Medication Nurse?

gwenith, BSN, RN · Jul 18, 2003

Oh! Boy! back to the days of "functional nursing" One nurse one function. I will give it this it is efficient in terms of staff but way not efficient in terms of patient care.

I have said this before and will again - the main purpose of going through all that education to give out medications is so that you can accurately evaluate the patient and the effect of the medication - not so you can do the 5/6 R's of administration!! Tehy are only a part of medication administration and if they were all there was to it then we would be better served having all meds in "webster" (blister) packs made up by the pharmacist.

Better yet! do what has been touted here - hire pharmacists to give out the medications!!!

Brita01 · Jul 18, 2003

When I first started working a few years ago, I was a medications nurse on a 30 bed unit. If there were over 20 patients, we had 2 med nurses and everyone got their meds in a timely manner. If there were 20 or less patients, we had 1 med nurse and a lot of patients got their meds late. The primary care nurses were responsible for their own accuchecks and insulin. They also gave their own PRNs. In the afternoons, when there were less meds to pass, the med nurses also did dressing changes. It's a good deal if there are enough med nurses to get the meds to the patients on time. Hope this helps.

live4today, RN · Jul 18, 2003

Originally posted by gwenith
...............Better yet! do what has been touted here - hire pharmacists to give out the medications!!!

An even better idea would be to have all our patients line up one by one at the pharmacists door on each unit to receive their meds straight from the pharmacy. Now...THAT idea I like!

We have a Satellite Pharmacy on our unit so that would be easy for the walkie talkies. As for the bedridden patients, the pharm techs can give them their meds.

I wouldn't mind at all if I didn't have to worry about the meds because the unit I work on is full of drug abusers, and it is more than tiresome to keep them "drug happy" during their stay. :rolleyes:

NicuNsg · Jul 18, 2003

Hi....I certainly hope your situation is not like the one I encountered at the hospital I tech'd at. Get this horror story.......

Say you have 32 pt's on your med/surg. floor, you have 4 RN's,

1 LPN, and "1" tech. Here is the following assignment

Each RN get's 8 pt's, the tech gets them all, and the LPN is the med nurse for the entire unit. As I would begin vitals (which I might add would begin again by the time I finished), if a pt had any pain I had to address it to the med nurse. Finger stix's med nurse, you get the picture...... At any rate, the info was given to the RN as well, but the LPN implemented the action. I truely believe that the med nurse had entirely too much placed upon her and the one suffering was the pt. and the poor tech who was running up and down the hall passing messages and attempting to care for pt's. It was a mess, which is why I choose never to practice at this hospital. It just simply is not a safe environment for anyone. As far as how to make it work, I am not sure I have the answer to that. Maybe 2-3 med nurses, good staff communication/morale, and a nursing supervisor willing to listen.

I wish you luck and hope all works out for you. Please let us know how it all turns out and how you all did it. :-)

gwenith, BSN, RN · Jul 18, 2003

Yeah I was probably a little rough but I sincerely believe that we should be thinking more about evaluation of medications. Even something as simple as taking the BP's before we give antihypertensives and then taking them afterwards particularly if they are new meds rather than sticking to a strict Q?H bps etc.

purplemania, BSN, RN · Jul 18, 2003

In Texas the LVN (aka LPN) works under the license of the RN, which means I would be responsible for her med errors. I would rather make them on my own, thank you.

barefootlady, ADN, RN · Jul 18, 2003

Love the team nursing concept, which was practiced when I started in nursing. Med nurse always consulted RN for problems, if Rn did not know then pharmacy was called. RN did fingersticks, prn meds, and maintance IV's. Worked well. If over 18 to 20 patients, then had 2 med nurses. If med pass was light, med nurse helped with dressings, treatments, whatever was needed and fit her job description. Staff worked as a team and usually had good days with minimal overtime. Hope this helps.

NicuNsg · Jul 19, 2003

Amen purplemania......my point EXACTALLY!!!!!!!!!

gwenith, BSN, RN · Jul 19, 2003

I guess we have such a different system that it is hard to translate at times. We have fewer Enrolled nurses and they have to be "endorsed" to give out medications but the legal system is that even though she is working under an RN supervision each person is held accountable for his/her own actions. We also work under "vicarious liability" which also changes the legal landscape. We do tend to do more primary nursing here with each RN responsible for thier own patient load - entirely responsible.

allnurses Guide · Jul 19, 2003

Sorry, I hate the med nurse idea . . that is how it used to be here at the hospital where I work, BEFORE I worked here.

I want to be able to assess my patient and take care of their needs, not rely on someone else to do what I've been trained to do.

Am I my patient's advocate or not?

This seems like an old idea come back to haunt us . . . .

steph

Zinnia · Jul 19, 2003

I have seen the floors do this, I work in ICCU. It seems to me they waste a nurse taking patients,when I feel every nurse should be giving her own meds anyway.