New grad med passing

817nurse · Jul 29, 2015

1.) Could I loose my license if I were to go over the 2 hour med passing window?
2.) Would state surveyor give me a citation if this happened on their watch?
3.) What would be the correct thing to do if i didn't give the medication with in the 2 hour window?
4.) I use electronic BP cuff to speed things up a bit. When DOH ( department of health) is in would it be ok to use the electronic bp machine or should i use manual?

1. I've never heard of any nurse who did "loose" a license for passing meds late. You can "lose" a license, not "loose" it, but I still never heard of any nurse who lost their license for a late med pass.

2. State surveyors only watch nurses pass meds to maybe 7 or 8 residents.

3. When state is in the building, you will see more staff than ever. Ask one of them to help you finish your med pass. Of course, once state exits the building and finishes their survey, all that extra staff will be gone.

4. When state is in the building, you need to use BP equipment provided by your nursing home. Your personal BP cuff hasn't been calibrated. Of course, you can do what you want when state isn't there watching you.

Been there,done that, ASN, RN · Jul 29, 2015

Sheesh **summoned***.. It's the DON not the pope. Try not to be so intimidated.

Wonder how don the pope would do passing meds on 30 patients.

It's not physically POSSIBLE to safely pass that many meds within the time frame.

Try to find a way to express that, while being politically correct.

As the PP said, there will be plenty of staff on duty when the state comes in.

Take note of how many are passing meds that day.. for THAT is the safe ratio.

allnurses Guide · Jul 29, 2015

4. When state is in the building, you need to use BP equipment provided by your nursing home. Your personal BP cuff hasn't been calibrated. Of course, you can do what you want when state isn't there watching you.

The LTC I work at has BP cuffs (Manual) that don't work either the bladders or gauges are broken. Silly me I aksed for new ones and was told to provide my own! I have both manual and automatic cuffs and use them interchangably based on the clinical situation.

Adele_Michal7, ASN, RN · Jul 29, 2015

I'm going to echo what previous posters have said.

I think that your management is being stressed and paranoid with a survey on the horizon.

However, they need to show more gratitude that a NOC nurse came in to do a 3-11 shift. You're not regularly acclimated to doing so.

Where I've worked, most new employees (and even some seasoned regulars) find it near impossible to pass medications in a two hour window.

Those that do are most likely employing dangerous shortcuts.

Keep being safe, and don't let management intimidate you into rushing.

As far as the blood pressure equipment, I think that it is okay to use an electronic cuff when there is no survey looming.

Where I work, the nurse assistants take vitals, but if a value is questionable, I retake it myself.

Good luck.

chedder · Jul 29, 2015

Thank You all for your response. It has certainly taken the thought of my license being suspended. I will continue to be more efficient with in time. @ Adele_Michal7 at the time i was not thinking about getting assist with CNA with getting Vital Signs. I will definitely try it out the next time I work 3-11.

Adele_Michal7, ASN, RN · Jul 30, 2015

Thank You all for your response. It has certainly taken the thought of my license being suspended. I will continue to be more efficient with in time. @ Adele_Michal7 at the time i was not thinking about getting assist with CNA with getting Vital Signs. I will definitely try it out the next time I work 3-11.

Let me know how it goes. Just make sure the facility permits it.

NOADLS · Jul 30, 2015

DON summond me and talk to me about med errors and how soon we are expecting DOH state surveyor.

What med errors?

kita5454 · Jul 30, 2015

Take your time. Trying to go too fast is what will get you a med error. Once you get used to the shift and have a routine you will be fine. 40 minutes late isnt bad when its your first time on a shift.

Here.I.Stand, BSN, RN · Jul 30, 2015

What med errors?

I think she was referring to the meds given past the 2 hr window--one could argue that they were not given at the right time. Myself, I think that's stupid. Nurses run the risk of making actual, dangerous med errors (e.g. giving the cup o' meds to the wrong resident, or missing meds as you work your way down the MAR pulling them) when they rush.

And what the heck are they doing, chastising you for being too slow when you did them a favor picking up the shift??? Really???? To your DON--"the proper response when someone does you a favor is 'thank you.'" :mad:

OP, I honestly wouldn't worry about your license being on the line over this. If nothing else, I'd think the BON would be more concerned about safety than speed. if your DON chose to report you over this, she is exposing herself as one who is more interested in speed than safety. Nursing licenses are usually revoked for working impaired, violating the nurse practice act, ethical violations, etc.

Quick story of my experience, for a couple of years I worked in the rehab wing of a SNF. I can probably count on one hand how many times I DID finish the pass in that window. And I only had 10 people to pass for! It was really tough because resident turnover was so high so I never did get used to anyone's routine, I'd have to pause multiple times to get PRNs for people, answer call lights (the nurses were the ones to get spoken to if the records showed that call light wasn't answered promptly, the PT/OT staff wouldn't let us interrupt their session to give the a.m. meds that we didn't get to before/during breakfast, resident needed to use the BR and the CNAs were showering other residents........ I also worked in an LTACH where most of the people took their meds through these tiny tiny bore feeding tubes that clogged if you looked at them the wrong way, pts popping off the vent, we'd have to draw all of the stat labs, address concerns with the families...who were often very on edge after dealing with hospitals for so long... There I only had 4-5 pts and could very rarely ever get all meds done by 0900.

I have never had issues with my bosses or the BON over it.

VANurse2010 · Jul 30, 2015

Take your time. Trying to go too fast is what will get you a med error. Once you get used to the shift and have a routine you will be fine. 40 minutes late isnt bad when its your first time on a shift.

40 minutes isn't bad, period, in that setting.

sallyrnrrt, ADN, RN · Jul 30, 2015

I once had to in an emergency, come in to a new building, of which I had zero orrientation, and for two days pass meds. For 60+ residents, thankful, chg. nurse covered insulin......I knew absolutely no residents....I only had in excess of four decades experience, Thanks to some remarkable CNAs, few oriented residents, I only ran over two hours........and was in tears towards the end......because I knew the standards having been a DON, in several other LTC....it was a true emergency in un expected staffing. Crisis.......and personal favor to owner....and the worst two days in my nursing career.....and I would for no amount of money do that again.... You will get more efficient in time, things will get a bit easier.....best wishes