How to get faster at med pass

divaRN* · Jun 10, 2011

I like to cluster my assessments and med pass together. If I have anyone on my assisgnment I know I will start with them first. I know the way they takes their pills and what they will need. Then i tackle the rest of my assignment, leaving the chatty one for last (unless they are not stable or need something immediate). Sometimes if I am running behind I will finish my med pass and then go back to do missed assessments. Your method will come with time. It took me a while to get a routine down but now that i do it makes it so much easier :) hang in there!

oh and if you need to see a patient that is chatty and you know you will not have the time to chat i will walk in the room and start with " I would just like to let you know I may be interrupted because I have something else going on right now (at the time i was discharging a patient and waiting for transport to come and i had to accompany the pt to the safe to get his belongings), if this happens i will come back to address the rest of your concerns but I would like to check your vital signs and give you your medications now" this usually makes the patient happy that you a. took time out of your busy schedule to pop in and say hi b. they know you will be coming back to talk later and they are less likely to be chassing you down the hall with questions about xyz. c. they got their meds :) then make sure you go back when you have the time (usually at end of med pass) to chat and address needs. Works well with those intense families!

noyesno, MSN, APRN, NP · Jun 10, 2011

I like to cluster my assessments and med pass together. If I have anyone on my assisgnment I know I will start with them first. I know the way they takes their pills and what they will need. Then i tackle the rest of my assignment, leaving the chatty one for last (unless they are not stable or need something immediate). Sometimes if I am running behind I will finish my med pass and then go back to do missed assessments. Your method will come with time. It took me a while to get a routine down but now that i do it makes it so much easier :) hang in there!
oh and if you need to see a patient that is chatty and you know you will not have the time to chat i will walk in the room and start with " I would just like to let you know I may be interrupted because I have something else going on right now (at the time i was discharging a patient and waiting for transport to come and i had to accompany the pt to the safe to get his belongings), if this happens i will come back to address the rest of your concerns but I would like to check your vital signs and give you your medications now" this usually makes the patient happy that you a. took time out of your busy schedule to pop in and say hi b. they know you will be coming back to talk later and they are less likely to be chassing you down the hall with questions about xyz. c. they got their meds :) then make sure you go back when you have the time (usually at end of med pass) to chat and address needs. Works well with those intense families!

Great ideas! I'm going to use those tips.

noyesno, MSN, APRN, NP · Jun 10, 2011

I'm loving all these ideas, keep 'em coming! Thanks everyone.

chicookie, BSN, RN · Jun 10, 2011

When I did them I would A)people with the least amount first. B) Save talkers for last. C) We do bedside reporting so when leaving I would say do you need anything? I have to check on my other patients first but if you need something I will come back with it and your medications as well as do your assessment. What I really liked was that behind us came the CNA to take vital signs so when I went to pull meds, I had all that information at my fingertips. We were also allowed to give meds a half hour before they were due. So I started early. By 10:30 which was my snack time, I was done with meds/assessments/charting.

Also for those patients that are slow taking meds, I would let them take their time, while checking lines, foleys, IV sites, making sure they had their cleaning up essentials. I also carried around my assessment page so I could chart while waiting on them. It helps to get as much as you can done once you are in the room.

Unless something came up of course.

mitral · Feb 16, 2013

I love the info on this thread!! Some of these time management tips are very practical and exactly what I've been looking for. Ty all for sharing

GLORIAmunchkin72 · Feb 16, 2013

When things get hectic I like to concentrate on my medpass and let the aides do their thing. Getting pulled into different directions you can lose your focus and endanger your residents. Besides, working second shift, I hate to wake people up at 10pm to give them meds. 9pm is bad enough. It just seems so wrong.

Meriwhen, ASN, BSN, MSN, RN · Feb 16, 2013

Thank you. Unless this is a new admit or the first time a new medication is being given, it really shouldn't be necessary to go into any more explanation than, "Here are your meds: Drug A for Condition 1, Drug B for Condition 2, and Pill C, which does this."

Also, consider that frequently, the patient has been on many of these medications even before they were admitted, so they probably know them better than you do. So while you should definitely verify that they do know and understand their medications, they may not necessarily need a complete Medication 101 lesson.

Of course, if there's a dosing/schedule/formulation change to a current med, they should be made aware of it. Otherwise, I think: "Here are your morning meds: X, Y and Z. Any questions?" will more than suffice.

OP: you will get faster with experience...and as this thread is nearly 2 years old, I guess it's safe to say you've gotten some experience since then . Hope things have improved for you!

noyesno, MSN, APRN, NP · Feb 16, 2013

OP: you will get faster with experience...and as this thread is nearly 2 years old, I guess it's safe to say you've gotten some experience since then . Hope things have improved for you!

I'm fast now! Thanks Meriwhen. :)

Good Morning, Gil · Feb 17, 2013

Aww...I could have written this post 2.5 years ago when I first started. I worked with some ortho patients, as well, and everything you said rang true for me. What I did to make myself more expedient....I still helped the people to the bathroom (because it's the right thing to do), but also, because if I didn't, there would be a chance they would get up after I left and would fall (delegating isn't always the best idea, especially since your nursing assistants are swamped anyway, though you do need to learn to delegate appropriately).

Educate your patients on their medications as you are handing them their pills. Get them all checked off and ready or whatever first, and then as they are sipping their water, etc, give them a little blurb about their meds if you like. That will save you time since you will be watching them taking their meds anyway. Or, if you have a patient that requires their meds crushed in applesauce, chatter with them or educate them as you're crushing them and feeding them. That kind of thing...you just need to learn how to talk and work at the same time.

mc3, ASN, RN · Feb 17, 2013

On the same idea......my first job was in rehab and I had a tough time with meds. There were so many! One woman had about 15 meds, and insisted on having a cracker in between each one ("because I have to do it that way"). I was taught you never leave the meds by the bedside - always watch the patient take each one. And she was a chatty Cathy. Then, inevitably her roommate would ask for a pain pill after I already gave her HER medicine, and asked her if she needed her PRN pain med. I'd tell her I'd be back after I finished my med pass, but it was always too late, in her opinion. I just didn't know how to handle it, and the other nurses told me to deal with it. My mentor was a joke..... It was a very bad unit for new grads, and I left after 3 months.

In all honesty, I should have just left them there, but I couldn't....it wasn't right. What would you all have done?

mc3

turnforthenurse, MSN, NP · Feb 19, 2013

A med pass isn't a race, so please take your time. If I am giving a medication, I tell the patient the name of the medication and what's for. If it's a new medication that they are starting, I go briefly go through some common side effects. That usually suffices. Cluster activities if possible. Save the ones with more meds last and save the talkers for last, too. If you had meds due at 8, 9 and 10, get all of them and give them at the same time, as long as there are no contraindications.

If I am going into a talker's room, I make sure I have someone call my phone if no one sees me within 10 minutes. Works every time.

brithoover · Feb 19, 2013

On the same idea......my first job was in rehab and I had a tough time with meds. There were so many! One woman had about 15 meds, and insisted on having a cracker in between each one ("because I have to do it that way"). I was taught you never leave the meds by the bedside - always watch the patient take each one. And she was a chatty Cathy. Then, inevitably her roommate would ask for a pain pill after I already gave her HER medicine, and asked her if she needed her PRN pain med. I'd tell her I'd be back after I finished my med pass, but it was always too late, in her opinion. I just didn't know how to handle it, and the other nurses told me to deal with it. My mentor was a joke..... It was a very bad unit for new grads, and I left after 3 months.
In all honesty, I should have just left them there, but I couldn't....it wasn't right. What would you all have done?
mc3
mc3

If a patient is alert and oriented they will want to take their Meds so they can get the heck outta there. With these people I leave them their cup of pills to take on their own. Will go back 15 min later to check if they took them