Gving all the meds all at once?

[ari3sdog]

I've been working as Nurse in LTC for 2 months now. Woot. I'm just concerned about the ways of other Nurses who gives all the meds for 5pm and 9pm all at once?

Is that bad?

I asked one of the Nurses if it is ok. She said.....

It's ok to give earlier if....

1. Vitamins

2. Eye drops

3. Docusate

4. Senakot

You have to give the other medicine on time if

1. B/P meds

2. Insulin

3. Heart Meds

4. Coumadin

5. Dilantin

6. Vicodin

7. Inhalers

8. Sleeping pills

I was thinking, if you guys do agree or disagree on these. It seems so hard to give all the 5pm meds and then later give all the 9pm meds on time. There are a lot of charting to do and Treatment, it so overwhelming.

They told me about the 1 hour before and 1 after rule on passing meds. They even laugh at me because I was doing the "Book Way" that pass all 5pm meds and then later 9pm meds, so I'm doing what they are doing. I felt I'm doing the wrong way, but everyone is doing it and nothing seems to go wrong. Also, I somehow agree about they told me about that certain drugs are ment to give on time, and some are ok to be late. Most of them are doing it for 17 years now and the patients are ok. Any comments to experience Nurses out there?

[leslymill]

This is an excellent topic; thank you for sharing.

I too want to thank the OP for posting this topic. It is by far one of my favorites debates to read so far.

We are all a little wrong.

We are all alittle right.

The standards are in the middle and we all have the goal to stay as close to them as possible to make the shift smooth and the pt care outcomes productive.

[Daytonite, BSN, RN]

The standards are in the middle and we all have the goal to stay as close to them as possible to make the shift smooth and the pt care outcomes productive.

The standards are in the middle? What does that mean? The standards are there to be followed, not bent and re-interpreted to what we think they mean. I think that it's this kind of thinking that has contributed to any substandard care in LTC. Working in LTC doesn't mean it's OK to lower the standards. Those who do lower them allow for facilities to get away with hiring more people who will do the same! If we all stood our ground and followed the standards to the letter then the administrators of facilities would be eating out of our hands. As long as there are nurses who are willing to cut corners and compromise the standards, they will make it difficult for those of us who want to stay happily employed in these places.

[Spidey's mom, ADN, BSN, RN]

The standards are in the middle? What does that mean? The standards are there to be followed, not bent and re-interpreted to what we think they mean. I think that it's this kind of thinking that has contributed to any substandard care in LTC. Working in LTC doesn't mean it's OK to lower the standards. Those who do lower them allow for facilities to get away with hiring more people who will do the same! If we all stood our ground and followed the standards to the letter then the administrators of facilities would be eating out of our hands. As long as there are nurses who are willing to cut corners and compromise the standards, they will make it difficult for those of us who want to stay happily employed in these places.

This is exactly the truth. Until we start to do our jobs as professionals, we will continue to have unsafe staffing that is evident in LTC and other areas of nursing.

Don't put up with substandard "middle" thinking.

steph

[Simplepleasures]

This is exactly the truth. Until we start to do our jobs as professionals, we will continue to have unsafe staffing that is evident in LTC and other areas of nursing.

Don't put up with substandard "middle" thinking.

steph

What?!Do you mean to say that there is unsafe staffing in LTC and other places as you said, BECAUSE we dont do a proper job as professionals, please tell me I misunderstood you. You dont see a corellation between poor staffing and corporate greed? Maybe you dont.

This blame the nurse mentality and accepting this type of reasoning, as good little nursies has kept us working in facilities that have substandard nurse/ patient ratios.

So what was it that improved nurse/ patient ratios in California? I bet it wasnt being perfect/ subordinate nurses, it was nurses who were DEDICATED enough and had the guts to fight for a better workplace.

[Simplepleasures]

I think that it's this kind of thinking that has contributed to any substandard care in LTC. Working in LTC doesn't mean it's OK to lower the standards. Those who do lower them allow for facilities to get away with hiring more people who will do the same! If we all stood our ground and followed the standards to the letter then the administrators of facilities would be eating out of our hands.

LTC administrators will not ever be eating out of the hand of the nurses, LTCs have substandard care because the nurse /patient ratio is based on PROFIT and GREED. How about the title of the article on this forum, "Dont Blame the Nurse, Fix the System."

[Jo Dirt]

LTC administrators will not ever be eating out of the hand of the nurses, LTCs have substandard care because the nurse /patient ratio is based on PROFIT and GREED. How about the title of the article on this forum, "Dont Blame the Nurse, Fix the System."

THANK YOU.

[Spidey's mom, ADN, BSN, RN]

What?!Do you mean to say that there is unsafe staffing in LTC and other places as you said, BECAUSE we dont do a proper job as professionals, please tell me I misunderstood you. You dont see a corellation between poor staffing and corporate greed? Maybe you dont.

This blame the nurse mentality and accepting this type of reasoning, as good little nursies has kept us working in facilities that have substandard nurse/ patient ratios.

So what was it that improved nurse/ patient ratios in California? I bet it wasnt being perfect/ subordinate nurses, it was nurses who were DEDICATED enough and had the guts to fight for a better workplace.

You did misunderstand me.

I am complaining about "perfect/subordinate nurses" who fudge the timing of meds against regulations and safe practice.

I also completely realize that "facilities" want to lessen the cost of doing business and unfortunately this usually falls on the reason we are all there - patient care. It happened where I used to work when our fabulous DON left and was replaced by a number cruncher.

Just because I comment on people who won't stand up to administration doesn't mean I don't think administration has perfect motives.

I've been a nurse for 9 years and it has always bothered me when the "status quo" continues because that is the way it has always been done . ..even though it is wrong.

steph

[Simplepleasures]

You did misunderstand me.

I am complaining about "perfect/subordinate nurses" who fudge the timing of meds against regulations and safe practice.

I also completely realize that "facilities" want to lessen the cost of doing business and unfortunately this usually falls on the reason we are all there - patient care. It happened where I used to work when our fabulous DON left and was replaced by a number cruncher.

Just because I comment on people who won't stand up to administration doesn't mean I don't think administration has perfect motives.

I've been a nurse for 9 years and it has always bothered me when the "status quo" continues because that is the way it has always been done . ..even though it is wrong.

steph

Maybe you misunderstood Daytonites post.I dont think she blames nurses in LTC for the poor nurse/patient ratio, does she? Or does she think that if we are perfect nurses LTC will eat out of our hands? Clarification?

[Spidey's mom, ADN, BSN, RN]

the standards are in the middle? what does that mean? the standards are there to be followed, not bent and re-interpreted to what we think they mean. i think that it's this kind of thinking that has contributed to any substandard care in ltc. working in ltc doesn't mean it's ok to lower the standards. those who do lower them allow for facilities to get away with hiring more people who will do the same! if we all stood our ground and followed the standards to the letter then the administrators of facilities would be eating out of our hands. as long as there are nurses who are willing to cut corners and compromise the standards, they will make it difficult for those of us who want to stay happily employed in these places.

i do agree with it . . . it is this kind of thinking that has allowed substandard care in ltc . . .along with the fact that the powers-that-be try to save money by hiring fewer nurses and increasing the amount of patients per each nurse, so some nurses feel they have to cut corners to get their job done, instead of standing up and saying no.

both the nurse and the "powers" are at fault.

steph

[Simplepleasures]

I do agree with it . . . it IS this kind of thinking that has allowed substandard care in LTC . . .along with the fact that the powers-that-be try to save money by hiring fewer nurses and increasing the amount of patients per each nurse, so SOME nurses feel they have to cut corners to get their job done.

Both the nurse and the "powers" are at fault.

steph

I think the substandard care is based on the nurse patient ratio , I think nurses in LTC want to be able to do a job that they can be proud of every night, not one in which they come home sick to their stomachs from worry something didnt get done.I worked in LTC for 30 years, I still have the scars to show for it, some are not physical.

[Spidey's mom, ADN, BSN, RN]

I think the substandard care is based on the nurse patient ratio , I think nurses in LTC want to be able to do a job that they can be proud of every night, not one in which they come home sick to their stomachs from worry something didnt get done.I worked in LTC for 30 years, I still have the scars to show for it, some are not physical.

I really don't want to make this personal. You have extensive experience in LTC and have your own story to tell. I respect that.

From my perspective, when I worked LTC as a "float", I did not pre-pour or give all the meds at once. It took me a long time to pass my meds (being new and having many patients). If I was late, I wrote the reason why, inadequate staffing. I wasn't floated there very often.

My question is, WHY put up with this? Why give 5 p.m. and 9 p.m. meds at 5 p.m. and then lie on the MAR? Why not work with the doc and pharmacy to reschedule meds? Why take a job in the first place where the staffing is so unsafe? Why stay at a job like that?

I think the substandard care may start with the staffing arrangements of the "powers" but the nurses who put up with it have some culpability too.

steph

[Simplepleasures]

I really don't want to make this personal. You have extensive experience in LTC and have your own story to tell. I respect that.

From my perspective, when I worked LTC as a "float", I did not pre-pour or give all the meds at once. It took me a long time to pass my meds (being new and having many patients). If I was late, I wrote the reason why, inadequate staffing. I wasn't floated there very often.

My question is, WHY put up with this? Why give 5 p.m. and 9 p.m. meds at 5 p.m. and then lie on the MAR? Why not work with the doc and pharmacy to reschedule meds? Why take a job in the first place where the staffing is so unsafe? Why stay at a job like that?

I think the substandard care may start with the staffing arrangements of the "powers" but the nurses who put up with it have some culpability too.

steph

Maybe I need to clarify here, I dont advocate prepouring or giving all meds at once, I am trying to get the point across that these things may be done by some BECAUSE of Nurse/Patient ratios and untenable workload, doesnt make it right, but is a symtom of a VERY SICK system. Again, dont blame the nurse fix the system.