Situation: I'm working in a skilled nursing facility and the unit/station I'm in charge of has 39 residents. For AM shifts, all 39 residents have scheduled medications due at 9am. We are using electronic medical records so we are allow to give medication from 8am to 10am, all medication given after 10am will be considered as late.
Problem: the management kept on reminding me that I need to pick up my speed, they don't want my med pass to be late.
So am I lacking a certain skill or is there something essential that I didn't learn from nursing school? If anyone actually bother to do this simple math, to get through 39 patients in 2 hours that's 3 minutes per patient. THREE MINUTES PER PATIENT. Each patient has an average of 8+ medications need to be given. On top of that, 2/3 of the patients requires BP and/or apical pulse check before med administration. Furthermore, because it's a SNF, we get mostly geriatric patients, so these patients need time to take their medication. So yea, if any of you are working or has worked at a SNF with similar situation, I will really appreciate it if you could share your experience on how to handle this.
The unit I work has up to 45 Residents when full, and only one nurse - the nurse does it all meds, treatments, charting phone calls orders incidents "excellent" customer service etc. We have the two hour window in Illinois for med passes (one hour before the scheduled time and one hour after). We have a widely varied population on my unit - from young rehab short stay to tricky sub acute people to time-consuming multiple comorbidity people to wild and wooly dementia people {that we have to keep away from the others without restraining them}. And most of my people take 8+ meds, some as many as 15 in addition to supplements. I do not have the time to spend 10 minutes with each one to ensure all 15 pills and special protein drinks and the required amount of water all goes down - but I must do it anyway. Patient care suffers severely in many ways in the LTC setting and nurses who are everything-to-everyone on their units cannot safely spend 80% of their shifts passing meds and then be expected to give superb HILTON QUALITY CARE that has become the expectation of our newly aging population.
I am sorry for the rant.
What we have had to do at my facility is schedule some meds at 0700, some at 0800, some at 0900 to stagger the pass times so that no one's meds are "late." We also work 12 hour shifts so we have two "big" passes a day (0800 & 2000) with the obligatory noon and 1600 some midnights and then another pass at 0500. I feel jaded about my life revolving around pills, and I wonder just how much does this actually improve anyone's quality of life at 95 years of age? Really.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
I would love to know how it's done. I passed meds for somewhere around 40 residents and my morning pass nearly always ran right up to the noontime pass. Impossible to get done in 2 hours. Like said, residents are slow, and often fight the medicines. We have to crush what we can often,others cannot be crushed. Trying to cajole residents to take meds is tough and takes time. Charting meds not given, takes time. I have no idea how it's possible to do in 2 hours.
jrost80RNBSN
42 Posts
I'm charge on my floor, when I pass meds for half the floor (24 patients) it takes about 2.5-3 hours. I would clearly speak with the DON.