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Murphy's law

Posted

I'm very slow and deliberate when I pass meds, having made a couple of dozzies in the past, since I move at turtles pace time is always an issue with me. I can't help thinking what would happen if a patient fell, or became ill, anything that demanded a significant portion of time, then something would have to. So it would help me to know how you would prioritize and what you would decide would not get done? Would it be a treatment? what if it was a BID treatment? Would it be not giving a calcium or vit D pill? Also let's just pretend that the nurse manager or another nurse on a different unit is there to help you.

Thank you.

bluegeegoo2, LPN

Specializes in LTC. Has 11 years experience.

All residents would get all tx's/meds regardless of time issues. Someone with a higher education than me decided the resident needed this med or that tx and I lack the authority to decide otherwise. The only thing I would likely leave until a later date is a monthly summary. Those can be caught up. I don't like to leave them, and rarely do, but I can catch that the next shift. My charting may be short on the routine ones such as MCR's, f/u ABT's, etc., but it gets done. I always chart as if I'm going to court over it with incidents, changes in cond, etc. You never know. I may get out late, but that's life in nursing. IMO.

All residents would get all tx's/meds regardless of time issues. Someone with a higher education than me decided the resident needed this med or that tx and I lack the authority to decide otherwise. The only thing I would likely leave until a later date is a monthly summary. Those can be caught up. I don't like to leave them, and rarely do, but I can catch that the next shift. My charting may be short on the routine ones such as MCR's, f/u ABT's, etc., but it gets done. I always chart as if I'm going to court over it with incidents, changes in cond, etc. You never know. I may get out late, but that's life in nursing. IMO.

I think your a better nurse than me

Meds usually pop at the same time, so you migh try to "plan" your day around this. For example, meds may pop at 1600 and 1900. That means you've got about an hour before and after each med pass to give your meds. Depending on the treatment, you could work it in when you pass that patient's meds. A "typical" day might go like this: this patient I know needs insulin before dinner. She needs her blood glucose checked, along with her other pills, as well as a treatment to apply barrier cream to her coccyx BID. She'll get insulin, too. It's 30 minutes before dinner. In this example, the patient knows to wait on her insulin, and the CNAs know as we'll, so this puts the patient lower on the priority list. That's 15-20 minutes to work on other tasks. Ideally, I'll check her BG when I get her vital signs. When I come back 20mins later, I'll giver her her insulin and PO meds, as well as some barrier cream in a med cup all at once. I'll then walk her down to dinner - when she stands up, I'll apply the cream. One patient done. This organization is helpful, but don't be afraid to pass on certain treatments, such as dressing changes, to the next shift.

CapeCodMermaid, RN

Specializes in Gerontology, Med surg, Home Health. Has 30 years experience.

Please tell me I read your post wrong. You apply cream to someone's coccyx in the dining room or hallway?!?

I had to read my own post again. No, sorry, to specify its when I wrote, "when she stands up," meaning when she stands up in her room, apply the cream. Then, take her to supper. :)