Management of the med window

[wonderbee, BSN, RN]

I'm looking for ideas on how to better manage our straggling patients that show up whenever they want to for their meds. We do have some patients that are on close obs or wing restriction or have some other impedement that prevents them from getting to the med window during regular administration times, 9A and 9P. These are not the patients I'm referring to. It's the ones who display entitlement or just don't want to get out of bed in the morning or don't want to wait in line at night.

What works for you? Med administration for us has become like waiting tables. We have a lot of borderlines.

[inthesky]

we have the same issue.. I go to their rooms with their med sheet, a cup of water, and the night meds >_<. the only consequence i suppose is that they will get their meds last.. which meaningful when there are other patients. med pass goes so quickly those rare nights in everyone lines up="P">

[Loray]

Hi,

We do two rounds. First round call to come for medication. Second round patient's that have not come. I give the patient's the choice of coming in 2 to 10 mins. Most respond to this.

Cheers Loray

[kiwipsychnurse]

We have a locked smoking room and the room remains locked until everyone takes their meds. Peer pressure.

[green12, BSN, RN]

Our nurses all have their own style in the med room, and I have developed mine over time. If it's the am med pass I'll wake up the stragglers with my most annoying cheerful persistant attitude because I think they should be getting out of bed for tx/food/shower or whatever. If it's the hs pass then I will enlist the help of the other staff, especially census person, to steer patients to the med window which helps. If the patient has gone to bed I deliver- I want them to fall right back to sleep for the rest of the night! The stragglers used to get on my nerves but I have made peace with it. If you haven't noticed, nursing is like waiting tables, and I've made peace with that as well (it helps that I actually liked my waitressing career).

[RN007]

If you haven't noticed, nursing is like waiting tables, and I've made peace with that as well (it helps that I actually liked my waitressing career).

:rotfl:

[RN.38SPCL]

Tell them it's their responsibility to come get their pills. they are adults right? tell them "no show...no pills..no excuses." I bet they'll show up after the first time they miss their drugs.

[RN2begin]

Tell them it's their responsibility to come get their pills. they are adults right? tell them "no show...no pills..no excuses." I bet they'll show up after the first time they miss their drugs.

I doubt it as most don't want to take their meds in the first place. They would most likely take me up on that offer...

[wonderbee, BSN, RN]

Tell them it's their responsibility to come get their pills. they are adults right? tell them "no show...no pills..no excuses." I bet they'll show up after the first time they miss their drugs.

Tried that one. The result is no meds = sicker patients and angry docs and nurse manager. I like the rationale in the abstract though.

[aloevera]

our techs wake everyone up...they go to breakfast then when they come back they have to pass the med window.....that pretty much takes care of am meds. then same for noon.....after lunch, same for dinner, after dinner.....works out really well......a few sometimes on their first day may not get up but when they do, they generally come looking for their meds...

I have never worked the 9P pass so don't know how the night shift does, but days goes pretty smooth..never have to go hunting them down...

[wonderbee, BSN, RN]

Thanks for all the ideas. I usually work 3-11 so 9p med pass is mine. We experimented with giving snacks at the med window. That was successful for the most part. What we finally settled on was not opening up the kitchen and vending until most meds have been passed. That seems to work best.

[inthesky]

i think my unit is doing something wrong >_<. i end up hunting down and giving bedside meds to patients a night of having pts>