... I am new to nursing and ALREADY NOTICED/KNOW that things aren't exactly like nursing school. For starters, I did every one of my nursing school clinicals in a hospital setting and our courses were geared more toward managing the acute-care patient too boot.
I work at a SNF/LTC facility where not only to I pass a litany of oral medications per patient, but I do wound care, feeding tube administration, and the occasional IV antibiotic administration. All for 25 pts per shift. I runn my butt off!!
Oh, and only had 3 DAYS of 'training'.
Is this the type of place people warn about when they say "you'll put your license on the line" ??
Or, is there something more specific I should be looking for and worried about??
A want to avoid such a place, especially as a NEW GRAD RN.
I have been late. Very late. I am late because I do my 3 checks of 5 rights and I want my patients to take their pills with fresh H2O. I encourage fluids all the time unless it's contraindicated. My aides help patients with hygeine, repositioning, and feeding but are too busy / lazy to get my people fresh H2O. Add in 5 accuchecks x2 plus coverage, crushing many pts pills and mixing with applesauce, really crushing other patients' pills and administer via g-tube, and the continual trips to and from the narc room to get scheduled and PRN controlled meds for at least 10 of these people, and I am late. Really late to the point where the aides are saying 'what's WRONG with HER?!'
Nursing school teaches you how to make an impractically long list of everything that could be done for a patient, it's deciding what will be part of the 90% of that list that won't get done that nursing school isn't always so good at.
Tasks are arguably a minor part of how we earn our keep, really it's deciding what will and more importantly won't get done that defines our role (prioritization).
In order to provide good care and protect your patients, you might need to let some things go, learning to live with people taking pills with water that came out of the tap more than 5 minutes ago might be a start.
noun, plural lit-a-nies.1. a ceremonial or liturgical form of prayer consisting of a series of invocations or supplications with responses that are the same for a number in succession.
2.the Litany, the supplication in this form in the Book of Common Prayer.
3.a recitation or recital that resembles a litany.
4.a prolonged or tedious account: We heard the whole litany of their complaints.
litany
noun
Definition: 1. repeated series; 2. a long list of unpleasant things, particularly things that are repeated
Definition: 1. repeated series; 2. a long list of unpleasant things, particularly things that are repeated
Synonyms: recital, list, repetition.
Sounds like an LTC med pass to me.
The list, or the action itself, may be long and tedious...but it's the verbal or written recitation of its contents that constitutes "litany."
, ... pass a litany of oral medications per patient, ...
Let's see, what would be a better word for this idea? Hmmmm ... array, laundry list, series, catalogue, storehouse, agenda, inventory, schedule? Each, with a good adjective before it, would be good.
@ Grntea- If you wanna run through my comments and questions with a fine-tooth comb,go for it. I usually appreciate constructive criticism, but Im not a big fan of pointless scrutiny.
My med pass is late too. I work on rehab, right now I have 30 residents, probably 25 of them get meds during the HS med pass that I do. It is not physically possible for me to complete it in two hours and that's just the way it is. Luckily, I have just a couple that get really cranky if they have to wait, so I just do them first and be done with it. I don't do any vitals for my Med A's during med pass, I give a list of people I need to see to my CNA's and they let me know when they are heading into those rooms during the night.
Lol,
I have been late. Very late. I am late because I do my 3 checks of 5 rights and I want my patients to take their pills with fresh H2O. I encourage fluids all the time unless it's contraindicated. My aides help patients with hygeine, repositioning, and feeding but are too busy / lazy to get my people fresh H2O. Add in 5 accuchecks x2 plus coverage, crushing many pts pills and mixing with applesauce, really crushing other patients' pills and administer via g-tube, and the continual trips to and from the narc room to get scheduled and PRN controlled meds for at least 10 of these people, and I am late. Really late to the point where the aides are saying 'what's WRONG with HER?!'
I'm a big fan of the word "plethora"! Not commonly used and very appropriate here!
The list, or the action itself, may be long and tedious...but it's the verbal or written recitation of its contents that constitutes "litany."
Let's see, what would be a better word for this idea? Hmmmm ... array, laundry list, series, catalogue, storehouse, agenda, inventory, schedule? Each, with a good adjective before it, would be good.
In order to provide good care and protect your patients, you might need to let some things go, learning to live with people taking pills with water that came out of the tap more than 5 minutes ago might be a start.
Understood. The thing that's troubling me is that so many of my patients are incredibly THIRSTY when I give them their pills. We learned in nursing school that the feeling of thirst diminishes with the elderly. And that adequate hydration promotes adequate tissue perfusion, thereby reducing the incidence of pressure ulcers, infections, and heck even codes. Each of my 25 residents/patients gets an average of 8 medications on my shift (2nd) alone. I was taught that the elderly metabolize medications more slowly (ok, so everything slows down with them except BP), so if my people aren't well hydrated, we are asking for trouble. Obviously, I have some work to do with time management, the place I work at has unrealistic expectiations, &/or I should be delegating more.
I would like to figure out how I can delegate more effectively to my aides. We got oh, 1 chapter on managing styles in nursing school.
To be honest, I am struggling to worry about and learn MY job 1st. I must say that I'm feeling resentful towards the established nurses who haven't delegated a thing to these aides. We nurses run around like mad-women while many of the aides sit around and play on their iphones.
What part of this is putting your license on the line? They all seem to be tasks well within your scope of practice and licensure...
Yes, they are. But like I said, I am LATE. Like 3 hours late, maybe 3.5 for some of my patients and it's documented on our electronic charting system as such. I try my best to hurry things along, but many times I'm assessing and trouble-shooting as I make my way around the facility with meds.
If you're letting your aides play on their phones, you need to step up your management skills NOW. In my facility, having a phone on the floor is an INSTANTLY fireable offense. All I have to do is call my DON and she will come in and walk them out the door. It's happened too. Water passes are done 4x a day where I am, done by the CNA's. You're bringing on some of your headaches yourself I must say. I wholeheartedly agree that running for fresh ice water for each patient is ridiculous. Why do you not have a fresh pitcher on your med cart? And if you don't, again, cool tap water will not hurt to take a few pills with.
Understood. The thing that's troubling me is that so many of my patients are incredibly THIRSTY when I give them their pills. We learned in nursing school that the feeling of thirst diminishes with the elderly. And that adequate hydration promotes adequate tissue perfusion, thereby reducing the incidence of pressure ulcers, infections, and heck even codes. Each of my 25 residents/patients gets an average of 8 medications on my shift (2nd) alone. I was taught that the elderly metabolize medications more slowly (ok, so everything slows down with them except BP), so if my people aren't well hydrated, we are asking for trouble. Obviously, I have some work to do with time management, the place I work at has unrealistic expectiations, &/or I should be delegating more.
I would like to figure out how I can delegate more effectively to my aides. We got oh, 1 chapter on managing styles in nursing school.
To be honest, I am struggling to worry about and learn MY job 1st. I must say that I'm feeling resentful towards the established nurses who haven't delegated a thing to these aides. We nurses run around like mad-women while many of the aides sit around and play on their iphones.
As said earlier, no one knows of any nurse who had their license yanked by the board for being late with a med pass. Yes, your state might have a stroke about that, but that will come back on your facility, who of course is going to want to know why you're late, but again, NOT something you can lose your license over. I refuse to hurry along and risk making a med error, which, if serious enough, COULD jeopardize that little piece of paper I've worked so hard for
Yes, they are. But like I said, I am LATE. Like 3 hours late, maybe 3.5 for some of my patients and it's documented on our electronic charting system as such. I try my best to hurry things along, but many times I'm assessing and trouble-shooting as I make my way around the facility with meds.
MunoRN, RN
8,058 Posts
Nursing school teaches you how to make an impractically long list of everything that could be done for a patient, it's deciding what will be part of the 90% of that list that won't get done that nursing school isn't always so good at.
Tasks are arguably a minor part of how we earn our keep, really it's deciding what will and more importantly won't get done that defines our role (prioritization).
In order to provide good care and protect your patients, you might need to let some things go, learning to live with people taking pills with water that came out of the tap more than 5 minutes ago might be a start.