Interesting convo with a former coworker...

[herculean]

A friend/former coworker and I were speaking on the phone, and she told me about an LPN at her job. This LPN apparently finishes morning shift med pass in one hour or less, for 25+ patients and then sits at the desk for the remainder of the shift, helping out the floor supervising nurse with paperwork. Apparently the other nurses are upset because they feel as though she should be helping them if she finishes early. My friend suspects that this LPN probably does not pass all her medications.

I told my friend that she should say something to their immediate supervisor immediately, but my friend/ex-coworker thinks that she should stay out of it, mind her own business, and eventually this LPN will "get caught."

I'm appalled that someone would jeopardize their license by obviously not giving people their medications and/or taking lots of shortcuts.

Any thoughts on this? Do you think its possible to complete a med pass at an LTC in less than 2 hours? If so should this nurse help out the other LPN nurses with their paperwork, patient care etc? What would you do? :)

[TheCommuter, BSN, RN]

It is possible to pass medications to 20+ elderly redients in one hour if you know them very, very well. Some LTC nurses are less bubbly and talkative than others and can complete their tasks more efficiently. Compassion is not efficient.

You see the same faces daily and already know that Mrs. Smith gets a calcium and a Lopressor 25mg while her roommate gets Colace, Senna, Diovan, Metformin and Januvia because you pass to the same folks day after day.

[Nascar nurse, ASN, RN]

I agree with Thecommuter. Back in the day I had 50 LTC meds (true ICF, not skilled). There were just 2 of us that could bust out that med pass in less than 2 hours but we were full time & had both been there for years. Not only did I have most meds memorized, I could have reached into the cart blindfolded to pull the pills....at least until some ding dong decided to clean & rearrange the drawers. The DON followed me one day saying it couldn't be done. One time with each of us & we were never questioned again!

Compassion is not efficient....sad but true!

[mvm2]

Also she might have 25 patients, but maybe she does not have a heavy load of meds to pass. It could be possible that a few of those patients may not have any meds to take, or maybe like nascar and commuter she just knows how to organize her med pass really well and it is not a difficult one for her. Also I would not jump to conclusions that she is not passing all her meds. She obviously is close with supervisor, and I would suspect that if the supervisor thought she was rushing her med pass she would be observing her to make sure she was doing her job properly.

Though I can see why the other nurses feel that maybe she could help them out once in awhile. Personally if I had a lot of time on my hands, I would probably help the supervisor with some paperwork, but also help my fellow nurses and CNAs as well to see if they could use a hand.

[PeacockMaiden]

It's dangerous to pass meds on 'auto pilot'. People in the SNF do sometimes have changes in meds or dosages, and so one still needs to read the MAR carefully and do the 3 checks of medication administration.

When I was working at a SNF, I could never do the med pass in one hour. Anyone who says they can are probably cutting some serious corners.

[doppelganger2]

If they truly believe the nurse is not passing meds as scheduled and have proof of it then bring it up to the immediate supervisor.

From your own statement it seems as though this nurse is finishing and with that extra time is helping the supervisor.

Maybe instead of the other nurses throwing accusations around they should ask this nurse how she is effectively managing her time and learn some new things OR better yet pay attention to what they are doing and they might get done faster.

I've been the nurse with 20 plus ltc patients, and it turns out if you stop flapping your mouth, pay attention to what you're doing and actually do it, things get done.

[youngheartoldhead]

Sure a med pass can be done in that time frame. if the nurse doesnt get distracted and she is organized.

And NO she shouldn't be expected to help anyone when she's done. why should someone get punished for being efficient?

[Blackcat99]

I use to work in a nursing home many years ago where it took everyone at least 3 hours to complete the morning med pass. It was interesting when they would pull the "education nurse" off of his job and put him on a cart. He always finished his med pass in about 30-40 minutes every time. It was obvious to all that he was not giving everyone their meds. Everyone knew it and nothing was done about it.

[heartsgal, ADN, RN]

If she is used to she and didn't have accu- checks also, then she probably can. I'm new at my SNF, so 10-12 accu-cheks and 5-7 scheduled insulin and often sliding scale on top of that along with med pass take me 2 hours or more some days, but the other nurses are finished way before me because they're used to it and know what the pts get. She shouldn't say anything unless she has first hand knowledge she isn't passing all the meds because it is simony an assumption on her part.

[Melfldrn]

I can sometimes get done in about an hour. I work night shift and I'm passing 6 am meds...which isn't as many meds as the day shift girls have....tons of blood sugars though! My co-worker on night shift and i have a great work relationship though so if one of us gets caught up with something, the other one will pick up some slack for each other. We are lucky and are probably in the minority!

[herculean]

4 gastrostomy tubes, 10 blood sugar checks and all the other morning meds. In addition to checking blood pressures prior to administration of meds, there's no way this can be done in one hour.

[DHawkinsrn]

It's sad that no one has asked the LPN how she does it? Instead the assumption is made that she is doing something wrong.