the neverending med pass

[FROGGYLEGS]

I work 7p-7a and the 8p med pass went beyond being ridiculous a long time ago. Amidst the regular falls, elopement attempts, fighting (yes fighting), irate family members, and calling the MD routinely for the multitudes of problems every night, the med pass is often running over into 3rd shift.

I've worked LTC for a number of years now and while I don't think I'm super fast, I know that I can do my med pass as fast as most of the nurses I've worked with. I don't draw the meds up beforehand and I always work with the MAR. I do know the residents pretty well and know most of their meds so I'm not slowed down by that.

On weekdays there are two nurses to split the same med pass as I do alone on the weekend. They also have a supervisor in-house that can help with issues where we do not. I am the type of person who tries to do things "by the book" and this is really driving me batty because even on the very best of shifts there is no way I can complete this med pass within the required timeframe. I have made my frustrations and concerns with this known to the administration and have asked for help. They've told me they weren't aware that we were having these problems and would try to get some additional help at least for the hs med pass. So far nothing has happened, but I can't say I honestly believed that anything would. I really worry about what would happen if anything is ever said about the fact that some of my meds are late every night. I'm sure I'd be blamed, but I am doing the very best I can. I honestly don't believe it is possible to complete that med pass on time without some shady maneuvering.

I spent several years at one LTC that progressively deteriorated with revolving door management. I spent the last three years waiting on empty promises of improvements that were to be made. After I finally left I said I'd never waste my time with another job that made me miserable like that one did. Now here I am and while I have a nice salary it isn't nearly enough to compensate. I'm thinking of leaving, but I worry about getting labeled as a job-hopper too.

Just a random thought, but tonight there were FOUR people making sandwiches at Subway. That just caused me to think about how messed up priorities have gotten. Subway has four sandwich makers and the

elderly share one frazzled nurse with up to 70 other people.

ugh.....I'm not even sure if this is a rant or vent or what. I do apologize for the length though.:) Someone please tell me that there is at least one good LTC left out there.

[CapeCodMermaid, RN]

I had once did it...the on call for that weekend was the DON....ok, i told all the Nurses not to work if ever they will call them...let her work her @$$ on the floor, i didn't work that night...then the next day....i ask her if she could add one more Nurse in the Night shift....she just simply say "YES".

Ask your DON and Administrator to have a Tx Nurse...that way your load will be lessened.

You'd be better off asking for a book on English grammar.

[Bokyo]

i once did it...the on call for that weekend was the don....ok, i told all the nurses not to work if ever they will call them...let her work her @$$ on the floor, i didn't work that night...then the next day....i asked her if she could add one more nurse in the night shift....she just simply said "yes".

you can request your don and administrator to have a tx nurse...that way your load will be lessened.

thanks...capecodmermaid...

[Katie5]

It is a horrible system, the way they expect you to pull a pill passing marathon. Amidst eye drops, ABO's, swish and swallows (and the list goes on) they expect you to do tx's and chart the same old crap shift after shift on the same patients until you run out of ink.

I have tried, I have really tried, and I was defeated. No matter how energetic or how good your intentions are there is just absolutely no way to get it all done. Half-a$$ed is the mantra of the nursing home floor nurse. And that doesn't make THEM the bad people, that's just the way it is.

I attempted to orientate a 3-11 nurse who insisted on doing it all by the book. After two weeks of staying until 2-3AM and a lot of frustrated tears she quit and went back to a quiet ICU.

Most nursing homes are hell and are just old people mills where they ship them in and haul them to the funeral home and ship another one in the bed before the sheets have been completely changed.

I hope I never have to be in a nursing home. I'd shoot myself first.

I did't want to, but I laughed

[Katie5]

You'd be better off asking for a book on English grammar.

Mean, just mean:D

[robinhiker]

I'm new in LTC - in fact still orienting and I have seen what you all are talking about. It took me until 1:00 to pass 8:00 meds. I like the idea of getting pharmacy to decrease BIDs to QD where possible. What else can be done? Can we get new laws passed that demand better nurse to patient ratios and review of polypharmacy on a regular basis? It seems to me if we want new laws we better do it now under the current governmental administration.

[CapeCodMermaid, RN]

The current governmental administration is cutting funding to nursing homes so don't expect any new regulations for patient to staff ratio.

[SuesquatchRN, BSN, RN]

The current governmental administration is cutting funding to nursing homes so don't expect any new regulations for patient to staff ratio.

I've noticed that the government is great, though, at cutting funding and then mandating more care.

[c.oconnor]

Obviously, management has failed most of the nurses who have replied to this thread. As an administrator, I do my best to listen to what my staff is telling me.

All of the jobs in a nursing home are busy and hectic. It is an overwhelming job for any person, no matter whether you are a CNA, licensed nurse, office manager, activities, etc. Sometimes, it is not as easy as it would seem for the management staff to change things so that what occurs in the nursing home is most beneficial to the residents and staff.

Some days I go home feeling like I failed both staff and residents, so please understand that management is nearly as powerless some days as you are. With the current regulatory environment, this feeling of dissatisfaction is just part of the job. However, I enjoy the residents so much that I cannot imagine doing anything different.

The government could make a big difference for all of us if they would ease up on regulations and actually allow for resident choice. Hopefully, this will get better as time goes on. For those of you who can, please stay in the LTC field! We need good nurses! We really do!:)