NurseEe1

Hello! I work for a local health system in case management/utilization review. Looking to connect and share ideas with other inpatient case managers in order to grow our case management department. Our department has RN case managers and social workers, and originally the case managers came to be during Covid when things were a bit crazy for social work. Now that things are a bit more calm, we find that our case managers often do initial meetings/d/c screens of new patients and collaborate with social work with d/c needs and such but would really like the nurses to be more involved. I’m thinking education, assisting floor staff and so on. We do have diabetic education, cardio navigators and such that we work with for patients that need those things but would like to get the inpatient case managers more involved and not just doing an initial visit then passing it on to SW. Anyone willing to share what their day looks like as an IP case manager or ideas we could trial and possibly implement? thanks!

Time management is a requirement for long term care, but it is manageable and can be done safely and properly. I’m not saying lower ratios wouldn’t benefits the staff and residents but it’s not a reason for this behavior. I’ve worked 3-11, 7a-7p, and 11p-7a. I know it’s a lot of work and sometimes it takes longer than your shift to get it all down but once you get the hang of it and get a routine it’s not bad. The thing is these nurses are using prepulled meds from another nurse so not only are they risking their license and the safety of those they care for they aren’t learning time management at all. One nurse told me with her meds being prepulled she has a 10 minute med pass rather than 1.5-2 hour morning med pass.

While I get that med passes are heavy in LTC, it is possible to pass meds to patients properly. I have done it for years and never have I used meds pre pulled by other nurses. typically the morning med pass is the heaviest then it’s a few throughout the remainder of the day.

This is definitely not a practice I would ever be involved in. I want to fix this at my facility but it seems these are very much set ways of these nurses that Im not sure I can fix it. I have been very vocal about my concerns with them doing this and have been met with not many similar feelings. this is poor practice, a huge safety issue. I would never give medications that were pulled by someone else unless they were packaged and easily verified. All it takes is that person pulling to make a mistake.

We are currently in between DONs, new one should be starting soon but as of right now I am kind of alone in this. Staff has been in building for a good while, so it seems it’s probably been going on for awhile. I am very concerned about survey, patient safety, new nurses learning these habits and not learning how to actually work the floor and develop time management.

Management, new to the building so just finding these things out. It seems to me other managements knows and doesn’t do anything to correct it. I plan to have a discussion with them about it further and plans for fixing these issues.

New to a facility and have recently learned that floor staff is pre pulling medications for the next shift. These medications are being popped from a blister pack and then are unidentifiable pills in med cups with resident info labeled and the next nurse is passing to the residents. Also have overheard, but not witnessed talk of nurses giving meds early for next shift and then next nurse signing out meds. Anyone been in this situation? Any tips on helping shift the staff to safe practice and stopping this? It seems like it’s been going on for quite some time in this building and majority of the nurses are doing it and okay with it.