Help speeding up

[Cranberrygirl]

New to LTC. I have 40 patients and can’t seem to do all my med passes in time because of so many interruptions. All 40 patients have 8 o’clock meds; that leaves me a 2-hour window which is 3 minutes per patient. Plus, I have to take vitals and fingersticks. Inevitably when I see a patient to pass a med, there is an issue that needs to be addressed or the patient requires a treatment, nebs etc. That is slowing me down, and the constant but necessary interruptions, i.e. doctors and families, patients trying to escape, and the paperwork is NUTS. The GNA’s are awesome and take care of ADL’s.

The nurses who are training me all insist that management expects too much, and they are correct. They all have ways to cut corners to get the work done, i.e. giving 2 o’clocks with the 8 am med pass or they just sign a treatment as completed when it is not. I see now how they get their work done on time! My manager says I need to speed up. Of course I never take a lunch and always get out late.

In any case, I really need this job. I’ll take any advice on how to speed up while still remaining safe and legal.

[cecilsgirl]

remember you have Nursing license, maybe those nurses who give meds early , or sign for things not done, should take an ethics class or something, maybe they won't get caught or have not yet, but don't do it, you worked too hard for your license!! look for a different job, and good luck to you!!!

[mareeposa RN]

Being new to a facility is always difficult try not to allow the negative feedback discourage

you,maybe talk with your unit manager about medication reviews for residents that have numerous medications.or similar medications. hang in there

[Leelee2]

I work in LTC, it takes me four hours to med pass during an average shift. While preparing meds, I am pretty blunt with staff that interrupt.

It best be an emergency situation. If not, I will let them know that it is unacceptable practice to interrupt any nurse during a medication pass.

Family ?'s (unless urgent) can also wait, the residents on the floor and their care is my priority. I will let them know that I am in the process of distrubiting medications, I ask them for their number and return their call, at my convenience, usually later in the shift. Vitals, I prepare (at the beginning of the shift) a vitals sheet for the CNA's to do, and they are very good about it.

I ask CNA's to report on any skin changes and issues daily. Utilizing a cheat sheet really helped me, I have a system that i use, where i make notations in boxes as far as crossing off 1600 meds/2000 meds, dressings, etc. That helps me stay organized and helps me know exactly what still needs to be done. Do you have a unit manager/or charge RN that is available to help in emergency situations?? That can be helpful. Also, some documentation can usually wait till the end of shift, things like medicare charting, and routine vitals, etc. Keep open communication with unit managers/ management and other nurses there, bond together to create some needed changes, and advocate for your residents.