Published Oct 1, 2013
withasmilelpn
582 Posts
Our facility has undergone a quite a few of changes of late, for the past few years we have endured construction so that we can have a 'house hold' model of care. Some of these changes have been positive, such as full showers in each room, and our own kitchen on each unit for meals.*
Others have not been so great - medications are now in cabinets in each Resident's room for example, no nurses' station, and no *nurses cart because they are too 'institutional.'*
You walk miles more and in circles, med pass takes ALL DAY, no one can find you, you can't monitor other residents since you are stuck in rooms, they want you to help them in the *middle of meds so you do more care than ever, or look like a mean nurse when you don't, Residents want to know why you are in their rooms and get paranoid you are stealing from them, putting meds delivered from the pharmacy away is a pain in the you know what...
But today topped the cake when they told us 2 things - that Day shift and evenings would have to take over the weekly cleaning and auditing of the drug cabinets since 11-7 can't do it when Residents are sleeping. *They estimate it's only a 'few minutes' each. *Never mind that I have no idea how I will find those few minutes...
The second thing they told us that bothered me the most is that we will no longer be called nurses. All *LPNs and RNs will be known as Care Coordinators. *Can I tell you how much I hate this? I find it utterly depressing. I realize that this comes from the push to make nursing homes more homelike and get away from the 'medical model' of care, thus the fact that none are called nursing homes anymore, but I take pride in the fact I'm a nurse. I just feel like no one respects nurses in LTC, not even those that work in LTC (non - nursing) - they'd rather we weren't necessary at all.*
If I didn't love my Residents and like my hours I'd leave. *
*
MarggoRita
52 Posts
My facility had once talked about keeping meds in the rooms as well, I hope it never happens for the very reasons you spoke of, and I would insist on keeping my title as a nurse, after all I am a nurse, and that does not make me un-homelike, it makes me a nurse. I feel for you. I also feel that all the changes are almost adverse to creating a homelike environment, like saying it is negative to need a nurse, we are why they live there. Our dietary manager gets mad because we don't transfer some of our residents out of w/c into dr chair at meals to make a better dr appearance, this is their home, and if a w/c is what they need and want to remain sitting in they have that right without it being a 'bad' thing. Just out of control.
bluegeegoo2, LPN
753 Posts
Last I checked, I graduated from a "School of Nursing" not a "School of Care Coordination." That would, and does, offend me as well. I understand the culture change that is occurring in some regions, but come on. We are nurses.
systoly
1,756 Posts
i worked in a facility where they tried to keep meds in the rooms
that lasted until the state came and the inspector went straight to admin
asked who's bright idea that was and that she didn't want any meds
in the rooms by the next morning
the name change could come in handy
you know when that pesty visitor asks if you're the nurse
Other facilities have done meds in the rooms Systoly - and have been cleared by the state inspectors. I don't think we will be so lucky.
morte, LPN, LVN
7,015 Posts
I worked in a hospital with that arrangement, ie , meds in the room. loved it. BUT pharmacy stocked!...I would be happy to have Tx supplies in a lock box in the room....
Blackcat99
2,836 Posts
I would hate to have medications kept in the resident's room. Sounds like a nightmare to me.
tinkerbellpn
21 Posts
I have heard of linen closets having another door in the hallway, that way it can be stocked or cleaned without having to enter the patient room. May be that would work with a med cabinet also. Have locks on both sides.....?
our state inspectors big problem with meds in the room was that no matter how locked up they were
access was out of site of staff and anybody could defeat the lock without
being observed
at first, we (the staff) thought it would be great, because of no more pushing the heavy med carts
in reality, it translated into a lot more walking and time added to med pass and prn's
controlled substance count was something else
and... this was in AL, but some of the residents suffered from paranoia, delusions or both, believed
people were stealing stuff out of their cabinets, or took away the key to their cabinet
all in all, we did not find any practical benefit
it made the med pass more difficult and time consuming
it made management of medication more difficult and time consuming
Havin' A Party!, ASN, RN
2,722 Posts
I would hate to have medications kept in the resident's room...
I'd love it!