Impossible to work correctly

I understand! I would never cut corners as a nurse. I would prioritize and delegate. I make sure that my fs and insulin is done first. I know which meds are critical for 30 min windows. I know who will refuse or be LoA and offer before I draw up.

Oh! I also think that we need to remember that this is 24 hour nursing care. There is always work to do....support your peers. Give and receive work that is hanging in the transition and enpower yourself and your culture.

Did you say 5hrs for one med pass with 22 residents??! Sheesh. It usually takes me about 2.5 hrs with 29 residents. Once you find your routine, and know what residents to tackle first, it usually cuts down your time. The hardest part is learning and figuring out your residents. Once you get that mastered, you'll do great!

As soon as you get your time management down, that med pass will be under 2 hours. Never chart something you do not do. I had 23 PEG tubes and over 30 blood sugar checks. It took me 8 hours to do my first med pass, after that I got a routine down. Good luck

I agree with TheCommuter 100%. Trying to do too much too soon will completely burn you out. When I first entered in SNF, I would come in to work 15 minutes early and I would write in my notebook which assignment I had, which vitals I had to do, write down how many g-tubes, trachs etc were on my assignment, see who had appointments and what time they were leaving and broadly look over what treatments I was responsible for that day. Just having somewhat of a game plan for the day helped me with my time management so I wasn't caught off guard. The name of the game in SNF and longterm care is multi-tasking and time management!

Just like being an athlete, you will speed up with time. Eventually you will have the MARS memorized and med pass will go quickly.

Just like being an athlete, you will speed up with time. Eventually you will have the MARS memorized and med pass will go quickly.

BUT (not stating YOU do,M.A.N.) don't rely on that. I've seen too many nurses get burned.You will get into a zone...it just takes time

Yes don't try to memorize your MAR as it changes too often. I tend to know who gets blood sugars, puffers, eye drops. Pretty much anything that isn't in their blister packages. I still double to check to make sure they are still in MAR, but knowing who gets what is helpful. We don't have daily vitals on most people. We have daily BPs (not very often), or weekly BPs but I usually do them after the breakfast medication pass as they are only daily/weekly. You will get quicker.

You'll definitely get faster as you get to know the residents. When I first started working the LTC unit at my facility, I was horribly slow and med passes felt like they took forever. The beauty of LTC is that the residents are stable and they aren't getting new orders every week. As you get more familiar with the residents and where meds are located in your cart, you shave off a lot of time. Instead of reading through the MAR and learning all of their meds for the first time, you can start reading through the MAR and looking for changes. Even though I have the same residents each shift, I still take time at the beginning of each shift to flip through each individual MAR and look for new orders. Don't get complacent or assume that things never change just because it is long term care. It just doesn't change on a daily basis.

With time, you'll also learn which residents you need to get to right off the bat so that you don't waste time during your shift chasing them down for meds and treatments. I also try to get the treatments that require the patients to be undressed or in bed (ie, wound care on bottoms, creams, suprapubic catheter dressing changes, etc.) before patients get dressed and out of bed for the morning. Taking the time to organize your med cart at the beginning of the shift and making sure that you have all of your supplies will also cut down on the number of trips you make to the supply room in the middle of med pass. I also try to keep my med cards in alphabetical order in the drawers so that they are in the same order as the meds appear on the MAR. If meds are kept somewhere other than a card, we jot a little note on the MAR (ie, "bottled med" or "in fridge") to make it easier to find things.

We only do vitals on the people who have parameters for holding meds or a specific order for more frequent vitals. Even that isn't a full set. If it's a BP med, we get BP and HR. If a resident is on O2, we get O2 sats q shift. If they are on abx, we take their temp q shift while they are on them. Assessments are only done if ordered or if there is a change in condition. Otherwise, I spend the bulk of my shift passing pills. I can usually finish my morning med pass and the majority of my treatments for 20 residents in about 2 - 2.5 hours. And that's with me only working this unit once every couple of weeks. I'd be a lot faster if I worked it every day.

I also found that my time management got a lot better when I organized myself by task. While I still try to cluster cares for residents when possible, some tasks such as getting blood sugars, passing out supplements, and taking vital signs are easier when you get into that groove and knock everyone out one after the other. If I try to gather all of those things and take them with me to a room with meds, I usually don't have a free hand left to knock on the door.