how much time for AM med pass?

ChristineN, BSN, RN · Jan 7, 2009

I don't work in LTC, so maybe my opinion isn't as valued, but I'd be more worried about quality of care, and less about quantity of time used. It sounds like you are getting your work done in a reasonable amount of time.

lpnflorida · Jan 7, 2009

This weekend I worked as a med nurse on a trauma floor of our hospital. I had 10 patients, 3 blood sugars along with scheduled medications, there were the prn pain medications. I lost count of how many iv piggybacks, and Iv reglans. It took me approx 2 hours . I save my dressing changes for after lunch unless of course they were saturated in which case I did them as I found them.

I would focus less on the amount of time it takes and focus more on being accurate in the 5 rights. Also when giving the medications I always verbally tell the patient name dose and what it is used for.

Thank God, for computer charting, it allows me to chart prn medications as I give them.

dorianna · Jan 7, 2009

I am a med aide in LTC. My HS pass for 40 to 55 residents usually takes me about 3 hours to 3 1/2 hours. I don't do dressing changes or insulins--just pills (many of which have to be crushed and mixed in applesauce or pudding, eye drops and liquids. I always have a goodly amount of prns mixed in. My supervisor periodically chides me for taking so long. I rarely make an error and it gripes me that she always seems to be 'on me'. I got in trouble, again, the other night for trying to make sure the CNAs didn't put some residents to bed before their meds. Some stay up late and some are easy to give in bed but I don't like waking old and frail people for meds that could be given earlier if we all cooperated and communicated about who is ready to go down and who isn't. Her attitude is that the CNAs can put people to bed in any order they desire and mine is that cooperation between the med tech and CNAs is important. I certainly don't ask that all residents stay up--we're talking between 1800 and 2130--and I am always willing to change my routine if a CNA wants to do a particular resident next. Does the length of time and my opinion sound unreasonable?

I get so tired of all of this. Although I enjoy the residents, I'd like to find another job but don't know what it would be. I've been working in LTC since my divorce about 5 1/2 years ago. I had worked in libraries and a human service agency prior to this but after my divorce I needed full time with benefits and more money, which my library job could not provide. I am currently 59 and starting a new 'career' would be difficult.

kermitlady · Jan 7, 2009

I have 14 people whom I do AM meds, which includes 3 FSBS, 1 insulin, 2 BP, 1 ted hose, (2) topical creams with one leg wrap, and one inhaler.
I think it takes me about 30 min. just to preset meds if I am not interrupted and the orders are perfect. Is this too slow?
the pass itself depends on morning care. I am med tech/care staff

Depending on how many residents I'm caring for it can take me a couple of hours. Technically, you have an hour either way to give the med. Why are you presetting your meds, though? I was always taught this is never to be done. For one thing, it puts you at an extremely increased risks of a med error! Also, in the 30 minutes you've taken to preset the meds, you could have passed quite a few.

Honestly, I'd love to have your med pass! I don't do treatments (ointments, dressing changes, etc) until after breakfast and my AM meds are out. The hall I worked on yesterday has 22 residents who all get pills. Of those, one gets meds by g-tube, 12 were accuchecks (several of which received insulins - sliding scale and/or routine). Of course, I'm not doing the bathing, dressing, toileting, etc.

kermitlady · Jan 7, 2009

Oh, how much actual time does it take me? I do accuchecks starting at 0630 (they're scheduled for 0700), then start my actual med pass at 0700, I give insulins when I give their meds. Most will take their meds before breakfast but I had a handful who won't take them until after breakfast. So, about an hour and a half before breakfast and about half an hour after; therefore, about two hours total.

achot chavi · Jan 7, 2009

Is med pass part of the official Olympic Summer Games or Winter? I forget.

Is there a record for fastest pass time in the Guinness Book of World Records?

retread71 · Jan 8, 2009

I preset because the med cart doesn't go in the halls, it stays in the medroom. I preset, grab my treatments, BP cuff and go. And the state is CA, and allowed under the DSS regs for Residental care.

CapeCodMermaid, RN · Jan 8, 2009

Not to be dumb, but what exactly is 'presetting meds'? Is this the same as pre-pouring? This is frowned upon in this state and leads to more mistakes.

retread71 · Jan 8, 2009

yes, its pre pouring. I believe its allowed in RCFE.

achot chavi · Jan 8, 2009

Not to be dumb, but what exactly is 'presetting meds'? Is this the same as pre-pouring? This is frowned upon in this state and leads to more mistakes.

I am sure the OP is doing as per her DON's instructions, It differs in each facility. Sometimes time constraints make it a necessity.

While idealistically we should prepare each med as it is needed- we don;t work in an ideal world. There is a parallel post where nurses aids are being trained to give meds!!!! a far worse situation- that can lead to mistakes and other problems!!!!!

dorianna · Jan 8, 2009

I know that there is a lot of prejudice against med techs. I am one and my understanding is that we work in LTC, never hospitals, where meds change frequently and the patients are more acute and changeable. My med error rate is below some of the nurses. I do a better job than most nurses--leave my cart ready for the next person, make sure expiring meds are ordered in a timely fashion, and often recognize problems before they do, etc. I have caught many errors made by both med aides and nurses. The only people I have ever seen preset meds are RNs. Most nurses in LTC think that it is beneath them to pass meds and love having a med aide. We work closely together--I frequently help them with treatments and procedures (within my scope of practice, of course), and I bring any questions to them immediately. After doing this for several years, I do have quite a bit of knowledge. Also, overall, I have more general education than most nurses. I am a smart, dedicated and valued member of the team.