7:30 meds? Who is responsible for giving?

[Manda92]

My nurse manager is constantly coming up with new rules. One of the latest ones is we must give 730 meds. My shift is from 7p-7a. We are required to be on the floor by 630 to give report. Since we cannot give the 730 meds until 630 we are scrambling to give the meds and then give report and be out by 730. If we clock out late too many times, we can get in trouble. I feel like this not only stresses us out, but it is not safe because not only are we rushing but most meds are scheduled at 730 because they are to be given with breakfast. I just want to know is this common practice or are we the only ones required to give meds due after the end of our shift?

[~PedsRN~, BSN, RN]

0700 meds, Yes. 0730? That's day shifts problem.

[Farawyn]

Nights. Day shift never showed up until 7:30, are you kidding me?

[babilidose]

I give 0700, but not 0730. Just like I expect 1900, but not 1930 to be given. If in giving 0600 I try and give them at 0630 so I can give 0730 as a COURTESY if possible.

[proud nurse, BSN, RN]

Proud nurse-you arrive to work at 1900 vs our 1830? If that's the case, do you give 800 meds before you leave?

No I don't. And the 0700-1930 nurse that I follow does not give 2000 meds.

[ixchel]

I feel like after report is given, the patient "belongs" to the oncoming nurse, therefore all meds due after the scheduled off going nurse is supposed to be off (meds after 1900 or 0700) should be the responsibility of the nurse who the patient currently belongs to - the oncoming nurse. If the off going nurse makes a med error after they've given the patient to the next nurse, it's that next nurse who has to deal with the outcome and they don't have first hand knowledge of what went wrong, i.e. Over-coverage of insulin way before breakfast arrives, etc. I mean, you run that risk with 0600 and 1800 meds as well, but I know at my place, we don't give high alert meds at 0600 or 1800, so it's not as much of an issue with those.

[ixchel]

All that said, I'd give a kidney to give one less dose of insulin in a day shift. We require an RN witness, which really sucks when all the other nurses are also stuck in patient rooms.

[proud nurse, BSN, RN]

Our PCA's on night shift take the morning blood sugars. I'd only give the insulin if the breakfast tray is at the bedside. There aren't many meds scheduled for 0730 for this to be that big of an issue. I would just give it with 0700 meds around 0630.

[CelticGoddess, BSN, RN]

The policy (facility wide) where I work is that 7p shift give 7a meds and 7a shift gives 7p meds. As we can give them at 0600/1800, and report isn't until quarter til, corresponding shift has time to give said med. If it's a 0730/1930 meds (insulin is commonly given at 0730) then it's the shift who is on at that time who gives this med. It's a policy for the entire system, so managers aren't really allowed to deviate from it.

Our schedule is 6:45 to 7:15.

[Manda92]

farawyn. Then 0730 does not apply to you. I clearly said incoming shift is required to be there at 0630. It would be the equivalent of whatever is 30 minutes after your shift ends

[Farawyn]

farawyn. Then 0730 does not apply to you. I clearly said incoming shift is required to be there at 0630. It would be the equivalent of whatever is 30 minutes after your shift ends

Whoops!

[Manda92]

We have soo many meds scheduled for 0730. The past two days every single one of my patients have had 0730 meds so I've had to make a full med pass at 0630 instead of giving report which needless to say has put me clocking out late. We have addressed this with pharmacy who says it is not safe due to the breakfast thing but she doesn't care. They honestly should just schedule them for 800 because breakfast is not even on the floor until that time. The rest of the hospital only does 0700 meds. A lot of the nurses on my floor just give them early but I don't feel comfortable doing that.

[canigraduate]

That's stupid. If your manager is being a jerk about it, get some EBP together and go over her head. Especially for the insulin. That's just not safe. Or call pharmacy and have them reschedule stuff consistently until someone gets a clue. Or, estimate how much overtime you work because of it and generalize that across the shift and let the bean counters in on the situation. That will fix the situation quick enough.

I only give what's due on my shift. If I am not struggling to get finished and get out on time, then I help day shift out and give the early meds. If I'm struggling, they can hit the floor running just like I do.

The place I'm working now, they are more concerned with overtime, so this isn't an issue.