Gving all the meds all at once?

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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?:o

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 untennable workload, doesnt make it right, but is a symtom of a VERY SICK system. Again, dont blame the nurse fix the system.

Well, I don't agree that the nurse who puts up with it (and/or who cuts corners) doesn't have to share the blame of allowing a broken system to continue. Paraphrasing the quote below - No one can make you work in a place with a very sick system without your consent.

"No one can make you feel inferior without your consent" Eleanor Roosevelt

Gonna have to agree to disagree here. :flowersfo

steph

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Well, I don't agree that the nurse who puts up with it (and/or who cuts corners) doesn't have to share the blame of allowing a broken system to continue. Paraphrasing the quote below - No one can make you work in a place with a very sick system without your consent.

"No one can make you feel inferior without your consent" Eleanor Roosevelt

Gonna have to agree to disagree here. :flowersfo

steph

I have seen nurses who do prepour and give meds all at once, and ,they are the so called perfect nurses because they get their work done on time, they are LOVED by administration. Guess what happens to nurses in LTC that try to help fix the sytem, who refuse to do illegal/ unethical practices? They get fired in retaliation, nurses without protection, either by state or union have no voice, cant fix anything without the tools. Its OK if we disagree, at least there is a discussion about WHY these things happen in LTC and that can help bring about needed changes in LTC. I never felt inferior by the way.
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I have seen nurses who do prepour and give meds all at once, and ,they are the so called perfect nurses because they get their work done on time, they are LOVED by administration. Guess what happens to nurses in LTC that try to help fix the sytem, who refuse to do illegal/ unethical practices? They get fired in retaliation, nurses without protection, either by state or union have no voice, cant fix anything without the tools. Its OK if we disagree, at least there is a discussion about WHY these things happen in LTC and that can help bring about needed changes in LTC. I never felt inferior by the way.

It sounds like you've worked at my place. Anyone who even mentions that something might need changed gets labeled as a trouble maker. Even if they are doing it against "the rules", they ones who get done on time are the blessed ones. The ones who sacrifice their health and sanity to play by the rules end up being forced out by the powers that be. I've seen this at a lot of places. It's really sad that it has to be that way.

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I have seen nurses who do prepour and give meds all at once, and ,they are the so called perfect nurses because they get their work done on time, they are LOVED by administration. Guess what happens to nurses in LTC that try to help fix the sytem, who refuse to do illegal/ unethical practices? They get fired in retaliation, nurses without protection, either by state or union have no voice, cant fix anything without the tools. Its OK if we disagree, at least there is a discussion about WHY these things happen in LTC and that can help bring about needed changes in LTC. I never felt inferior by the way.

Re: "inferior" . . . that is why I paraphrased it . . . .I'm suffering from a head cold and "medicine head";) and I was trying to remember a quote and that is the closest I could come. "Inferior" doesn't work.

Thanks for discussing this with me - Taking my "medicine head" to bed.

steph

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It sounds like you've worked at my place. Anyone who even mentions that something might need changed gets labeled as a trouble maker. Even if they are doing it against "the rules", they ones who get done on time are the blessed ones. The ones who sacrifice their health and sanity to play by the rules end up being forced out by the powers that be. I've seen this at a lot of places. It's really sad that it has to be that way.
Yes, there is a PANDEMIC in LTC across the country,its damn sad.Doesnt HAVE to be this way, but will be this way unless we come out of our stupor and stop blaming the nurse, first step, get PROTECTION, good laws, good unions, then you and I and LTC nurses across the country can take a stand for improved conditions in LTC for the resident and the nurse.
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i agree with stevielynn, the best thing is to call the doc and let him naw abt the situation. it aint that hard to change a 9pm med to 4pm.esp the vitamins and stool stoftners.

but till that is done, i would stick with the MAR giving meds an hour before or

an hour after which is ok.

i wouldnt advice anybody to do what other pple are doin, do wat u naw is right, wen u get busted, it will be you alone and ur license, remember how hard u worked to get that license, im sure u wouldn't be too happy to lose ur license jus because u din wanna follow the MAR!!!

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Most of our complaints come from us as staff. Then we have complaints from pt's family members. Most are related to staffing. Most of us in the medical profession have complained again and again. Family members will complain.....but only to us. The state gives us guidlines as to the ratio of staff to pts. But these are bottom line. These are the least amount of staff they need to take care of this many people. Most LTC facilities use this as a given. It is not! For quality care you may need to add a staff member here and there to make a unit or floor run better. But, they will use the State guidlines as a rule. If family members and patients would go to thier state and ask for a change in the baseline, then maybe our voices would make a difference

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Most of our complaints come from us as staff. Then we have complaints from pt's family members. Most are related to staffing. Most of us in the medical profession have complained again and again. Family members will complain.....but only to us. The state gives us guidlines as to the ratio of staff to pts. But these are bottom line. These are the least amount of staff they need to take care of this many people. Most LTC facilities use this as a given. It is not! For quality care you may need to add a staff member here and there to make a unit or floor run better. But, they will use the State guidlines as a rule. If family members and patients would go to thier state and ask for a change in the baseline, then maybe our voices would make a difference
There are quite a few nursing home reform advocacy groups as well as nursing groups that have asked to have the nurse /patient ratio improved, well asking didnt get recieving, it will take mandates by the federal and state governments before we see improvement.Similar to what has occured in California, strong union, union helps enact laws.
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