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?

[Tenebrae, BSN, RN]

On a night shift, hand over is at 0645 and I finish at 0700. I'll give the 0630 and 0700 meds before I finish but anything else inclluding insulins is the responsibility of the incoming shift.

[icuRNmaggie, BSN, RN]

If you are working with Epic McKesson Meditech or Allscripts 0700 meds are in the dayshift column in the EMR. Likewise any 1900 meds are in the nightshift column and are not flagged as due until that time.

To avoid confusion I do not routinely give meds that are scheduled to be given by the oncoming shift and I would not want the off going shift to give meds that are scheduled for my shift. This is a standard practice in hospitals.

[SubSippi]

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.

The last time I asked pharmacy to reschedule something the pharmacist asked me when I became a doctor.

[Manda92]

Wow subsippi thankfully our pharmacy is not rude like that. But they might be kind of snippy if we start asking them to change that many med times.

[sugarmagnoliaRN]

I give the 0700 synthroid, Prilosec, carafate, etc. Anything that should be given before meals/breakfast. We do Not give scheduled or sliding scale insulin unless the Pt's food is in front of them.

This seems like best practice to me... sliding scale insulin should be given based on when the patient gets their food (which, on day shift, can be before I even have a minute to get report if they order early enough) but nexium, carafate, synthroid, etc should be given 30m before. I've worked both day and night shift and when I worked night shift I would get the before-meal meds to my patients at 0630 before I go give report so they are ready to order breakfast at 0700.

[canigraduate]

The last time I asked pharmacy to reschedule something the pharmacist asked me when I became a doctor.

You work with a turd.

[ixchel]

The last time I asked pharmacy to reschedule something the pharmacist asked me when I became a doctor.

Jeez. That's rude, huh? I work with pharmacists who understand nursing staff needs flexibility some times. They also understand that sometimes the doctors don't actually think before putting in orders. No, I don't think arixtra at 0330 is necessary. Pharmacy agrees.

[amzyRN]

As a courtesy on my unit nurses have been giving the 730 med on the previous shift. And any other change of shift med is given on the previous shift so that the next nurse won't be late on their med pass.

I work in a unionized hospital, so there is less bullying about getting out on time, but being late on meds is a big no no. If you didn't have time to give the med, don't give it, nursing is 24 hours. I've had nurses not give my 730meds because they were busy and I totally understand; so I gave the med.

[CelticGoddess, BSN, RN]

The last time I asked pharmacy to reschedule something the pharmacist asked me when I became a doctor.

Dang: I would hate to work with your pharm.'s. We call and get meds rescheduled all the time, as the Pharm. is who schedules the meds. We'll have a pt go for rad tx and have to call the pharm to reschedule an IV antibiotic all the time. (Scheduled pain meds are also reschedule a lot. I am NOT about to give a patient 2 90mg doses of MS Contin)

[michlynn, BSN, RN]

We do 0645-1915, I pass 1900 meds as a courtesy to the following shift, we aren't required to do it.

[Conqueror+, BSN, RN]

At 0730 I'm probably pulling into my driveway already. It would feel sketchy to sign those meds off on the MAR.

[CT Pixie, BSN, RN]

i work 11p-730am, days works 7a-330pm, the 1/2 over overlap is designated to giving report. The oncoming shift does those types of meds that fall in the 730am, 330pm, or 1130pm meds.

If I'm not going nuts with 15 other things I try to bang out the 730 meds for the next shift, but if I can't its really not a huge deal to the next shift because they are usually having to pull a ton of meds for the 8am time frame.