My back is against the wall... what should i do now?

[NurseLoveJoy88]

A while ago I posted a thread about passing meds for 60 plus residents and refusing the assigment. Well now I was told that there will come a time when I would have to work as the med nurse and pass meds for 60 plus residents. I explained that even though I would only be responsible for the med pass I still can't see myself getting it all done. I work with alzheimers residents and sometimes it takes 20 min. Just to find them. Then we have 20 plus residents that take ensure, some meds must have vitals, some are crushed, some residents have to be encouraged for 20 min. To take their meds. Sometimes its a nightmare. I see nurses pass meds hours late and make many mistakes due to med errors. I just really don't want to be unsafe , behind or stressed. I don't have any option but to comply or I will become another new grad with no job. What should I do? I feel stuck .

[softstorms]

Please check out the state laws within your own licensure. What do they say about nurse to pt. ratio? Even here, in S.C. it is 1/44 for a long term/dementia unit. Stay if you have to, but look around and move on! Never put your ability to use your license to care for people in danger,,,,it is not worth it! Best Wishes

[LesMonsterRN, ADN, RN]

In my last LTC facility I was charge nurse on top of passing meds to 30+ residents. Something's gotta change.

[JenniferSews]

Its easier to get a job when you have a job. Do the best you can do for now. In the meantime, look for employment elsewhere. The current company you are working for does not value patient care and safety, otherwise it wouldn't be practicing nursing like this. Since you recognize and are concerned about these safety issues, it obvious that your beliefs and values regarding nursing do not align with this company. You will never be happy at this job - so get out as quick as you can.

It's easy for many to say you should just quit and find a new job. But since new jobs are hard to come by where I am I say do your best for now and keep looking. My license isn't much good if I can't get a job anyway.

[NurseLoveJoy88, ASN, RN]

Ok everyone, I have already contacted the BON and they told me it all depends on the facility. I asked them if padding meds for 60 plus residents is safe.

Alzheimers resident Do have the right to refuse. Some res. Take 6 or 7 pills one at a time 5 min. Apart. Our facility have done away with med techs so there can only be the med nurse passing meds. I'm just stuck!!! I did go from working full time to parttime so the less I'm there the better it should be. I feel sorry for those poor residents. Some of them are on so many drugs that it probably does them more harm than good.

[RN_Canada]

It sure is in New York State.

OK if giving out medications is a "protected" task and only nurses can do it, how do people look after themselves at home - do family members give out medications?

can doctors give out medications? can pharmacists?

What about LPN's or nurses aides?

how do family members look after each other at home and give medications to children? to elders?

How can you protect the task giving out medications- especially low risk oral administrations?

I can see how doing surgery is protected, or administering certain forms of electromagnetic energy ... but giving out medications?

...sorry don't mean to take this off topic but this might actually be at the root of the problem here.

It certainly is a good argument for patient centered care and not task focused nursing.

Have you been to the union about this, it seems like a good "working conditions" issue. Or do you have a union?

A union should protect your job and advocate for better working conditions so that you could continue to work within your professional standards in the patient's interest, not the employer's interest.

In Canada the regulatory nursing authority works in the public interest. Their job is to protect the public.

The union works in your interest to make sure your working conditions are such that the public interest can be maintained.

If you do not have a union then you are between a rock and hard place. How can you work in the patient's interest if the employer requires you to do otherwise and your job is at stake.

Which sounds like the original point of the original post.

[Kooky Korky, BSN, RN]

The situation you describe is not uncommon, OP. Sadly. After you do the med pass a couple of times, it will get easier and quicker.

[cookienay]

OK-I know this is off topic (somewhat) and I am not an LTC nurse, but some things I have learned (and some I have learned the hard way):

1- only a judge can declare a person "incompetent". Yes it is a gray area when your patient obviously does not understand what is going on. To force any treatment, regardless how innocuous it may seem, constitutes battery.

2-patients can refuse treatment, even if it is not in their best interest. We had an MD try to place a pt. on a 72 hour hold because she wanted to leave the ER after a seizure. Um, no.

3-even patients with a surrogate or POA can refuse treatment. Had to laugh at the doc who wanted us to restrain a patient to obtain bloodwork after her POA said we could. She would not let it go until I got legal on the phone who told her in no uncertain terms she was NOT to do such a thing. Got a big "thank you" from legal for that one.

I know LTC has various other issues and many gray areas. I know there are alot of new nurses on these boards who do not have the benefit of the experience some of us have which is why I posted this. Hats off to you LTC nurses!! I could not do it!!

[cmonkey]

So how do you get them in? Hold his nose until he has to open his mouth to breathe and shove them in? God knows, I've been tempted.

Hey, I do it to my kids... Not an RN yet, so I don't pass meds. Pretty much anyone who refused got "applesauce" a while later after they'd forgotten about the first attempt. Generally didn't take long .

[nursel56]

RN_Canada;4148335]OK if giving out medications is a "protected" task and only nurses can do it, how do people look after themselves at home - do family members give out medications?

can doctors give out medications? can pharmacists?

What about LPN's or nurses aides?

how do family members look after each other at home and give medications to children? to elders?

How can you protect the task giving out medications- especially low risk oral administrations?

A medication can't be assumed to be low risk because it's given orally. If something goes wrong, what was the likely cause of it happening when meds are passed? Wrong route, wrong med, wrong patient, wrong dose, etc. A family member giving a med obviously knows who the patient is, has the right med in a bottle with instructions on it as to dose and route. The doctor/pharmacist will have explained the reason and side effects to the family.

An untrained staffer handing out meds to 60 people increases the chances of an error a bunch (not good at math). Must rely on other than family recognition for identification, has not been trained in some routes of entry, doesn't know what a med is supposed to look like, cannot assess a patient face to face and does not know what side effects to expect.

Those are some reasons I could think of. Perhaps there are others, too.