I just started a job in LTC last week. I never worked LTC before. I have been a nurse for 3 yrs but I worked in Rehab and only had 15 patients on day shift. Now I am working 3-11 and have 30 pts. I am to be part time in a facility with 180 beds. I will be a floater.
I oriented 4 shifts so far. The last 2 shifts, I was told by my preceptor to go ahead and do the med pass since she watched me already.
I am having a hard time #1 getting done on time (My preceptor had to jump in at 10:30 to help me finish up and she did the treatments and there was a re-admission to the floor) I was getting upset. She said to me "Now you know why I give all my meds at one time" "otherwise, you'll never get done." I simply nodded my head in agreement but I am bothered by this. 9 pm meds should not be given at 5 pm just because they are "going to go to bed eary" "just give them everything"
What should I do? I ended up going back to patient's rooms at 10pm waking them up and they were angry. I tried to explain I was new, etc. but--- HELP!
Wow, why isn't first shift giving the insulin. At least in our facility aand the couple of other facility I have worked in, 3rd shift checks the blood sugars and 1st shift gives the insulin just before breakfast. Exactly what type of insulin are you giving? That is a long time between getting the insulin and getting breakfast, especially if they are running late on any given day.
I couldn't tell you why first shift isn't giving the insulins, believe me, it would save me a lot of time if I could solely do blood sugars at 6-6:30am for the day shift, and have them admin the insulin. I could actually start my med pass at 5:30am instead of 5am! But, it would probably come down to "day shift has too much to do!" or "that's the way it's always been." I generally have to start my blood sugars early (like the above poster) in order to get done on time. I have about 8 blood sugars to do in the morning, and with the slow old machine we have, it takes me awhile.
The nurses at my facility tell me that they memorize which medications their residents receive. That sounds all fine and good, except I've found several med errors that they didn't catch because they apparently don't look at the MARS anymore except to sign stuff off. (Which I've seen done in one fell swoop at the end of the day).
I made a major med error last week, and practices like that were a contributing factor.
The DON a my ALF recently looked into this. A lot of med times were changed. If I was giving an HS med at 6 because the patient was in bed by 7, the time was changed to 6. The only drugs we have to give exactly at the ordered time are Sinemet and some antibiotics.
evilolive, BSN, RN
193 Posts
I couldn't tell you why first shift isn't giving the insulins, believe me, it would save me a lot of time if I could solely do blood sugars at 6-6:30am for the day shift, and have them admin the insulin. I could actually start my med pass at 5:30am instead of 5am! But, it would probably come down to "day shift has too much to do!" or "that's the way it's always been." I generally have to start my blood sugars early (like the above poster) in order to get done on time. I have about 8 blood sugars to do in the morning, and with the slow old machine we have, it takes me awhile.