med pass procedure on your unit

[jessnurse05]

I was reading the thread about not giving meds that you didn't draw up and it reminded me of an issue that I've been having lately on my unit.

I'm still fairly new so I probably have RN-itis and I also am still filled with some of the nursing school idealism that doesn't apply to real life. But lately I've been having trouble being able to do my med pass without being interrupted umpteen times by usually little things, but I get the charge nurse breathing down my neck to go answer call lights and do other things when I'm right in the middle of pulling out meds. I do see all of my pts before I do my meds so I know what condition they are in. Usually what they want is to brush their teeth or wash their face and the CNAs take care of that. When I try to tell this charge nurse it comes out sounding a little uncaring of me, but I don't want to make a med error because I was interrupted while I was pulling out my meds. The other day I was on the phone with the pharmacist trying to straighten out the new TPN orders and the charge is telling me about my IV beeping, yes I know it's beeping, but I'm on the phone at the moment and I can't turn it off. I will be off the phone in a few seconds, then I will be able to stop the beeping and hang the new TPN.

Is this a problem everywhere? Do you guys go somewhere to get out meds so you aren't interrupted?

Sorry I had to vent about this. I've been very tired from work lately, I work on a med/onc unit and the pts seem to just get harder and harder every shift. And I always go home thinking about all of the things that were done wrong on my shift that the day nurse notices (pt NPO, but accuchecks still done AC &HS instead of q6hrs, etc). I don't know why I don't catch these type of things.... It just makes me more tired to think about it. Most of the time the day nurse who gave me the pt didn't catch it either, it's still not right but it makes me feel a little less incompetent....

Jessica

[KaroSnowQueen, RN]

Your charge nurse sounds like a micro-manager. Place a clean sheet of paper on your clipboard and make a note of everything she tells you, if you're on the phone, do it, smile and motion to it, and continue on about your business. If the pt needs CNA help more than yours, if you're busy, ask them to page the CNA.

Yes, this does happen, maybe not to this degree, but it does happen everywhere, everyday.

[HeatherLPN]

Is there some reason that your charge nurse can't take care of some of those things? Teamwork is so important for our sanity and our patients.

[steelydanfan]

OK, to get right to the heart of your post:

Medication distribution is one of the RN's most important functions, and PROPER med administration is one of the RN's most pertinant duties.

Med errors are the #1 cause of legal action against RN's.

Medication administration is often times fraught with interuptions by:

Phone calls, pharmacy needing pyxsis acess at the same time, call lights, etc. You simply have to state "I'm doing meds here, please do not interrupt me". It sounds trite I know, but it WORKS!

I don't think much of a charge nurse who is breathing down your neck instead of answering lights for a nurse she can clearly see is busy with other tasks.

Find a new job.

[sc11111]

Yes it is busy..somedays busier than others....but med errors are something you can't take back...and it is important that you have the time to think through this process daily. I agree with the others write it down to acknowledge you heard her...and continue what you are doing....we have started something that works really well when we have it....we have tasking nurses...nurses that come up to our floor for a short period of time, they may not be needed on their unit at the time...they answer lights, help with med administration, hang IV's, restart IV's, help with admissions, give pain meds....generally are angels....when possible our charge nurse is given no patients and they act as tasking nurses...I also agree with the idea that the charge nurse that is breathing down your neck is not showing you any respect and perhaps you do need a different job. Cooperation starts at the top.

[Tweety, BSN, RN]

I don't have any answers. Perhaps you need to sit down with the charge nurse and have a face to face talk.

I don't think because the charge nurse is informing you of patient call lights and beeping machines that she is "breathing down your neck", being lazy or disrespectful. She is only doing her job and she can't ignore patients calling. The charge nurse can't get up and answer every call light and every beeping machine on the floor. Although interrupting your phone call was not appropriate.

When you have her face to face talk you can ask her to find out what the patient needs and if it's something a CNA can do so you're not interrupted.

There has to be a happy medium somewhere. Making yourself completely unvailable to interruptions during med pass is not appropriate.

Good luck.

[KellieNurse06]

When we did clinicals at a hospital in our 2nd semester..there was a med room that didn't have locked doors on it..it was a little room that was like a small hallway and they had a big sign on the wall at each end it was a stop sign then underneath it had in big black letters Do Not Enter If Meds Are Being Obtained By Nurse Please Wait Unless It Is An Emergency

If we even tried to walk through just to get to the nurses station on the other side of the med room we were in big trouble by our instructor...if you had meds to do you stood against the wall waiting until the person in the room was done, many times there were a line of us if we all had meds at the same time....I can honestly say everyone respected the posted sign...I never witnessed anyone getting interrupted when I was there ....I liked the sign thing.....it seemes to work very well.......Just an Idea maybe if you talked to the other nurses about something like this....it may work.....good luck!

[Ms.RN]

Was she just letting you know that your TPN machine is beeping or did she want you to put your phone call on hold and turn the machine off?

Does she answer the call light herself, try to find CENA who is assigned to the room, or page overhead that the call light is on in certain room?

All she have to do is to page overhead to alert the CENA that call light is on.

Frankly i cant work with nurse managers who are breathing on my neck. How can she be a charge nurse if she doesnt know the concept of what the team work is?