. I hear you with being late, and well nothing you can do really. It sucks because yes everyone wants their pills at the same time, as well as PRN's, but like you said to your patients, you're telling them the truth.

I know its hard, that's why I work part time nocs, it's not easier it's just the meds are less, however, the stress is higher because i'm the only nurse on the floor with 2 CNA's and 60 something patients under my belt.

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Medication administration is time consuming in all facilities.

I am in a hospital right now, only 6 patients, start my 9 pm pass @ 8 and finish around 11.

It is a system using the computer and scanning arm bands.

I feel your pain, no break, never sit down, ache all over !

Sorry no real advice here, just commiserating.:twocents:

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Specializes in LTC,Hospice/palliative care,acute care.

You are going to work like a dog in health care on every shift these days. Staff continues to be cut and we are all called upon to accomplish more and more with less resources on a daily basis. My advice-take an OTC pain med at the start of the shift.Wear ted hose and shoes or sneaks with good support. Once you get each resident's routine down you will be able to manage your time more efficiently.AND actually spend a few minutes making someone's day.....

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Specializes in LTC.
Thanks for your replies. I do condense my 4pm-6pm pills into one pass, as well as my 8pm-10pm pills. If I didn't, I would never stop passing meds and I wouldn't get anything else done. And yeah, I hear you about everybody wanting their meds at the same time. Once in a while one of my patients will say, "You're late!", to which I reply, "Well, I do the best that I can, but they give me a lot to do." Our aides get the same thing, because they all want to get ready for bed at the same time too. It can be so frustrating working in LTC!

And when things have lost control at the desk (admissions, piles and piles of orders, consults, labs and charting).. I make it 1 pass. I have to. Or else I'll be leaving at 3am instead of 1am.

As far as treatments go.. the CNAs at my facility are so good they even tell me when to have the treatment ready for Mary's bottom. So when I do finish the meds the only treatments I have left are those who get a clean dry dressing to a leg/arm skin tear. So maybe coordinate your treatments with the CNAs .. saves time and you get your treatments done.

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Specializes in Med/Surg, Tele, Dialysis, Hospice.

One thing that makes it kind of hard where I work is that I am only part-time, and the unit I work on is divided into two assignments. Which assignment I get depends on which full-time nurse I'm working with, since they have their regular assignment and don't have to switch back and forth. This means that I am having to learn the meds and treatments of everyone on the entire unit, since I will have all of them in any given week. If I had the same group of patients every time I worked, I would have it down by now, but I don't. Every other weekend, I even work on a completely different unit, an alzheimer's unit, so I have to know those patients too. All in all, it's 75 different patients that I will pass meds to in a pay period, and on afternoons no less. I don't know if your facilities use the blister packs of pills, but after a shift, I actually have cracks in the index finger and thumb of my right hand from popping open so many blister packs. I don't mean to sound like I'm complaining, but I do work my butt off. I think I will try taking some Motrin before I start my shift next time I work. I went to a specialty shoe store and had my feet measured and analyzed and spent $150 on expensive orthopedic shoes with arch supports, and it hasn't made a bit of difference. I can't see myself doing this job for more than a year or two.

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Specializes in LTC.
One thing that makes it kind of hard where I work is that I am only part-time, and the unit I work on is divided into two assignments. Which assignment I get depends on which full-time nurse I'm working with, since they have their regular assignment and don't have to switch back and forth. This means that I am having to learn the meds and treatments of everyone on the entire unit, since I will have all of them in any given week. If I had the same group of patients every time I worked, I would have it down by now, but I don't. Every other weekend, I even work on a completely different unit, and alzheimer's unit, so I have to know those patients too. All in all, it's 75 different patients that I will pass meds to in a pay period, and on afternoons no less. I don't know if your facilities use the blister packs of pills, but after a shift, I actually have cracks in the index finger and thumb of my right hand from popping open so many blister packs. I don't mean to sound like I'm complaining, but I do work my butt off. I think I will try taking some Motrin before I start my shift next time I work. I went to a specialty shoe store and had my feet measured and analyzed and spent $150 on expensive orthopedic shoes with arch supports, and it hasn't made a bit of difference. I can't see myself doing this job for more than a year or two.

Thats pretty much my deal also. I look at it this way.. I can do any assignment in the facility and know the residents. We do use blister packs. and my thumbs look the same way lol

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Specializes in LTC,Hospice/palliative care,acute care.

I hear you-I'm full time but now I'm a float. I work on a different unit every darned day ("lucky to have a job,can't complain" etc,etc) I've been there going on 11 years so I pretty much have the routine down on each unit but somedays on certain units I ride home in tears. When I work on the larger units I am one of two and I take whichever hall the regular does not and I try so hard to do everything to help them get through the day because they are ultimately responsible for so much routine crap. BUT many (most) of the prn pool coul not care less.They make more money then I do and can barely get their meds passed-forget about calling a doc,taking off an order,etc. It's tough to maintain a positive attitude.

We still have meds in blister packs and I carry children's blunt scisors to open them-my fingers are so painful from arthritis( EEEKQ!!!! I have become amd OLD nurse!).We are going to bingo cards and a pxysis system any day now.I can't wait.

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Since meds are ordered Q6 H, BID, etc. before and after meals, at HS, etc. it is very hard to control how many are given at a certain time. I always said if they ever did a time and motion study and expected us to do every thing exactly by the book we would never get our work done. Having the ability to stand endlessly is defiantly a requirement. Then again I think about bank tellers and cashiers who have to stand and don't even get a chance to walk around.

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