I have to say that I agree with the problem of meds getting given on top of each other. How will you know that Mr. Jones took his AM dose at 11:00, so he shouldent get his afternoon dose at 12:01. It just seems like it would be very confusing. I TOTALLY know about med passes. I worked in LTC for many years. I can guarantee that lots of things, (MedPass, Metamucil, Miralax) did NOT get given. How the heck can you pass meds for 35 people, 20 of whom have narcs that you have to sign out in 3 different places, give 99% of them Miralax and probably 50% of them MedPass and get done on time. I would clock in at 6, get on the floor at 6:30, have to do treatments to bottoms (before they got up), do blood sugars, get insulin ready, start to pass those meds before they go to the dining room--yeah no problem! Most of these people need to take their meds at the time of their meal. I wouldn't like to take a whole handful of pills on an empty stomach-I don't blame them. Then AFTER their breakfast, most of them go to therapy. So you have to try to chase them down in therapy-again, not in private and give their meds. I calculated how many meds I was giving in the morning and....no kidding......287 medications. Keep in mind I'm trying to carefully check these against the MAR as I should and follow the 5 rights. Sorry to go off on a tangent-but I just think the only answer to this problem is...you got it.....more nurses! I know for a fact that many meds simply did not get given because of time.