Med cart challenges

soulofme · Oct 27, 2008

Sounds like some lazy people that don't give a good gosh dern:twocents:

NurseKatie08, MSN · Oct 27, 2008

I take the time to make sure my med cart is organized at the beginning of my shift, although it's not ever as bad as you describe. in my top drawer, where the stock meds are, i keep bowel meds together, multivits together, aspirin & apap together, etc. Eyedrops, multidose vials, etc are also found in this drawer, i keep those separate by patient.

Furthermore, I go through the bubble packs, make sure duplicate meds are turned backwards so that I use the already started bubble packs first(which should be punched out in order..thats just laziness on the other nurses' parts at the facility you're talking about) When I do the count, I always make sure narcs are in the order that they are listed in the index of the narc book.

Then I make sure I'm stocked up with alcohol swabs, syringes, cups, med cups, etc. Even if other people are lazy and mess up the cart I fix it because it makes my day easier to know everything is where it should be.

lpn1313 · Oct 27, 2008

I am such a med cart neat freak that I couldn't even start working on a cart like that without reorganizing it! I agree with NurseKatie08, take the time to organize it. It may put you a bit behind, but knowing where thing are will make that time up. Plus, if someone needs nitro or glucose stat, you'll know right where it is.

twistedpupchaser · Oct 27, 2008

The 10/60 at the start of the shift sorting your cart/area is more than made up for by avoiding the 10 x 5/60 "searches" during the shift. I dont understand how some others can work with their stuff in such a mess.

CoffeeRTC, BSN, RN · Oct 27, 2008

It is probably more than just organizing the basics at the start of the shift. It sounds like the whole system is messed up. I worked prn at a place that had one drawer for 7-3 meds and one for 3-11 and a little section for 11-7. What killed me is that they had the 5pms and 9pm meds together. They would have one card for each time too.

Where I work now...each med pass has its own card. They are separated by rooms too. Top drawer has eye meds, patches, inhalers, alcohol swabs, accucheck machine. A bottom drawer has the OTCs etc. Every time I work all I need to do is neaten it up.

SunnyAndrsn · Oct 27, 2008

Although med carts CAN be a challenge to keep organized, what you are describing is unsafe.

Some days it feels like I'm the only one who tries to keep things clean and organized. I take a sharpie with me, and before I start my shift go through the stock meds and make sure they are not expired and have dates as to when they are opened. Since I don't work the same wing each shift, this can be a bit of work! But I can also see what I need to grab from the med room before I start my med pass then.

I also try to make sure that meds for residents who are no longer with us are pulled out, as well as meds that have been d/cd. Very important to prevent med errors as well.

Every couple of weeks I try and actually physically clean the drawers too.

I am a new grad LVN working F/t and have taken an oncall job recently. The on call is a problem area in regards to the med carts. Realizing I am new to the real world of nursing, however, the med carts at the skilled facility is so disorganized to the point that as an orientating nurse on the floor it took me FOREVER to just FIND the right med, eye drops, etc. None of the room numbers "flags" can be used because they do not match what pt is in that room. The meds for pt in room 100 may be in the middle of the draw and 102 may be the 4th one in. And the meds are pulled from any where in the bubble pack, in random order, from any number of bubble packs for the same med and pt. Is it just my inexperience with med carts? My f/t job is organized and flows with the MAR and pt and room numbers are matched accurately. Ointments, powders etc are kept separately yet easily found.
Spoke to the Staff Developer on the floor today and was told that they are aware of it and will be addressing it. Is this fairly typical? In the meantime, is there anything in particular I should do to assure I don't make a med error other than the 5R's. Any suggestions to make my med pass operate smoothly and without wasting so much time in the process?
I am SO frustrated after this floor orientation!!

caliotter3 · Oct 27, 2008

I am a project person. Seeing something like this and realizing that nothing will be done about it, I would take it upon myself to correct the situation. If I were you I would approach it from this standpoint. I would pick one activity. Say, you are going to turn the duplicate "open" cards around. Then I would go through the entire cart and turn these cards around. If you don't have time to do this, then do half the cart, or one row or x number of rooms. Then continue on, doing something to the cart to organize it each shift, until you have gone through the entire cart. Then, continue with this activity each time you work because chances are quite high that the people who let it get messy to begin with won't keep it up. You should also speak to your co-workers and encourage them to keep it up. Once you have done the initial work, they might be more prone to help. Quite frankly, there is no excuse for this. Going through the cart and fixing it should be done on night shift during down time. When I worked nights, we always did housekeeping type tasks to make things easier for everyone.