Monster Med Passes

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What's the largest number of patients you have passed meds on in a shift.

I recently took a break from ICU and took a foray into Corrections. They do 8 hour shifts. I'm the sole nurse on evening shift in their behavioral house (tons of psych meds). The house has 4 wings. The way it's set up, you have to -pre-pull meds for each patient in the med room and hand carry them up to the wings to pass them. Last night I pulled and passed meds on 125 patients (including diabetics).

What's your record?

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How long does a 125 person med pass take? That’s insane! I work in med surg, so 4-6 patients, er, “customers.”

You enjoying your “break”?

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Specializes in ICU, trauma, neuro.

Maybe 11 or 13 when I was floated to Med/Surg and had eight patients with several admissions discharges and helped a couple of other nurses. I cannot imagine how you would begin to even document a basic assessment on even 100 patients. Heck even at five minutes per patient for pulling and passing the medicine you are at 500 minutes or 8.3 hours. Just passing and documenting the medicines without doing anything else. This is what I call "license lottery" and they are playing on your dime (something I believe to be more common in LTC) where the facility saves money by "gambling" with your license knowing they will almost certainly get caught (and often have been in the past). When they inevitably get "slapped" they pay a modest fine, terminate the RN (and sometimes the facility management) and go on about their merry money saving ways. They then hire a "new crop" of nurses and management to be "used" until the next "corporate hand slapping". For some companies it is almost "business as usual". However, the RN's career is often devastated and the patients suffer.

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1 hour ago, myoglobin said:

Maybe 11 or 13 when I was floated to Med/Surg and had eight patients with several admissions discharges and helped a couple of other nurses. I cannot imagine how you would begin to even document a basic assessment on even 100 patients. Heck even at five minutes per patient for pulling and passing the medicine you are at 500 minutes or 8.3 hours. Just passing and documenting the medicines without doing anything else. This is what I call "license lottery" and they are playing on your dime (something I believe to be more common in LTC) where the facility saves money by "gambling" with your license knowing they will almost certainly get caught (and often have been in the past). When they inevitably get "slapped" they pay a modest fine, terminate the RN (and sometimes the facility management) and go on about their merry money saving ways. They then hire a "new crop" of nurses and management to be "used" until the next "corporate hand slapping". For some companies it is almost "business as usual". However, the RN's career is often devastated and the patients suffer.

Corrections is a little different from Med/Surg or hospital nursing. I don't do assessments on these patients unless the patient is newly locked down or there is a medical emergency. They aren't infirm. I pass these meds because it is a safety and security issue for them to keep and take their meds themselves. And it's not a corporate facility. It's a prison. It's a state facility.

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1 hour ago, beekee said:

You enjoying your “break”?

Every job has it's advantages and disadvantages. You take the good with the bad and keep on rolling.

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Specializes in ICU, trauma, neuro.

Still 125 med passes? You still have to do a basic assessment for certain medications (BP/Heart rate for beta blockers) or blood glucose before giving insulin for example. Also, I'm sure that you must document somewhere the medicines that you give. Again, even at five minutes average per patient (total time including pulling the medicine, interacting with the patient, and documenting) you are well over 8 hours. I do not believe there is anyway this can consistently be done safely, but perhaps I am wrong.

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Just now, myoglobin said:

Still 125 med passes? You still have to do a basic assessment for certain medications (BP/Heart rate for beta blockers) or blood glucose before giving insulin for example. Also, I'm sure that you must document somewhere the medicines that you give. Again, even at five minutes average per patient (total time including pulling the medicine, interacting with the patient, and documenting) you are well over 8 hours. I do not believe there is anyway this can consistently be done safely, but perhaps I am wrong.

I think some experience in corrections nursing is necessary for your full understanding.

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Specializes in ICU, trauma, neuro.
1 minute ago, Ms_Interpret said:

I think some experience in corrections nursing is necessary for your full understanding.

Perhaps, but my six months as a CNA in LTC only convinced me that the nurses, administrators and essentially everyone else there (including myself) was taking a really big gamble. Other staff told me about repeated "cycles" of essentially everyone being fired and sanctioned. Then during my ASN we had to go to an actual board of nursing hearing (where people had their licenses suspended) and it was essentially a parade of either drug abusers (understandable) or people working in LTC under impossible conditions where records or care was deficient. Now I would imagine that one major difference is that corrections doesn't fall under the same level of scrutiny as long term or acute care. Still, if what you describe is typical I will never get the experience that you reference unless you can help me understand how it is even remotely possible to assess, give and document that many patients safely.

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1 minute ago, myoglobin said:

Other staff told me about repeated "cycles" of essentially everyone being fired and sanctioned.

The facility that I work in does not have that kind of history. The majority of nurses in my facility have been employed there for a decade or more.

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Specializes in ICU, trauma, neuro.

Then maybe my math is wrong or I'm just missing something about the mechanics. I would have trouble giving 125 dogs their supper in 8 hours or delivering 125 pizzas in my local neighborhood (accurately).

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10 minutes ago, myoglobin said:

Then maybe my math is wrong or I'm just missing something about the mechanics. I would have trouble giving 125 dogs their supper in 8 hours or delivering 125 pizzas in my local neighborhood (accurately).

*Shrug* Maybe. I'm not sure what it is you're wanting me to tell you, but I don't really want to spend a lot of time convincing you that what you believe is impossible is possible. You're definitely free to form your own conclusions.

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Specializes in ICU, trauma, neuro.

Keep in mind that if I am confused (having not worked in corrections) then it is quite likely that others who read this might experience the same challenge. When I write something here I do it not only for the benefit of the actual person posing the question (and my own knowledge base ie myself), but indeed for the benefit of posterity. It is conceivable ( perhaps likely) that historians 50 or 100 years (300 years?) from now will review these posts long after we have "passed on" in order to gleam "tidbits" of information about aspects of our civilization. Another example, recently one of my favorite podcasts drew upon posts here for material concerning paranormal experiences and NDE experiences by nurses.

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