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?

[sugarmagnoliaRN]

At the end of the day, it's always nice to set the next shift up for a good 12 hours, regardless of whose "problem" it is to give the meds.

[RainMom]

We rarely have 0730 meds but I'll try to give them; otherwise I give a heads up to the oncoming nurse.

Night shift gives AM insulin here (scheduled for 0700 - stupid, I know), so I start rounding about 6:20 or so to remind my diabetics to order breakfast asap (dietary opens at 0630). Then I can be giving insulin just before report or often take it with me so that the oncoming nurse can cosign during report.

[brownbook]

I think the elephant in the room is why in the heck are any meds (with a few exceptions) scheduled to be given at change of shift. The exceptions should be very few and far between and it should be clearly stated in policy what shift gives them.

Unless timing is critical meds should scheduled at a minimum of one hour before or after change of shift, and ideally two hours.

ISMP safety practice administration guidelines advise a one to two hour window before or after a scheduled med is due for it to be given.

[BrandonLPN, LPN]

Is there any earthly reason meds truly need to be scheduled at such an awkward and inconvenient time? The answer is probably no.

[ixchel]

Is there any earthly reason meds truly need to be scheduled at such an awkward and inconvenient time? The answer is probably no.

Right??

The way we schedule is ridiculous.

ACHS:

0730, 1130, 1630, 2200

BID:

1000, 2200

QID:

0600, 1200, 1800, 24/0000

TID:

0600, 1400, 2200

Calcium/vit D or calcitriol:

0800, 1200, 1700

WB:

0800

Before breakfast:

0600

And then whenever the levoquin/arixtra/vanco may fall.

Being on the cardiac/neuro/respiratory/step down unit, we usually have many of our patients with all times scheduled. If you're lucky enough to get those TIDs done before 1500, you JUST MIGHT be able to chart before that 1630 insulin.

[RNKPCE]

I don't think I've ever seen meds where I work due on the half hour.

We try to avoid meds due at the change of shift hour. If there are meds due at 7a night shift gives them, their shift ends at 0730. Day shift may not be done with report until after 0730

[BrandonLPN, LPN]

But try to question these extremely inconvenient med administration times, and watch how fast certain people will imply you're worse than Hitler for suggesting anything be adjusted to fit nursing's timetable.

"How dare you suggest the two 1600 meds be switched to 1700 so they don't run the risk of turning red when you can't quite make it in by 1659? You're putting your convenience before the patient!" (As though streamlining the med pass could have no conceivable positive impact on patient care...)

[SubSippi]

But try to question these extremely inconvenient med administration times, and watch how fast certain people will imply you're worse than Hitler for suggesting anything be adjusted to fit nursing's timetable.

"How dare you suggest the two 1600 meds be switched to 1700 so they don't run the risk of turning red when you can't quite make it in by 1659? You're putting your convenience before the patient!" (As though streamlining the med pass could have no conceivable positive impact on patient care...)

My patients are just always requesting their meds to be given clustered together...if you know what I'm sayin'.

[ixchel]

But try to question these extremely inconvenient med administration times, and watch how fast certain people will imply you're worse than Hitler for suggesting anything be adjusted to fit nursing's timetable.

"How dare you suggest the two 1600 meds be switched to 1700 so they don't run the risk of turning red when you can't quite make it in by 1659? You're putting your convenience before the patient!" (As though streamlining the med pass could have no conceivable positive impact on patient care...)

Preach it!!! Amen!

[NurseLexx]

Only if it's a time sensitive medication other than that, no!

[Meriwhen, ASN, BSN, MSN, RN]

When I work NOCs, 0730 meds would belong to the AM shift. NOC may decide to give the med if things are slow and they're able to, but technically AM is responsible.

But it's also very rare for a routine med to be scheduled for 0730. Routine meds are scheduled for either 0700 or 0800 (shift change is at 0730).

[calivianya, BSN, RN]

I find it fascinating that this is an issue facilities actually regulate.

Not to be rude, but who really cares? If the 0730 isn't insulin and I have time at 0630, I'll give it. I'll definitely give 0700 things 90% of the time, unless I am just drowning in my other patient's room. If I don't have time, day shift does it. I have given 1800 meds for day shift before because they didn't have time to do it. They have given 1900 meds because they had time.

Are we REALLY that focused on who does what? Nursing is a 24/7 job. If someone else doesn't have time I'll do it, if I don't have time they will. I would wonder about what sort of coworkers you have in your facility if who gives what meds is really enough of a problem to have to be regulated.

My shift is 1845-0715, if that makes a difference.