fed up and set up

TwoTrees-

I'm not sure I understand what you are saying about writing the meds in so many places. I've worked in 6 facilities and the process has always been the same..you write the telephone order on an interim order sheet and transcribe that order to the med sheet. That's it. Nothing goes on the original order sheet except the original orders. The new orders would be added to the NEXT month's order sheet at edit time. Seems you are making more work than needed and we all have enough as it is. My suggestion when the doc wants to know what meds the patient is on is to read them off the MAR instead of trying to look through the interim/phone orders. We have residents on our subacute unit with 15-20 new orders a week and it would be a nightmare to go through each one of those pages when we are on the phone with the doc. Do your 11-7's do 24 hour chart checks? Make it a practice and you'll find fewer mistakes.

you are so right on all accounts!

i worked midnights too and it seems like day shift wants all the diabetics done on midnights and evening shifts.

and tube feeders galore loaded on the midnight crew.

i always prefered 3 pm -11 pm shift because of my husbands work schedule.

we have less cnas and less nurses on the evening & midnight shifts, yet we get more done than all those overloaded staff day shifts ever do.

but do we ever get any pay increases or credit for our extra efficiency, heck no.

i worked day shift as prn too and i found more cnas and nurses hiding in patients rooms with the doors closed and i actually caught 2 cnas watching soap operas when the patient was sitting in the bathroom with the er call light on for 10 dang minutes.

one was in a chair and the other had the gall to be lying in a bed.

i took them to my don and not a dang thing was done!!

the don & adon spent most of the day hiding in their office talking about everything but the patients and eating their way to a heart attack, every dang day!

amen!! it's amazing what can be accomplished when the staff works together as a team .

regarding new medication orders, if it is transcribed incorrectly then it's a problem that needs to be written up. another reason i work the 11p-7a shift, so i can have the time to check on new orders. i know this isn't always possible for everyone.

It would be great to have time to check all the charts and orders, but it has never been possible for me unless there is a question in my mind or problem. I have 12-15 patients as an LVN on a med surg floor and trust me most days I never look at the main chart only the bedside charts. I do however check the chart whenever I am in doubt about an order, etc. In a perfect world (not nursing) we would have time to check everything we would like to. Unfortunately when we are overloaded with too many patients we have to do the best we can to keep them safe. It's overwhelming to me most days just trying to get the meds out and not be 2 hours late. Lord help me.