Earthgrlrn

There’s quite a debate at my work regarding the responsibilities of the RN charge nurse vs. LVN medication nurses. When any change of condition happens (falls, vomiting, new pain onset, falls etc) the medication nurses immediately call on the charge nurse to attend to the patients. Their argument is that they have too many meds to pass and they don’t have time for anything else. The charge nurses say while they don’t have meds to pass (besides the occasional IV) they also have a full plate, and the medication nurse should at least take some kind of action to help the patients. Often times, if something happens to a patient, the medication nurse will chart “informed charge nurse” or “charge nurse aware” and then nothing gets done for the patient. For example, we had a patient that was alert x 4, for angry at another patient (confused) and began yelling at the confused patient. The medication nurse saw this, but was in the middle of passing meds and told a staff member to tell the charge nurse. Now this can of worms has been opened, medication nurse vs charge. What are your thoughts? I know every facility is different, but generally shouldn’t medication nurses take some kind of action with changes in condition? It’s seems a prudent nurse would do something to help patients, not just expect the charge nurse to do everything.

I think the nurses wait because they think somebody else will do it (for example, if they are down to the last pill and tomorrow is their day off they figure someone else will do it, and someone else does—the RN!) It mostly had been happening to narcotics that need an MD’s signature to be refilled. When I passed meds & a medication was almost out I would call the pharmacy and/or the MD and get it refilled myself. I never asked the RN Charge to do it for me. Besides, I never access the med cart. I have no idea what needs to be filled, or what medications are about to run out. That should be the med nurses’s responsibility.

I am a charge RN at a nursing facility. We have 99 beds & 4 med carts. The med nurses are constantly down to the last 2-3 pills (narcotics) or completely run out of medicine. Instead of calling the pharmacy themselves, or calling the doctor (for narcotics, if a signature is needed) they expect me to do it. I think the med nurses should be responsible for making sure that refills are sent to the pharmacy, for calling the pharmacy, calling the MD, etc if they run out of a medication or are almost out. I am never on the med cart & do not know which meds are running out. It’s a giant waste of my time to try to get refills because the med nurses waited until the last minute. Also, patients who need narcotic pain medications end up having to be without medication when they need it. Lastly, if the charge nurse is the one obtaining refills & med nurses are not held accountable, there is really no reason for them to put in refills before the patients run out of medication. Therefore patients will always run out of medications. If med nurses are made accountable for obtaining refills (calling pharmacy/MD) then they will be more likely to try to get the refill before it runs out. Anyone have a reason why the charge should be responsible for obtaining med refills? Or am I right that med nurses should be 100% responsible?