Doing a med pass at ANY LTC is a finely tuned art. I have discovered this. I'm still a WIP myself, but doing agency four months after graduating has taught me A LOT, honed my skills, and helped me to have the ability to "hit the ground running." Difficult? Yes. Endangering to my license? Never.
You will always find a shortcut or several that will work for YOU, and once those become habits, and you get into that "med-pass mindset," things will start to flow a bit more smoothly.... no matter what though, it's always a pill-pushing fiasco.
Some tips that work for me:
Sometimes you'll have a patient who's on eyedrops, inhalers, liquid meds, pills, and a f/s.... plus U need to bring them in something to drink. With a patient like this, I use my clipboard as a "tray" to carry everything in, so that I'm not juggling and/or making multiple trips in/out of room.
I ask the patient if they need anything for pain or need anything for PRN.... this can help avoid those moments where U finish a patient, are moved on to the next one, and then the patient calls out "Can I have a pain pill?"
If I bring in a drink for the patient (i.e., water) and they request something else (i.e., apple juice, cranberry, etc.) I say sorry, this is all I have. (I feel bad- but- if I dumped out whatever I had brought them, and went back for something else, for everyone that asked.... and have 30+ patients..... time's a tickin', folks.
I'm not afraid to write "patient refused" on MAR. I see nurses who beg, plead, and cajole with certain residents to take their meds..... and spend 15 minutes in the room..... then just end up throwing the med out and still marking it off as "given." This is BS. If I have a fussy resident who won't take meds, I ask "Should I come back later?" or I'll try again and if still no- I mark them as REFUSED and put on 24 hour report....
I used to start with the "easy" patients first, then do the hardest ones last.... But now I just go in room order, parking med cart from door to door. If I see a wanderer or passer-by, I flag them down and give them theirs. Also, If I have someone I truly dread giving meds to (biter, GT with 20 meds, etc.) I do them first to have it out of the way.
Hope these help and if not, at least provided some amusement.....