Med passes

[payitforward]

I would like to know if there "rules of engagement" when you are on the need cart, attempting to pass meds and CONSTANTLY get interrupted,by either resident s or family members. I was on my cart, in the middle of my med pass and several family members kept coming up to me asking me questions that would take me away from my cart. I explained to one, (who just stood there) that I was in the middle of med pass.some folk will say okay,some are so nasty.

[Davey Do]

I have my own"rules of engagement" which are obviously much like yours, payitforward, and have received guff from my supervisor when I informed a family member they they had to "wait your turn".

I have also said things like "Excuse me, but I'm focused here". I don't give a rat's rear if they are put off by my appropriately direct method. Priorities are priorities and from this I will not budge. My focus upon a skilled nursing duty will always be more important than some ignorant need for less important immediate gratification.

Another line I've used is "Unless you're bleeding from one or more orifices, what I'm doing here is more important".

I could go on and on, payitforward, but to you I say,"Keep on keeping on".

[AlwaysLearning247, BSN]

I would just politely tell them that you’re in the middle of passing medications, which needs your full attention to avoid making an error. Tell them you’ll be with them when you are done (unless it’s an absolute emergency).

[myoglobin, ASN, BSN, MSN]

1 hour ago, AlwaysLearning247 said:

I would just politely tell them that you’re in the middle of passing medications, which needs your full attention to avoid making an error. Tell them you’ll be with them when you are done (unless it’s an absolute emergency).

In the ICU I explain that I will attend to their needs absolutely as soon as possible. If it is an emergent, urgent need and I cannot delay my med pass I ask the charge or another nurse to assist. If they push me I often say with my characteristic, psychopathic stare "look I don't care if my only son was bleeding to death in the ER, I'm not going anywhere until I hang this levophed drip because this clients life is dependent upon me doing just that. I will however continue to endeavor to attend to your needs absolutely as soon as possible". They usually back slowly out of the room at that point.

[payitforward]

Thank you! I find that unfortunately, the old adage of "An emergency on your part does not constitute one on mine", comes into play. Im trying to do what I need to do to prevent errors, and still give good customer service, but sometimes I feel like folk honestly believe that YOU ARE suppose to drop what you are doing and cater to them. They will either stand right there by the cart, or go back to the room and wait in the doorway until you come. I find that to be very annoying, and I'm REALLY trying hard not to show it on my face! whoooooooosaaaaaaa

[Davey Do]

25 minutes ago, payitforward said:

"An emergency on your part does not constitute one on mine"

Good one.

I've modified the adage a bit with "A priority on your part does not necessarily constitute one on mine".

Something has been said along the lines of "We don't ask someone doing nothing to do something that needs to be done. We ask the busy person because we know that it will be done".

When I'm busy and someone asks me to do something which I don't consider to be all that important, I will say, "I'll put that on my list of priorities. But I have to tell you, it'll be at the bottom of the list".

[JKL33]

6 hours ago, payitforward said:

I would like to know if there "rules of engagement" when you are on the need cart, attempting to pass meds and CONSTANTLY get interrupted,by either resident s or family members.

It seems like this would vary based on what alternatives they have besides interrupting someone whom we know is involved in a task that should most safely be done with out multiple interruptions.

If the place is staffed such that there aren't others whom they could fairly easily engage with their requests and needs, then that is a problem that is not your fault but not theirs either.

3 hours ago, payitforward said:

They will either stand right there by the cart, or go back to the room and wait in the doorway until you come.

At least some of these people are trying to be polite - - just like the folks who walk up to the nurse's station and tell their needs to whomever is standing there rather than pushing the call light. They feel it better to whisper, "when mom's nurse has a minute..." to someone in person rather than yelling back and forth through a speaker on the wall for something that they know can wait. I get that.

Maybe you could make a sign that says "Quiet Zone" like they did for areas where nurses were obtaining and preparing medications in hospitals, and hang it on your med cart ?. But no, in all seriousness, unless there is a realistic, readily available and well-publicized and effective alternative..the interruptions, the stalking, the sidling, the hallway monitors, the door-way lingerers....that's what you're gonna get.

[JadedCPN, BSN, RN]

Whenever I admit a new patient, part of my spiel of orienting them to the unit and routine involves discussing typical med pass times and the importance of minimizing interruptions. I also inform them of change of shift/nurse report times and educate them that studies have shown less interruptions can lead to improved safety. I make sure they know that if there is a true emergency, by all means they can interrupt, but otherwise try to avoid these times if possible. It works like a charm most of the times.

[TriciaJ, RN]

"I'm sorry. I have to focus on this. Accuracy counts."

[Tenebrae, BSN, RN]

I usually ask "are they breathing? Do they have uncontrolled bleeding"

"I need to finish this, I will be with you in x amount of minutes"

[Glycerine82, LPN]

If i'm in the middle of prepping I finish the med I am on, pause to say "just a moment please" they usually get the idea by then. If it's a CNA I ask them to levee me a note if its not an emergency. For family members I address whatever the issue is as soon as I can but I don't allow them to stop me mid prep.

[CardiacDork, MSN, RN]

The worst for me is:

I am assessing my critically ill patient and the family calls. The HUC comes to the room to inform me the family is on the phone, I tell the HUC that the family can either try calling back in 15 to 20 minutes or better yet I will call them within the next few minutes once I’ve done all my safety checks.

Here is what makes me mad. When the family says they’ll just wait.

I tell the HUC, tell them then they may be waiting a while.

I dont give a RATS A** I am not leaving the room to answer your phone call.