Nurses forced to stop med pass

TheCommuter, BSN, RN · Mar 5, 2016

How do you cope/deal with it?

I worked at such a place several years ago...the nurses coped by dividing the dining room duty into four blocks. All nurses cannot stop what they are doing at 1700. Dining duty must be divided.

1700 to 1730 - Nurse 1 stops his/her med pass, passes trays and feeds residents, then resumes the med pass at 1730

1730 to 1800 - Nurse 2 stops his/her med pass, feeds residents, then resumes the med pass at 1800

1800 to 1830 - Nurse 3 stops his/her med pass, feeds residents, picks up some dirtied meal trays, then resumes the med pass at 1830

1830 to 1900 - Nurse 4 stops his/her med pass, picks up dirtied trays, wheels some residents back to their rooms, then resumes the med pass at 1900

If management expects all nurses in the facility to drop what they are doing at the exact same time to attend to meal time, it is time to find another place to work. Or better yet, work the midnight shift where no meals are served.

Zyprexa_Ho · Mar 5, 2016

It sounds like you and the other nurses need to get together and tell them "no." If they are having trouble passing food and feeding people, they clearly need more CNAs.

allnurses Guide · Mar 5, 2016

I've never been in a place where the nurses pass the trays out and feed people. The Alzheimer's facility where my mom lived out the last two years of her life had the nurse in the dining room with her med cart passing out medication and the CNA's taking care of the patients and their meals and feeding some of them.

Our little local hospital has a LTC as well and the nurse has her med cart in the dining room and the CNA's pass trays and feed people.

djh123 · Mar 7, 2016

The only time I help pass trays is when we're very short on CNA's, or one is doing something important with someone down the hall for a few minutes. But although I/we don't have the same problems, the general stupidity of demands and decisions from above us are somewhat similar. My job has gone from 'I kind of like it' to 'I practically can't wait to quit', and it's not because *I* have changed.

CapeCodMermaid, RN · Mar 8, 2016

I worked in one building where admin. demanded there be a nurse in the main dining room for all meals. They started a restaurant dining thing so one meal could last more than 2 hours. I asked them to show me in the regulations where it was written that a nurse has to be in the dining room. They couldn't so I took the nurse out. Plenty of CNAs in there...all the residents in there were alert and certainly safer than someone left to eat in their room alone. DPH had nothing bad to say.

I'm the DNS and I still hand out trays. Not my favorite thing to do but if we don't all pitch in the food gets cold and the residents don't deserve cold food because the company won't pay for sufficient staff.

Kooky Korky, BSN, RN · Mar 11, 2016

Wasn't sure where to post this so I'll try here. I work at an LTC on pm shift. We have all new management (shocker!) and of course they want to implement new things.
The newest thing they are changing is how our dining works for all meals. At 1700 all nurses are expected to stop med pass regardless of what they have or haven't done (and of course we can't actually start our med pass til 1600) check trays no big deal, but then pass trays along with CNAs and then to sit and feed for 2 hours.... Then take my lunch come back at 1745 and finish my 5pm med pass and soon after start my last med pass mean while I still have my treatments, behavior monitoring, charting and just clicking my eMAR so it's no longer red. So of course we do a little overtime but then get in trouble for that. Something needs to give. Can't talk to management and corporate does not care. We are aware a nurse needs to be in the dining room and we can't pass meds in the dining room but there use to be a time when we could bring our carts in there and at least do other things whilst supervising. Now we get written up if our carts are even parked outside of the dining rooms. Anyone else work at a facility that's like this? How do you cope/deal with it? Nurses are out looking for other jobs right now because of this and because of how bad management has been treating us.

From 4 to 5 you pass meds,

you help in dining room for 2 hours (from 5 - 7)

lunch from 7 - 7:45 (when do other nurses get lunch? and the aides?)

I'm unclear on your timeline.

No matter how long or how briefly you are in DR, this sounds impossible.

Sounds like time to either quit or notify the accrediting body, state and federal legislators, CMS, and local news media. All nurses need to stand together and all speak up or all put this in writing. If you do it alone, you'll be crushed, fired.

Or divide it up like Commuter said.

Did this start because aides complained about how lazy the nurses are? Do you normally get a meal break? Do the other nurses? Aides?

MsMistyRN · Mar 12, 2016

They do this at my facility although it is not this long. Every nurse from every wing is assigned a dining room. I start med pass at 1500 and generally finish around the time hall trays arrive (around 1730). I then head to the dining room and help pass out trays, make sure all the residents are there and served the correct meals. I help out the aid with anything she might need and then I am free to go. It only takes about 15 or 20 minutes of my time. Some of the nurses refuse to go to the dining room to help... most do. The NM does come to make sure we go and razzes us if we don't but I know he really takes into consideration what kind of day we are having. If I get bogged down with work and cant make it, everyone is ok with that but I really do make an effort. Now, if it was for a couple of hours I would be hoppin' mad!! No, way....

rnman99 · Mar 20, 2016

How many meds are there at 1700? No place I've ever been has had a huge med pass at 1700, mostly coumadins and sliding scale. Our BID meds were saved until 2000. Maybe they could shift times a bit.

ltcnurse4u, CNA, LPN · Mar 21, 2016

Its been a while since I have pulled a PM shift, but as I recall, most afternoon med pass is fairly light. Just blood sugars, and coumadins with a few blood pressure meds. Maybe the pharmacy rep can do a review and suggest alternate times on some of the meds. For example in most cases, BID meds should be Q12hrs (unless MD ordered at a certain time). Also, make sure you have a solid routine..and stick to it. If you know that you MUST be in the dining room by 5pm, then set your routine so that this is possible. And don't be afraid to ask for help.

Hoosier_RN, MSN · Mar 21, 2016

Could some of the meds get a time adjustment? It's what we did at the facility that I work for (we have broad time range now instead of a rigid set in stone time). It's helped out immensely. Just a thought