Med Pass Times

caliotter3 · Jul 27, 2010

There is something wrong with this picture. I would take my time, do the med pass correctly, give report when done, and only when done and request any overtime pay due. Of course, since this is management's big idea, I would also be actively looking for another job. I was going to say something very true but not nice concerning the idea, but I think you already think along those lines. Good luck getting this bad idea changed. Actually, I have always thought, with the exception of before breakfast insulin, that 8 am meds made more sense, but nobody else thinks so.

CNL2B · Jul 27, 2010

I hate the 0700 med times. We don't have many, thankfully. There are a few meds that are supposed to be given on an empty stomach before breakfast (PPIs) that are timed for 0700. Occasionally we will run into the odd antibiotic that is timed for 0700. Those are the ones that get missed the most frequently. It's the end of the night shift, and nurses are tired.

It looks like you work in LTC -- are you trying to say that your new AM med time is 0700 (the end of the night shift) -- right in the middle of shift change? That's nuts. So, we want all the night nurses, that are probably tired and ready to be done, to pass all the AM meds, many of which are the QD ones? Sounds like a recipe for med errors to me.

If that is what your management wants, I would at a minimum say that it is not possible to do an entire med pass on all your residents right before you have to leave. I would think that day shift would have to pick up 1/2 the med pass, or something.

gentlegiver, ASN, LPN, RN · Jul 27, 2010

Forgive me if I implied that the majority of the meds were due during Shift Change. My morning med pass starts at 4:30 AM, between passing meds, dressing changes, PVRs, straight caths, PRNs for those waking up, the unfortunate falls from patients who don't want to wait for my 2 CNAs to get to them, mornings are hectic to say the least. If the meds were scheduled at say 6AM, that would be ok, just scheduling them in the middle of Change-over is crazy. It's hard enough to get all the information needed passed without stopping in the middle to give a few more meds.

caliotter3 · Jul 27, 2010

If your shift change is at 0700 there should be nothing scheduled to interfere with that. Our med pass was at 0700, but day shift started the med pass after report and when they were good and ready, closer to, maybe, 0730. I am very certain that the med pass did not end promptly at 0800 either. Night shift has enough trouble with anything that is scheduled for 0600 much less the 0700 pass. This just plain does not make sense.

eriksoln, BSN, RN · Jul 27, 2010

I work 11PM to 7AM. The new fad for new admits or orders are to schedule them for 7AM! This is usually done by the 7Am to 3PM shift, and the ADON has decided that all 7AM meds are to be passed by 11PM to 7AM shift. This means I am literally passing meds during Shift report!! Yes, I know we are allowed 1 hour before to give the meds, but, they are usually due to patients who will not take them until the moment they are due and get angry if you are 5 minutes late getting to them. Anyone else with this problem??

Honestly, I don't have a problem with this. My shift ends at 0730. We use "voicecare", the phone recording system of giving report. That half hour overlay we have between shifts, I'm watching the pt's while others listen to my recorded reports.

I have given 0800 meds to a few pt's during that time to help the day shift out. They love me for it. Then, they hang up the phone, I give a few updates and answer questions and...........thats that.

IDK. I guess if you give verbal report it's different. I just.........don't have an issue with it.

SaltyNurse · Jul 27, 2010

I agree, nothing should rush med pass or report. Plus, that is when people are waking up and also want to go potty. Just not a good time.

Nurses still do recorded report? What? I thought JCAHO nixed that!

eriksoln, BSN, RN · Jul 27, 2010

I agree, nothing should rush med pass or report. Plus, that is when people are waking up and also want to go potty. Just not a good time.
Nurses still do recorded report? What? I thought JCAHO nixed that!

Hecks no. I believe they prefer that type of system (the phone recorded reports). They keep all reports on log for...........years. A lawsuit or complaint comes up.........they can listen. Pt. claims no one helped them walk in the hallway and report gives details of them being ambulated.........there you go.

Or, in my case, when a nurse claimed I did not tell her in report that a med was given, they went back to see. I actually mentioned "Pt. got their coumadin at the scheduled 1800 time" three times. She was fired.

Perhaps they nixed the tape system that gets recorded over every day. No records. IDK.

CNL2B · Jul 27, 2010

Honestly, I don't have a problem with this. My shift ends at 0730. We use "voicecare", the phone recording system of giving report. That half hour overlay we have between shifts, I'm watching the pt's while others listen to my recorded reports.
I have given 0800 meds to a few pt's during that time to help the day shift out. They love me for it. Then, they hang up the phone, I give a few updates and answer questions and...........thats that.
IDK. I guess if you give verbal report it's different. I just.........don't have an issue with it.

OP is talking about passing meds in LTC at shift change. She is probably talking about a whole hallway's worth of people. It's a lot different than doing scheduled meds on 2, 4, or even 6 patients. I think you are comparing apples to oranges.

eriksoln, BSN, RN · Jul 27, 2010

OP is talking about passing meds in LTC at shift change. She is probably talking about a whole hallway's worth of people. It's a lot different than doing scheduled meds on 2, 4, or even 6 patients. I think you are comparing apples to oranges.

I can't find where it says LTC. IDK. I'm lost now.

Mind you, when I do this to help out, I don't rush and try to pass meds to the whole assignment. If I get 2 done, thats that. If I get 3, even better. W/E time allows.

Guess thats where it is different though, I don't have to complete it for everyone.

kcochrane · Jul 27, 2010

At my last job in LTC we stopped scheduling them for 7am. It causes confusion if you have a float or agency. They don't know if 7am is the night or day shift. We had a float give insulin a second time because she thought the 7am pass was hers. But nights do the MARs so we were able to change them all to 6am.

I think its a bad idea - can you talk the NM and see if they can be changed? We were allowed to change times as long as the MD didn't state the time in the order. If that fails, I'm with caliotter3, do your med pass as its stated and let days wait. They will get sick of this after awhile.

Many hospitals are changing their times to at least an hour before or after report in order to give nurses times to get report and get settled in.

gabrielle76 · Jul 27, 2010

I worked 11-7 most of my career. 0700 is not a smart time for a med to be scheduled for. Not only being COS but Nights always has less staff. I spent the majority of my time helping my CNAs out because my patients shouldnt have to wait to do things like......go to the bathroom! Your ADON is nuts, she obviously has no concept of what is done by the night shift and when she is out of compliance with med times....she will wish she listened to her night nurses!