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Should I say NO to refilling meds for med nurses?

Medications   (722 Views 13 Comments)
by Earthgrlrn Earthgrlrn (New Member) New Member

49 Visitors; 4 Posts

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I am a charge RN at a nursing facility. We have 99 beds & 4 med carts. The med nurses are constantly down to the last 2-3 pills (narcotics) or completely run out of medicine. Instead of calling the pharmacy themselves, or calling the doctor (for narcotics, if a signature is needed) they expect me to do it.

I think the med nurses should be responsible for making sure that refills are sent to the pharmacy, for calling the pharmacy, calling the MD, etc if they run out of a medication or are almost out. I am never on the med cart & do not know which meds are running out. It’s a giant waste of my time to try to get refills because the med nurses waited until the last minute. Also, patients who need narcotic pain medications end up having to be without medication when they need it.

Lastly, if the charge nurse is the one obtaining refills & med nurses are not held accountable, there is really no reason for them to put in refills before the patients run out of medication. Therefore patients will always run out of medications. If med nurses are made accountable for obtaining refills (calling pharmacy/MD) then they will be more likely to try to get the refill before it runs out. 

Anyone have a reason why the charge should be responsible for obtaining med refills? Or am I right that med nurses should be 100% responsible?

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9 Followers; 22,393 Visitors; 2,943 Posts

What, in your estimation, is the reason that the nurses wait to address this issue until it absolutely must be addressed because they are running out (or have run out) of meds?

Edited by JKL33

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TriciaJ has 37 years experience as a RN and works as a Retired.

10 Followers; 32,570 Visitors; 3,116 Posts

The only time I worked long term care was a few agency shifts before I ran away screaming.  I would come on duty and take report from another agency nurse.  Then I would spend the entire day chained to the med cart.  I had to hurry up and be finished on time because the next nurse, also agency, needed to hit the ground running.

I always inherited a sticky, unstocked cart and I passed on a sticky, unstocked cart.  There was literally no time to wipe it down, restock, etc.  If something was missing during my med pass, it was a huge ordeal to locate it.  That's because I didn't know where anything was and got minimal help when I asked. ("It's in that room."  Said room being full of stuff with no apparent order to placement of items.  Huge time suck.)

The RCM would frequently come up to my cart, turn my MAR book to a different page to update an order and leave it there.  A manager would occasionally come up to me and remind me to "be sure to initial all the squares".

OP, if the working conditions are at all similar in your facility, the med nurses may already be maxed out.  I have found that when hard-working people quarrel about whose job something is, it usually means that there is just too damn much work and too few people and too little time to do it.

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9 Followers; 22,393 Visitors; 2,943 Posts

When I hear that nurses will never be responsible if blah, blah, blah, I check out.

🤡

 

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6,330 Visitors; 565 Posts

It’s been a couple years, but I vaguely remember that our med cards had reorder stickers you could pull off and place on a reorder sheet. Do you have something like that or is that something your pharmacy could do?  If so, the nurse could throw the sticker on the sheet as they go and turn them in to you to fax?  With this system, it really wasn’t to hard to do as you go. 

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MunoRN has 10 years experience and works as a Critical Care.

63,670 Visitors; 6,068 Posts

I would guess that for a nurse passing meds on 25 different patients, there's not going to reliably be sufficient 'spare' time to manage the facility's medication supplies as well as passing meds.  A good system for making this happen that doesn't rely on time that doesn't exist might be more effective.

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49 Visitors; 4 Posts

I think the nurses wait because they think somebody else will do it (for example, if they are down to the last pill and tomorrow is their day off they figure someone else will do it, and someone else does—the RN!)

It mostly had been happening to narcotics that need an MD’s signature to be refilled. When I passed meds & a medication was almost out I would call the pharmacy and/or the MD and get it refilled myself. I never asked the RN Charge to do it for me. Besides, I never access the med cart. I have no idea what needs to be filled, or what medications are about to run out. That should be the med nurses’s responsibility. 

 

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685 Visitors; 262 Posts

Yes, it should be the responsibility of the nurse that passes the meds.  Maybe there is a way to make the reordering process easier?

There should be a policy that says that the meds must be reordered when there are X days worth of pills left (probably 7 days, or whatever time the pharmacy needs to refill & deliver).  That way, there should be less passing the buck of reordering.  

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"nursy" has 40 years experience as a RN.

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I would think the facility has a policy addressing this issue one way or the other.  Whoever does not follow policy consistently should be written up.  If there is no policy, then administration should be informed that a policy should be created.  And also there should probably be a meeting to address easier approaches to getting the meds reordered so that people will be more likely to do it. 

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4,742 Visitors; 171 Posts

Wait, don't LTC nurses have like, 30 patients at a time? And only 8 hrs to deal with all of them?

IDK, I don't work in a LTC facility, but I can't imagine they have much time to breathe, let alone call in refills...is there a reason that they can't let you, as charge, know when they are running low, and have YOU do it? 

Seems more appropriate for someone not in patient care to be making frequent phone calls to pharmacy and MD offices than to have headless chickens who are already swamped with meds, wound care, dealing with family members, charting....

It's like us hospital nurses with our sacred whiteboards...if management had soooo much time to chat with the patient, inspect the room, notice that my whiteboard was from last night...freaking change it yourself! You obviously "have the time!"

 

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49 Visitors; 4 Posts

On 4/1/2019 at 9:51 AM, MunoRN said:

What makes you think I have any more time than they do? I’m not just sitting down twiddling my thumbs. It’s not about time. There’s never enough time in the day for anybody—it’s about being accountable & getting refills before medications run out & not expecting someone else to do it. Guaranteed if the nurses are responsible for doing it they wouldn’t run out of meds as much as they do. 

Ive been on the med cart and never asked the charge to call for refills. In fact I did as much as I could, including skin tears, assessing patients with COC’s etc. 

If state surveyors were following a med nurse & a medication was not refilled, they would not say “oh why didn’t the CHARGE fill the medication..?” The person or persons responsible would be those on the med cart, not someone who never passes meds!

 

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9 Followers; 22,393 Visitors; 2,943 Posts

Tell them you are not going to do it, then.  It sounds like that will solve your frustration and the problem of running out of meds, both. Sounds pretty simple.

When typing a reply, you can't type in the box generated by quoting someone. It makes it appear that your words are theirs.

 

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