Interruptions during my med pass

Nurses Safety

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  1. How many interruptions have you experienced in one med pass?

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      Which shift do you think have the most interruptions?
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15 members have participated

I am sure this subject has been covered here but it is a problem that continues to put

patients in jeopardy.

Just yesterday, I was working the 3-11 shift at a LTC facility. We do have a policy that nurses are not to be interrupted during the med pass unless there's an emergency. It's a policy that is easily overlooked. I counted eight times during my 8 PM med pass I was interrupted and out of those eight times I had five near-misses (or near-hits) meaning I caught the med error before the patients were harmed. It really bothered me that I almost gave the wrong meds to the wrong patient because my supervisor interrupted me to ask me if a patient is wearing a cervical collar (she could've checked this herself) or a family member is in a panic because her mother didn't eat all her dinner. The crazy thing about all this is that I went along and investigated these things while I was in the middle of pouring. Next meeting, I will bring this subject up. The last facility I worked we reported near-misses as well as med errors for quality assurance. I will also make this suggestion. Any other ideas?? Thanks in advanced.

Specializes in ER.

Sometimes it's easier to do what they want than to explain and listen to people complain. I recommend you stick to your guns, because if people see you making exceptions, then everyone thinks their issue is an exception. The amount of time needed to politely explain will decrease with time as people learn the new system.

If management didn't want interruptions during med passes they wouldn't have the med nurse trying to figure out doses in the middle of the hallway. Management will maximize customer satisfaction because it brings tangible results, and the med errors you make are only in theory, and easily blamed on nursing inattention, not system problems.

I work per diem on a "rehab" unit for joint replacements (LOL) which really is med-surg and sometimes LTC; they basically accept anyone and I have more people with acute medical problems then anyone there for a knee replacement. Ratio is 10:1.

There is NO regard for med passes. Management doesn't care and there are no rules or policies in place regarding nurses being interupted. Med carts are right in the hallway with no visual cues to not interupt the nurse. CNAs and family members (usually its family!!) interupt constantly, along with managment themselves. it's just expected that you will drop everything and give family members a fake smile and go get a cup of water or something. It's all about customer service and kissing butt - because who cares about the safety during a med pass, right?? I catch myself almost making little mistakes sometimes because of all the interruptions, and I'm sure they happen with other nurses too. however, I will sometimes not acknowledge the family member if I am literally in the middle of getting meds out because sorry, med safety is usually more important than their (often) pointless request. No one has ever said anything about me being rude, because I couple it with a cheery fake smile after I get done and turn to them.

I used to be FT at this facility and this is one reason (among MANY others) that I left.

2 Votes
Specializes in Med Surg.
We do have a policy that nurses are not to be interrupted during the med pass unless there's an emergency. It's a policy that is easily overlooked. I counted eight times during my 8 PM med pass I was interrupted and out of those eight times I had five near-misses (or near-hits) meaning I caught the med error before the patients were harmed. Any other ideas?? Thanks in advanced.

We are nurses; we should be able safely pass meds even if we are interrupted.

Specializes in LTC,Hospice/palliative care,acute care.

Oops...I accidently hit "like" for the above post...that was a mistake.

Specializes in Med Surg.
Oops...I accidently hit "like" for the above post...that was a mistake.

No it wasn't.

This entire thread is a little disturbing - nurses are SUPPOSED to handle interruptions while still practicing safely. If you cannot do this, find something else to do.

No it wasn't.

This entire thread is a little disturbing - nurses are SUPPOSED to handle interruptions while still practicing safely. If you cannot do this, find something else to do.

To a certain degree.

But it does get annoying when I'm in the middle of my meds and someone stops to ask me something that could wait until later. And then I can't remember if I punched the lasix out of the card...then I have to waste more time pulling the card out to make sure.

1 Votes
Specializes in LTC,Hospice/palliative care,acute care.

So we are NEVER supposed to "make a mistake?" Physicians make mistakes...pilots and air traffic controllers make mistakes.....What an absurdly high standard...

2 Votes
Specializes in Med Surg.
So we are NEVER supposed to "make a mistake?" Physicians make mistakes...pilots and air traffic controllers make mistakes.....What an absurdly high standard...

Glad you mentioned pilots and air traffic controllers. Go find a few and ask them: "How many mistakes do you want to make today?"

If you find one that doesn't say, "None," let me know.

A licensed nurse should be able to pass meds even when interrupted. Pilots should be able to handle bad weather, air traffic controllers need to handle changing routes....the list goes on and on.

Rules, policies, goals, weird vests - whatever - will never change the fact that we WILL be interrupted while passing meds. We need to practice safely even with interruptions.

Specializes in Geriatrics.

Wow, you actually get a policy for that? I work LTC/Rehab and I get constant interruptions during med passes by family, residents and staff. The only unofficial policy we have at my workplace is go ask the nurse. I have a personal policy that I will not stop in the middle of a medication pull unless it's an emergency, and if I do have to stop, I toss the medications and start over. I frequently get snide remarks or stern looks, but I don't stop a pull in the middle to answer anything due to the medication error issues.

But interruptions during med pass? Heck yeah, at least one every 5 minutes. Whether it's a doctor wanting me to drop everything to hold his hand through rounds, the DoN wanting me to drop everything to read a piece of paper to her, or a therapist coming up to me with, "Mr. Smith coughed twice in therapy, I think he has pneumonia. You need to call the doctor and get him on some antibiotics."

I've learned to deal with interruptions during med passes, though they still irritate the hell out of me.

1 Votes
I am sure this subject has been covered here but it is a problem that continues to put

patients in jeopardy.

Just yesterday, I was working the 3-11 shift at a LTC facility. We do have a policy that nurses are not to be interrupted during the med pass unless there's an emergency. It's a policy that is easily overlooked. I counted eight times during my 8 PM med pass I was interrupted and out of those eight times I had five near-misses (or near-hits) meaning I caught the med error before the patients were harmed. It really bothered me that I almost gave the wrong meds to the wrong patient because my supervisor interrupted me to ask me if a patient is wearing a cervical collar (she could've checked this herself) or a family member is in a panic because her mother didn't eat all her dinner. The crazy thing about all this is that I went along and investigated these things while I was in the middle of pouring. Next meeting, I will bring this subject up. The last facility I worked we reported near-misses as well as med errors for quality assurance. I will also make this suggestion. Any other ideas?? Thanks in advanced.

You are lucky you have a policy. My work does not so I use selective hearing. If its a family member I direct them to the DON or charge. If its a resident that needs something other than meds I get a CNA.

Glad you mentioned pilots and air traffic controllers. Go find a few and ask them: "How many mistakes do you want to make today?"

If you find one that doesn't say, "None," let me know.

A licensed nurse should be able to pass meds even when interrupted. Pilots should be able to handle bad weather, air traffic controllers need to handle changing routes....the list goes on and on.

Rules, policies, goals, weird vests - whatever - will never change the fact that we WILL be interrupted while passing meds. We need to practice safely even with interruptions.

Yes nurses are supposed to pass meds safely even when they get interrupted while pouring/passing meds.

However, since it is easier to make mistakes/loose focus when you are constantly interrupted it makes perfect sense to implement a routine that at least minimizes the interruptions.

I doubt that co-workers approach/disturb air traffic controllers or pilots with non-acute queries when they are busy with some of the more high-risk aspects of their jobs.

Part of increasing patient safety is to continuously evaluate our work environment. Since nurses are human beings they will make human mistakes. Several things can be done in order to minimize them. Among other things: education, information, adequate staffing levels, a climate where employees can admit to their mistakes rather than try to cover them up and a reasonalbly uninterrupted, organized, clutter free area with good lighting to pour meds.

Regarding your question about how many mistakes they want to make, I assume most nurses would reply "none", just like anyone else.

1 Votes
Specializes in Med/Surg, Academics.
Glad you mentioned pilots and air traffic controllers. Go find a few and ask them: "How many mistakes do you want to make today?"

If you find one that doesn't say, "None," let me know.

A licensed nurse should be able to pass meds even when interrupted. Pilots should be able to handle bad weather, air traffic controllers need to handle changing routes....the list goes on and on.

Rules, policies, goals, weird vests - whatever - will never change the fact that we WILL be interrupted while passing meds. We need to practice safely even with interruptions.

No one wants to make mistakes. What a weird statement.

"Should" is the operative word here. What is wrong with trying to reduce the risk of mistakes by minimizing (or eliminating) interruptions?

Anyway, mistakes happen, whether they are by pilots, ATCs, doctors, or nurses. I really don't know what point you are trying to make here.

As for ATCs, a mistake while I was on a plane nearly cost the lives of the passengers in two planes. Going in for a landing, almost touching pavement, and then, all of a sudden, feeling my plane ascend VERY QUICKLY. Apparently, there was already a plane on the landing strip.

Again, I have no idea what point you are trying to make here. We are all human, and minimizing risk is a good idea, not one that deserves an answer such as, "Find another profession if you can't pass meds while being interrupted."

1 Votes
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