Getting faster on the med cart & my stupid sore thumb!

[Dorali, BSN, LPN, RN]

Today was my first full day training on the cart! I really like it but I am SO slow!! I didn't finish my 9:00 pass until around 11:30. This cart has a lot of people on it. 29, I think. (I mentally walked down the halls just now! Ha ha!) The woman I trained with has been a med aide for years and years. She pretty much let me do the pass alone, but stayed by my side in case I had questions or issues. When it started getting close to the noon pass, she started popping them out and I ran to administer. I bought some thick paper today and made bookmarks so I could flag my noon's instead of digging through the whole dang book & also so I could keep track of where I am on the page. I kept losing my place, on top of double & sometimes triple checking what I was popping out. Anything else you guys can suggest would be great!

So my sore thumb... I hate the thick backing on some of these cards!!! I had gone to press a pill out of the card, and when it FINALLY broke through, there was a stiff edge on the plastic that went straight between the skin & my fingernail!! Oh boy, did it bleed! I'm even having a hard time swiping across the screen of my phone! It's so tender! And, of course, it's my thumb. Tomorrow will be a lovely day!

Dondie

[CoffeemateCNA]

Is 0900 considered your "heavy" a.m. pass? If it only took you 3 1/2 hours to pass a.m. meds to 29 people, you are doing phenomenally. I wouldn't be any faster myself. I always take my time, especially with the a.m. pass since there is SO MUCH to give. I really don't care if I'm "late" with meds, because, in my opinion, 90% of the meds given in LTC facilities are completely unnecessary. I will never understand why we are giving, for instance, calcium and vitamin D TID to end of life residents to prevent fractures, or why blood pressure meds need to be split up into 3-4 daily doses. Doctors don't usually prescribe such frequent regimens to people at "home," so why in the world do they bother to do this to LTC residents in the place that has become their home? I think they just want it to look like we are really trying to "cure" all of the resident's ailments to make families happy (who don't want to face the fact their loved ones will not be getting better). Why is it such a big deal if you are 30 minutes late with something? People at home don't flip out or face loss of life or limb if they don't take their meds at 0900 on the dot. Why is LTC any different? Nobody will die if they have to wait a few extra minutes for their Tums or Lasix. It's LTC, for goodness sake, not an ICU! And if they do face that imminent danger, then they obviously have no business being in LTC and need to be shipped to the nearest acute care facility STAT!

As far as flagging goes, what are your MARs put into? Every LTC facility I have been to uses 3-ring binders. If this is the case in your facility, I would just pop open the rings, and move the paper off to one side, so that it will be sticking out the top/bottom, and only two of the metal rings will be holding it into the binder. You have to come up with your own system as to what to flag versus how to flag it. For instance, flagging the individual resident tab divider if you haven't given them any of the meds for the resident that pass, or flagging individual pages for PRN reassessments, breathing treatments, etc. Post-its are also great for flagging as they are abundant and inexpensive.

I hate popping meds out of the bubble packs, too. I still get callused thumbs from it. Medication storage seems to be a no-win situation: bubble packs are difficult (and painful) to manipulate, and bottles make it difficult to find quickly or easily get the correct number of pills out. Ahhh.

I'm glad you became a med aide. It's nice to have someone else on here that does this too!

[Dorali, BSN, LPN, RN]

Hi Coffeemate! I am so glad you are a med aide too! It's hard to vent when no one knows the reality of passing meds!

Our MAR is also a THICK 3 ring binder, but most of the pages are falling out from being ripped and are all off center. It's a mess. I let my daughters (8 & 4) pick out some scrapbook paper at Hobby Lobby so, of course, they're all colorful! Love the idea of Using the tabbed divider to find out who you haven't passed to yet!!! My trainer and I completely missed a woman this morning. Luckily she only took like 2 minor things, one being a vitamin. I told someone yesterday that being a CNA, I didn't realize how much it affected the CMAs when it came to moving the residents around. Mine were on my routine as much as I could let them so in hindsight, I hoped that helped. You do a lot of bouncing around!

And now that you mention it, I know I forgot to check up on those PRNs! Oops!