Before you start, grab a piece of paper and tape it to the top of the cart. Jot things down on it so you can chart when you sit down. :)
Also before you start passing meds take a quick look at who will need change of condition charting and why. Why you are passing meds you can take a look at Mr. green's swollen ankles, ask Mrs Smith if it still hurts when she pees, etc. Jot your notes and you will have saved lots of time later running down all these little assessments.
hcrabby, get into the habit of revising the sheet every.single.day. Orders change. It'll take just a little time.
EVERY LTC I've worked in before this one, where we have a gorgeous computerized clinical system complete with MAR, has had "cheat sheets" with who got what when, mostly BPs and insulins and sats.
You'll get it. I've had as many as 44 and nailed it. You MUST get whomever schedules meds on board with helping you turn it into two passes at different times because you MUST have the extra time or you WILL fail. Fewer than 2 minutes per resident won't do it, not safely.
I'm a RN new grad, worked at a SNF, assigned to 32 patients, and I tried very, very hard to make it work. The nurses training me hinted that I needed to take shortcuts to do the med pass in time. I told them no, I'm going to do it right (take BP before BP meds, etc.). I never finished my shift on time...then the DON said "no overtime." So I clocked out and continued to chart for 2 hours. I did that for a month. And I had a knot in my stomach the whole time. New admits from the hospital...when I took the time to assess the new patient I was further behind with the med pass.
And then things got worse over the holidays...a CNA and a nurse calling in 2 hours before their shift!! And that's when I realized...I can't do this, I can't stay here. I became attached to some of the patients, I enjoy geriatrics, but I couldn't accept the short staffing, the sloppiness, the culture of not caring---profits, profits.
I know there are better SNFs out there and I would advise any new grad to check the medicare.gov rating of the SNF where you're planning to work. I checked another rating and got some info but I didn't know about the newer medicare ratings until after I was working...Find a good one that respects the dignity and rights of the residents...and doesn't pull them outta bed at 4:00...Geez, that's just wrong!
Nascar nurse, ASN, RN
2,218 Posts
Also before you start passing meds take a quick look at who will need change of condition charting and why. Why you are passing meds you can take a look at Mr. green's swollen ankles, ask Mrs Smith if it still hurts when she pees, etc. Jot your notes and you will have saved lots of time later running down all these little assessments.