I recently got hired at my first nursing job which is a ltc facility. I an extremely overwhelmed and want to go and find another job. The most confusing think about it is the system for passing meds. Unfortunately this facility is still living in the 80’s and still uses paper for everything. The mar is a binder you carry around all day on the med cart with over 1000 pages many of them are ripped out or hanging on by a tread. I am having a hard time adjusting too it. I also asked for a list of policies and was told the policies are scattered all over in the nursing station in many of the file cabinets
In the nursing school that i attended everything was all digital. To top it off i work 3-11 were we are short staffed so i am constantly watching the first door to make sure a resident doesn't escape because we do not have overnight security or a nursing supervisor.
The nursing patio ratio ranges anywhere between 25-32. Can anyone give me any suggestions on learning how pass meds with a paper mar. I witness two nurses administer the wrong meds because of this system. Most of our patients have dementia and do have wrist bands and the mar is missing pictures of them. I asked the staff several times for help and they all seem to brush it off because many of them have been there for 20 years and know all the patients.
sorry I assumed you were an LVN/LPN. if you are a registered nurse you have many job opportunities and can choose where you want to work. think about why you became a nurse and what you really want to do than apply for it.
sorry I assumed you were an LVN/LPN. if you are a registered nurse you have many job opportunities and can choose where you want to work. think about why you became a nurse and what you really want to do than apply for it.
once again good luck, I envy your degree
Thank you. Yes being an RN does give me many opportunities to choose from. In fact everyone i have worked with in the ltc facility is an lpn that attended vocational school. Most of them either attempted to go back for rn and didnt make it or just didn't want to go back. I want a job that i will love.
Believe me,I know how you feel. I find that what works best for me with facilities that STILL have paper MARS is if you have a census sheet for you hall/unit use it to write down report from the previous shift on your residents. After that,take your MAR start from the first resident(hopefully in room or alphabetical order) and go through each page,taking note of important things such as blood sugar times PT/INRS (Coumadin doses) GT feedings,etc. Then start your first med pass crossing off names or room numbers completely for residents who get medications or blood sugar checks once a shift and for residents who get medications or blood sugar checks twice a shift cross off with one line. Then when you are done with your first med pass,sit down,go through your MAR making sure you have signed every med you hav given and at the same time,flag your MAR for the next med pass, then,when you are done with that,sit down and go through your MAR completely so that you don't miss anything.It sounds like a lot,but it has worked for me for 28 years. A bonus for your census sheet,it makes a good report sheet for giving report to the next shift because it provides a picture of what happened during your shift. I hope this helps you as much as it helps me.
Believe me,I know how you feel. I find that what works best for me with facilities that STILL have paper MARS is if you have a census sheet for you hall/unit use it to write down report from the previous shift on your residents. After that,take your MAR start from the first resident(hopefully in room or alphabetical order) and go through each page,taking note of important things such as blood sugar times PT/INRS (Coumadin doses) GT feedings,etc. Then start your first med pass crossing off names or room numbers completely for residents who get medications or blood sugar checks once a shift and for residents who get medications or blood sugar checks twice a shift cross off with one line. Then when you are done with your first med pass,sit down,go through your MAR making sure you have signed every med you hav given and at the same time,flag your MAR for the next med pass, then,when you are done with that,sit down and go through your MAR completely so that you don't miss anything.It sounds like a lot,but it has worked for me for 28 years. A bonus for your census sheet,it makes a good report sheet for giving report to the next shift because it provides a picture of what happened during your shift. I hope this helps you as much as it helps me.
Thanks. It sounds as if you have a lot of down time where you work. To be able to sit down and go through the mar.
Specializes in Psychiatry, Community, Nurse Manager, hospice.
On 5/29/2019 at 1:46 PM, Lovethenurse2b25 said:
I wish it was this simple. The med times are just about every 2 hours or less for some. Couple of hospice pts require hourly morphine. Blood sugars at 4 and 8. Carbidopa every 2 hours, bolus gtube feeding, breathing treatments etc.
This is a lot.
I would guess your brain sheet should be organized by time.
Every hour list all the things that must be done.
You really must have ID bands to do your job. You can't rely on a demented patient to accurately tell you who he is.
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gooodnitenurse
10 Posts
sorry I assumed you were an LVN/LPN. if you are a registered nurse you have many job opportunities and can choose where you want to work. think about why you became a nurse and what you really want to do than apply for it.
once again good luck, I envy your degree