Is this an acceptable practice???

SuesquatchRN, BSN, RN · Jan 28, 2009

Well, that is a long time for 20 people, but are you doing more than straight meds?

All of the suggestions you have been given are common practice and will get you cited during survey. Pre-pouring is a non-no, and meds in open cups can be contaminated.

How long have you been doing this? It takes time to get it really down.

:)

systoly · Jan 28, 2009

That does sound like you are taking a long time, but a lot depends on the type of meds and patients. Do you have a lot of liquids and eye drops? Do you have a lot of g-tubes, dementia patients? Is it the AM med pass? Do you take a med cart down the hall? Can you provide more specifics without violating HIPAA privacy regulations?

mume2mykidz · Jan 28, 2009

I just started passing meds and it takes me that long too for the same amount on the 7-3 shift

my problem is the narcs,open the box,punch out,sign the other book,put back in the box in order{which during count I have screwed up}I am going to go back after the pass and do my own count so that everything is in order when I do the count with the next shift}

I wont pre-pour because I am afraid I will get confused I also sign the mars as I go unlike the pro's they sign later,so I think this takes up time too...

just take your time,at least thats what they keep telling me.

yoshana_x · Jan 29, 2009

well i am not even sure why i take so long yes i do stop and at times do wound care but for some reason I start out seeming like I am progressing well but then its as if i take a downward turn. I do try to go in early to do the BP's that are required for many meds and that is another thing I have seen the 'PRO's" skip things liek that taking apical for dig not doing BP for HTN meds and I guess stuff like that slows me down not to mention if somehting out of the loop happens. I don't know sometimes I wonder if I am cut out for this.

To answer the previous question this is the 7-3 med pass lots of crush with some difficult I dont' want to take it and I do stand there and watch until they take it all and that takes time when some pt have 10 and they taking it 1 at a time.

If you have any suggestions keep them coming.

Thanks for the feed back

agldragonRN · Jan 29, 2009

i am recently employed in a ltc facility and have a couple questions
1) how can i speed up my med pass i take all of three hours to do 20 patients i think that it is a very long time so any suggestions will be good
2) someone suggested that i prepare my meds in individually marked cups during the early hours i was wondering if that is legal as in can i do somehting like that when the state is there.
3)someone else suggested that i put stock meds that i constantly open adn close a small quantity in a cup of each (ie feso4, chew asa , vit c, oscal etc) is that legal and can i do that hwen the state is there observing.
hopign to hear what everyone has to say i want to see what i can do tomorrow to speed myself up.

i have 25 ltc patients on 3-11 shift. but i do ot on 7-3 and 11-7 shift so i know how they are like.

i am also a new nurse less than a year. you have to take "safe" shortcuts in order to survive and get done with everything. if you follow everything by the "book", you would be there for 24 hours. only you can know which shortcuts are safe. for example, i have a patient that has lipitor for 8 pm and that is the only med at night so i give it on my first round med pass at 5pm so i don't have to give her anything later on. but i don't do this for bp meds, antibiotics, narcs, etc. you also have to be familiar with the particular patient in order to do safe shortcuts.

of course when the state is around, you cannot do any shortcuts so you do need to know how to do everything by the "book".

mume2mykidz · Jan 29, 2009

I am in the same boat,no they don't take B/P which I don't get,the state was there this week and I didn't have to work thank god because I would have been freaked out since I am brand new...

JoAnnS · Jan 29, 2009

i have 25 ltc patients on 3-11 shift. but i do ot on 7-3 and 11-7 shift so i know how they are like.
i am also a new nurse less than a year. you have to take "safe" shortcuts in order to survive and get done with everything. if you follow everything by the "book", you would be there for 24 hours. only you can know which shortcuts are safe. for example, i have a patient that has lipitor for 8 pm and that is the only med at night so i give it on my first round med pass at 5pm so i don't have to give her anything later on. but i don't do this for bp meds, antibiotics, narcs, etc. you also have to be familiar with the particular patient in order to do safe shortcuts.
of course when the state is around, you cannot do any shortcuts so you do need to know how to do everything by the "book".

hi

i am also a new nurse. i work 3-11pm shift and i am there till 1 or 2 or 3 am. it is impossible to pass all those meds.. do b/p & a/p's and all that jazz.. i have 40 residents. i am only at this job since the last week of nov... yes i do hear about some short cuts... but come on.... a new nurse really can't start making his/her own decisions on which meds to give at which time. unless you got flying colors in chemistry..

the whole thing flips me out. i got home at 3am cause i had people where their b/p's were high, who took off their o2.. etc......

40 residents is a lot and i'm not sure this is not acceptable. i have to call or write to find out what the limit is on passing meds.

thanks

allnurses Guide · Jan 29, 2009

Putting up with this kind of practice is exactly what has gotten nursing into the fix we are in.

If you can't follow the safe practice rules because you are over loaded with patients, bending the rules just allows the unsafe staffing problems to continue.

Pre-pouring and meds in open cups and giving meds 3 hours from the time they are supposed to be given are all wrong and against the rules.

Don't take a job that forces you to make a choice between being a safe nurse and one who has to cheat to get the job done.

Seriously - we are professionals and should work like professionals.

You can't be taken advantage of unless you give permission.

steph

rnlately · Jan 29, 2009

I just started passing meds and it takes me that long too for the same amount on the 7-3 shift
my problem is the narcs,open the box,punch out,sign the other book,put back in the box in order{which during count I have screwed up}I am going to go back after the pass and do my own count so that everything is in order when I do the count with the next shift}
I wont pre-pour because I am afraid I will get confused I also sign the mars as I go unlike the pro's they sign later,so I think this takes up time too...
just take your time,at least thats what they keep telling me.

Never sign later; you'll leave holes and then your supervisor will either have a "Come to Jesus Meeting" with you or leave you a "nice" note close to the end of the month for you to rectify the errors of your ways. :bugeyes:

momtojosh · Feb 4, 2009

i have 12 residensts who are all g-j tubes....i start meds at 6:30am and i am not done til almost 9..which is fine.....we have an hour berofe and hour after rule for meds.....some of passes i have to do require bolus feedings which takes time....the others are continuous......i ahve to crush,measure and fix flushes.....sometimes the tubes are plugged and i have to unplug them...sometimes i walk in and a resident may have the tube out playing with it...have to put it back in.....i love it though...i wouldnt trade it for world....these 12 medically frail mentally retarded people at work are like my kids...i love each and everyone......

oh...i am not strictly on meds everyday......there are 5 lpns who work the floor and we all take turns....one nurse does strictly treatments too.....so the med nurse doenst have to do that.....

i remember in clinicals giving an 8am med at 11 or sometimes noon....i guess that is common tho right,cause we are all new....and there is only one instructor for 8 students....

i would never give a 8pm med at 5 tho....yikes

lindseylpn · Feb 4, 2009

You'll get faster with time.You'll eventually memorize everyones meds, know where everyones meds are in the cart, whos bp to take, who's gonna ask for a prn, who's bs will be low etc. Med passing eventually becomes like second nature and you'll breeze through those 20 people in no time. Good luck, just remember it won't always be this hard.