New nurse and Med Cart Interruptions

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As I always post, I am a new nurse working LTC (4months). Last night was a MAJOR storm and even problems with generator. Use of emergency paper MAR/TAR and flashlights. Chaos! I, even when using EMAR, ALWAYS do 5 rights/3checks, where I know longer time employees often do off memory...that's on them, not me. Anyway, through the chaos I noticed the crazy interruptions even more at my med cart. I don't want to make errors....I told myself to go slow regardless of the chaos. Then, when I got home, I started thinking that it has been not only during emergency that I was unnecessarily interrupted during a pass, but that it happens all the time by NON MEDICAL staff, to asks questions and give info. I am thinking not acceptable. Stopping to tell me something that they think I will remember to do or pass along in a hour is crazy. I have found that I must balance my "newness" with being a charge nurse and advocate for safety. How do I convey the urgency of this to ALL employees without being the new bad guy? That seems to be my M-O lately, as I want to be in charge, but cautiously tread as the new nurse that works with others. That seems to be my biggest problem. HELP! Thanks in advance. This site is the best thing that has happened to me in a while in nursing...amazing!

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Based on my personal experience of working in various LTC facilities over the years, nursing gets the least respect out of all of the different disciplines.

Staff from PT, OT, ST, dietary, social work, and the business office will constantly interrupt a nurse during med pass without even giving it an afterthought, but these same people will take their gripes to the administrator if the nurse dares to interrupt them in the therapy gym, kitchen, or medical records office. It's a double standard, IMHO.

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We have a "med zone" rug in our Pyxis area. We also had a little vest thingy that people would wear while they were prepping/checking meds for a while. And most of our nurses have no problem saying, "Wait, I'm pulling meds. Thanks."

It's all about creating a culture that values safe practice and advocating for your license and the safety of your patients. Maybe look into some of the above resources and see if you can educate your staff? Good luck!

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Specializes in Pediatrics and geriatrics.

I used to keep a notebook on the cart for staff members to write (non emergency) things down. It cut down on the interuptions from other staff members.

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I keep it at the desk by the phone. That deflects people from coming at the cart in the first place- nips it in the bud. They can jot a note based on pt., doctor, and what the issue is. Also keep labs, admit orders, clarifications, incident reports, etc. in the notebook so you can only call each doctor one time, preferably at the same time every day (to train them also on how to save hours of wasted time chasing calls back and forth) and be done with it. A few staff will hover by the cart anyway, but ignore them until they get the point that the notebook is near the phone and that any issue they have will be taken care of like clockwork, but on your time, not theirs. It works real gud.

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Specializes in retired LTC.
Based on my personal experience of working in various LTC facilities over the years, nursing gets the least respect out of all of the different disciplines.

Staff from PT, OT, ST, dietary, social work, and the business office will constantly interrupt a nurse during med pass without even giving it an afterthought, but these same people will take their gripes to the administrator if the nurse dares to interrupt them in the therapy gym, kitchen, or medical records office. It's a double standard, IMHO.

How true! :banghead:
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Specializes in Gerontology, Med surg, Home Health.

Be polite but firm that you don't want to make any errors and unless it's a true emergency they should wait until you're done with the med pass. On my long term unit, the med nurse has 30 patients. They take an average of 25 meds each. That is 750 opportunities on one med pass to make a mistake that could kill someone. OKAY so it may be a bit over dramatic but it's true. I haven't passed meds in years but I make sure not to interrupt the nurses unless someone is bleeding out.

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Specializes in LTC/SNF.

I work 1900-0700 and I am usually passing meds and doing treatments from 1930-2300 before I have a spare moment, and that is assuming that everything goes smoothly and nothing else demands my attention. I have several family members that will call me or come up to the cart during this time to tell me about a trivial, non-emergency issue. I really do care about their family member. But I also care about my 34 other residents that I need to get meds to on-time. I don't want to seem rude but some of these people majorly monopolize precious time that I don't have. For example, a family member interrupts me in the middle of me prepping meds to go on a 20-minute tirade on how she doesn't like how So-and-So CNA doesn't position mom's pillows and blankets right, and blah blah blah, but me saying "Ok, ma'am, I understand your concerns, I want your mom to be comfortable. I will make sure to let the CNAs and other nurses know to do it this way...." over and over again isn't good enough. I try to use my active listening skills, drop what I am doing and make eye contact, but this just eggs this lady on. I even told her point-blank after listening to her ramble on one time about nothing in particular, "I am sorry, but I need to get back to my med pass. If you have any other concerns right now please write them down for me here or let the administrator know," (we are lacking a DON right now) and she tried following me into another resident's room, continuing to go on about the same thing, which had nothing to do with her mom's care! :no: I really wish I had a "Do Not Interrupt" vest, or maybe a neon sign for the med cart. I am thinking of asking the administrator to send a mass message to all staff to remind them not to interrupt nurses at the cart unless it is a life-or-death issue. As for family members, I guess I have to work on being polite but not so friendly so as to convey that I have all the time in the world to give out free counseling :sarcastic:

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