How to organize medications

[Kelsie Gerth]

I am a new nurse on a med surgery floor. On average I have 4-5 patients every day. When I go to the med room to pull meds for all my patients I am nervous that I am going to mix them up. At my facility they have pencil cases with each room number on them and this is what I am suppose to put the medication in. I find myself carrying around a lot of med bags and afraid to put them down, so I take all of them into each patients room. Then I am worried that I will pull meds from the wrong bag. Does anyone have any advice on how to organize my meds better without carrying 4 to 5 bags into each room or leaving the bags of medication at my desk? 

[Rose_Queen, BSN, MSN, RN]

Why are you pulling meds for multiple patients at the same time? I would verify your policy for that- my facility makes it quite clear that only one patient’s meds are to be pulled at a time, for the exact concerns you’ve expressed. 

[Kelsie Gerth]

Thank you for your reply. This is how I was taught. I didn't realize that it wasn't like this everywhere else. I am going to look into this. I was taught to get the numbered zipper bag for each room and pull my patients meds and put them in the corresponding bag. Then go do med pass. I am just scared to have that many meds at one time. And I am scared to leave a bag at my station because someone may pick them up. 

[Kelsie Gerth]

And if I do need to pull one patient at a time then go give them their meds I am going to be so behind and walk forever cause we only have one med room and our beds are not grouped and spread out down 3 hallways... uugghh LOL 

[amgRN, ASN, BSN, RN]

On 9/20/2021 at 11:38 AM, Kelsie Gerth said:

Thank you for your reply. This is how I was taught. I didn't realize that it wasn't like this everywhere else. I am going to look into this. I was taught to get the numbered zipper bag for each room and pull my patients meds and put them in the corresponding bag. Then go do med pass. I am just scared to have that many meds at one time. And I am scared to leave a bag at my station because someone may pick them up. 

You should only have medications for one patient at a time and take only those medications into a room.  Also, never ever set your meds down and walk away/leave the room.  Do you have locked med drawers for each patient so you could prepare each one and then leave them locked until you come back to get them? 

Or, do you know what zipper binder notebooks are?  Those big three ring binders with the zipper that closes them.  If you had to, you could prepare the meds and since they are in pencil cases, they would probably fit in the three ring binder.  You could clip them in in order of the room numbers.  That way they would be secured and you could unzip it, take out just the one you need, and keep zipped between patients.  You might start a whole trend on your unit.  ?  

Of course check with your manager or another leader to make sure you are acting within your unit policy.  If they do say you should be taking multiple patient meds in one trip, I would suggest they be in something you can close securely between patients.  

[LeChien, BSN, RN]

It might put you behind for right now because you're a new nurse and haven't gotten your flow down yet, but I would only pull one patient at a time.

A mistake I made as a new nurse working in an assisted living facility was pulling multiple patients' meds at one time. I had them in little cups with the room number and even first few letters of the last name on my med cart. You can guess what happened. I handed the wrong cup to the wrong patient. Thankfully the patient was A&Ox4 and asked what the "big pink pill" was, and it hit me like a ton of bricks - WRONG CUP. I took the cup back and mumbled something along the lines of, "Oh let me see if there's a new manufacturer for that pill..." and gave him the right cup.

Here's another story of mine for pulling two patients at once. It was when I worked acute rehab and had two patients in the same room. Both wanted pain medication. I pulled both. The second patient stated she took a different-looking pill before, and I basically said the same thing like in the other story, about the manufacturer. Well once I got back to the med cart, I realized I swapped these ladies' pills. One was for Norco 5-325 and one was for Norco 10-325. Not a horribly big deal but definitely the last time I stopped pulling multiple meds at once ?

Remember it's not a matter of if a med error will occur by using this method of pulling meds, it's when, and who it will affect.

[inoc_]

As a medsurg nurse, it's vital to ensure you keep things organized to promote an efficient and safe shift. At my hospital we have little zip-lock type of bags where you can store meds. If your hospital has them then when you're pulling your AM meds you can number each one of the bags with the corresponding room number. Since you may end up with 5-6 of those bags, a lot of nurses I've spoken to find it is easier to stay organized by carrying a small bag [shower tote bag or craft organizing bag] and keeping all of those med bags in that. Never let your meds out of sight (patient safety comes first... plus you don't want anyone stealing any meds). And of course, during med pass always ensure that you're reviewing which patient gets which meds so you don't many any medication errors. I never pull narcotics until right before administration either. All of that being said, always double-check with your ANM/manager that it's okay per policy.