Astral Walker

Just an addendum, found a different policy regarding meds and it has this little jewel: Sorry my dear director, looks like it's policy that we need a lockable drawer. We're not supposed to leave them exposed on cart, ha! Thanks all for responding though, I appreciate the time it took ya'll took to write your responses. Hopefully this nugget will be enough to get us what we need.

That is an unfortunate message a lot of us are getting the past year or two. Fancy and shiny things are added, but nursing care isn't seeing any of it.

Now that I went through the policy, I see this is spelled out clearly. Still need a lockable drawer, in cart or room though I think. Hopefully we can get that. But it's a shame our patient scores are going to drop again with us being late with pain meds, but what else can we do? Most of us give pain and nausea meds to 4 out of 7 patients multiples times per shift. But if this prevents those kinds of med errors, then that's good. Do you think they'll fix our ratio too (I doubt it, but I can hope!)?

I'm glad I'm not alone at not understanding the lack of thinking in the exact choice of these carts, or at least the modular feature used. We are not allowed 4 rails, even with a doctor's orders, and something like a posey wrap has to be velcroed so the patient is able to take it off (which makes it pointless for those very confused patients, alas). As I said before to someone else, I think the one lockable drawer will be all we really need. Going back and forth will be a new hassle, but at least it's not endangering our patients or our license like unsecured meds, thanks for commenting :]

Locked drawers in the room sounds like an option, hadn't considered it since we have no supplies in rooms other than actual wound dressings perhaps if we are doing changes and have like extra boxes of 4x4s or something that will be used up the next time we do a dressing change. Hope that sentence made sense! Our hospital's culture makes bed alarms like a top priority. Write ups and such. Plus, I don't want my patients to fall, or even another nurse's patient! We don't want them to open their surgical wounds, plus we get a lot of knee/hip surgeries and have had those patients fall and have to return to surgery, which is absolutely horrible. Write and peer review are something we want to avoid as well.

So it becomes OK to pocket meds in case of a Code Blue? I should remind you this is med surg, so we do have occasional Rapid Responses and Code Blues. Tonight I had to leave meds on the WoW in a room UNSECURED because I heard someone's pulse ox go off. Thankfully it was simvastatin and a BP med, and the patient was bed bound, so wouldn't have been able to grab them or anything. lt seems to me from reading other notes that the majority of other carts have at least ONE lockable drawer for emergencies. Maybe that's what I should mention to my director, if we can get just the one added instead of the basket that is pretty useless otherwise (i saw another nurse's med cart drop the IV tubing since it slipped through the bars).

Long time reader, first time poster. So I need some advice. Our facility is switching out our computer+scanner+med carts, from huge, heavy, hard to push things with several drawers each (for separating patient meds into 6 drawers plus a larger supply drawer for primary and secondary IV tubing, alcohol wipes, labels, syringes, needles, filter needles, medicine cups, 2x2s, stopcocks, curos for peripheral IVs and central lines, etc).... to these really light computers with scanners. But no drawers. Word of mouth from our director (I need to check if policy has changed or has no mention) is to go back to med room for each patient compared to previously loading up according to the eMAR, and returning for only as needed extras or insulins, another IV bag, etc. With 6-7 patients receiving oral meds, IV antibiotics, IV bags, and pain/nausea meds PRN, we are not too sure how that's going to affect workload. And safety for all. And ignoring that part, how to keep the meds safe? We are a medsurg floor in a big hospital, so meds are in single dose packets. But without a drawer, they just sit on the flat top of the workstation. In perfect world, fine. But they're going to roll or slip off. And we can't be with them from med room to administering in patient room 100%. What do we do if a family member approaches as asks for water, or an emesis basin for another patient while we are in the hallway? Or what if I am in a patient room with them and family, and they ask to go to the restroom? How can I help the patient while leaving the meds exposed on the cart, opened or unopened? What if there's a narcotic? What if I am drawing vial or preparing to give an oral narcotic or patch like Fentanyl and a bed alarm goes on down the hall? Before, we could drop in a drawer, push to automatically lock, and scramble to find patient before they fell. I can't leave it on top, can't be like "here take this!" and wait, nor shove it in my pocket, or waste time taking the cart when we keep our patients safe by literally running to a bed alarm (which isn't going to help since it's loose on top, or open in a cup if I got that far). Besides writing to our director laying out some of these concerns, and finding one article to print out about workflow with carts that have lockable drawers or none concerning going back and forth, what can we do in the meantime? Oh yeah, the carts have an open basket near the floor we have some few supplies in ziplock bags, but a lot less than before, so we'll still have to make extra trips to med/supply room even then.