"Team Nursing"...hanging meds

carolmaccas66, BSN, RN · Aug 17, 2011

I enjoy team nursing. We were doing this last night in the ED/ER I work in. Mind you, you get the odd rude or nasty nurse, but I can deal with them now.

Anyhow, with all these IV meds, timing is everything. I ALWAYS write my meds - especially IVs - in red on my cheat sheet (my organisation for the shift sheet). If you get a minute when it's not busy (ha ha), draw up the parphernalia you need in the drug room ahead of time and as you say, double check everything along the way. Are you talking about ABX additives or just IVs like NS? My advice is to NEVER rush giving any drugs, especially add's to IVs.

Start your IVs one hour ahead of time if you have many - by the time you re-check everything with another RN, then re-constitute what you need, then actually set the pump to get it going & get the patient comfy, a good 20 minutes will be gone for one IV. Sometimes the shift before left out our bags & paraphernalia we needed, which was much appreciated.

Ensure you have all your times for ur shift on ur cheat sheet so you can cross off each hour as you go along, and also what u have done in that hour.

It is very hard managing so many drips. But my philosophy is ALWAYS do something re medications (meds) ahead of time. Do not leave meds till the last minute, cos that is when you get behind, - and there will be many days when u get behind, but don't sweat it - just document something went up or was given late and do the best you can. It is better for a med to be late than not to be given at all.

MEDICJOHN · Aug 17, 2011

Sounds like pretty much what I do. I was referring to antibiotics. I forgot to mention I am working on med surg now...(kill me)... and our hospital policy is RN's are NEVER to add anything to a bag...only pharm does that...safer that way. Anyhow, sounds like we work the same. and yes, I always start early, sometimes even an hour early to get finished on time. thank you

carolmaccas66, BSN, RN · Aug 17, 2011

No worries re the advice. Just start all your IVs even 1.5 hours earlier, and get your paraphernalia together for each one at the start of the shift. That helps alot. You can only do the best you can.

It's funny pharmacy only adds stuff - we RNs down under add everything, pharmacy isn't even involved.

I'm sick today so if I think of anything else I'll let you know. Let us know how you get on.

Esme12, ASN, BSN, RN · Aug 17, 2011

In the ED here in the states we add our own stuff too but the floors has only pharmacy dispensed and mixed items.

Team nursing is an old concept....one that was in use when I graduated. Our med times were kind of etched in stone on a 9-1-5-9. We didn't add in 8-2 AND other alternate start times. There were the 6A meds then the 9-1-5-9 meds then 6P meds. There was an hour window before and after due time to hang meds. I always placed my times to hang meds on my report sheet....but I think standardizing the times was very helpful to remembering when to hang them.....it's 1 pm I have meds...and off you go. Hope that helps

RyanCarolinaBoy, ADN, BSN, MSN · Aug 18, 2011

I'm not understanding where the problem is? I work in a busy surgical stepdown unit where we practice team nursing. I am usually responsible for PO meds and all IV ABX's and mainlines for 18 to 21 patients per shift when I do the med portion. We have scheduled med times, and also a computerized medication admin system. It works out well. Very rarely do I give a medication outside of the ordered parameters due to time. I guess maybe time managament might be an issue here? not sure...