Med carts with no drawers

We can't use a med-cart, or even a linen cart for that matter. We have to administer meds by going to the medication machine, then to the patient's room, scan the meds by lugging the huge, clumsy computer around, one at a time. Takes forever, and yes, people stop you for stuff all the time. (I usually work in the ICU, so I personally don't have to deal with this as much). Even linens and bath necessities are hand-carried. This makes it hard to be organized and efficient. Plus our med scanners must have been purchased at a used merchandise auction because they only work right about half the time. Very frustrating and time-consuming.

Just an addendum, found a different policy regarding meds and it has this little jewel:

Sorry my dear director, looks like it's policy that we need a lockable drawer. We're not supposed to leave them exposed on cart, ha! Thanks all for responding though, I appreciate the time it took ya'll took to write your responses. Hopefully this nugget will be enough to get us what we need.

I think you need to be careful. Obviously the policy to which you refer is going to change if there are no more medication carts and the entire procedure of obtaining all meds and supplies for a med pass and locking them into a cart is going away.

You are not going to get them over a barrel (so-to-speak) about something they have decided to change. I have observed numerous attempts at this type of thing from staff nurses and in return they have been made to look ridiculous and petty, labeled as being afraid of change, and accused of trying to hamper "patient safety" efforts. Becoming emotional with objections to change doesn't usually end well.

Probably the most professional and safe way to handle this is to simply be open-minded and seek to understand what they envision the new process looking like. After that, you can make appropriate inquiries. "How will our new process look during times where medication administration is interrupted after the medications have been removed from the dispensing cabinet?" [...hear their answer]. If the answer doesn't address your concern then you can be more direct: "Will there be a drawer in the room or another place that we can quickly secure medications if we are interrupted?" and "Will there be a workspace designated to be used during the immediate administration process?" and "Where will patient-specific multiple-use medications be stored (inhalers, insulin pens, etc.)?"

Be smart about this. Your ace-in-the-hole is not a policy that clearly isn't going to apply anymore, and it would be a good idea to save objections for things that are clearly in no patient's best interest. If they want to change a process and the main objection is that it's going to slow things down, well....okay. That's their choice. You aren't required to make up for their decisions in a way that compromises patient care, so you just play it cool. Let them worry about it.

did you miss the part about not being in individual packaging/

Yeah. As a matter of fact I did. I was going off what I read in the OP:

We are a medsurg floor in a big hospital, so meds are in single dose packets.

It is very exhausting having to go back and forward. I remember having to do that. I don't think there will be a better way because most places only want you handling one set of meds at a time.

I know it is time consuming, but I never have more than one patient's meds on my person at a time (except in the example with the big multi drawer carts which have been phased out in a lot of facilities). It is just too easy to make a med error.

I start my shift by making sure everyone's meds are accounted for so i can request missing meds, then i gather room 1's meds take them to room 1 administer. Go back to the med room gather room 2's meds repeat...

Now this is, in part, because i came from PediLand, so room 1's Diuril and room 2's Diuril will almost never be the same dose. But even in school I got in this habit to avoid double dosing a patient or mixing up meds. I'm sure having everyone's meds on me at the same time is faster, but I've never done it that way.

If this isn't really a safety issue that applies to your unit the other thing to consider is joint commision. All sharps have to be in locked containers if in public spaces so only clinical staff have access. If there are needles in these drawers do they lock?

Medications have to be stored in locked areas where only licensed staff have access, so the drawers have to lock, and only nurses doctors or RTs should be able to get to them. If you have more than one patient's medications on you; the other patient's meds are supposed to be locked to keep from being contaminated when you are in the room.

This might be why they are making you change your practice since there is only one unlocked drawer on the new carts.

Have you considered sorting meds for each patient in the med room ahead of time, and dividing them up maybe in lab bags with the patient's sticker? That might be a little more time consuming but not much more than what you were already doing.

As per keeping meds safe. It isn't uncommon for nurses to tell families they can't get them something because they first need to safely administer medications. "I would be happy to, but first I need to give my patient their medications" People generally know that is more important. If a patient can't take a narcotic right now, depending on the hospital, I will either put it in a med cup with their sticker covering the top and secure it in the med room. Or waist it and pull another when they can.

Again the lab bags have always been my friend. I put their meds in the bag, sticker the bag, and tape it to the cart. I even tape an extra one for small trash (blister packs, alcohol swab wrappers, unit dose wrappers) you can't walk away from the meds on the cart, they need to be in your hand. But at least they are all together.

I only use a med cart with drawers in my LTC position.

When I'm working in acute care, we have CoWs and pull each patients meds in the drug room and take them to the bedside

We have basic supplies in each room eg alcohol wipes, compression dots, wipes, etc and if we need anything else like IV supplies, we pull them in the drug room and take them to the patients bedside

What? You guys get carts? What a concept! If it had locking drawers I can imagine filling it up at the start of my AM med/surg shift and then going to town.

We actually have computers in each room, would store the patients meds in the med room and have to go back and forth. I wonder how much time I could have saved with a cart?

Long time reader, first time poster. So I need some advice. Our facility is switching out our computer+scanner+med carts, from huge, heavy, hard to push things with several drawers each (for separating patient meds into 6 drawers plus a larger supply drawer for primary and secondary IV tubing, alcohol wipes, labels, syringes, needles, filter needles, medicine cups, 2x2s, stopcocks, curos for peripheral IVs and central lines, etc).... to these really light computers with scanners. But no drawers. Word of mouth from our director (I need to check if policy has changed or has no mention) is to go back to med room for each patient compared to previously loading up according to the eMAR, and returning for only as needed extras or insulins, another IV bag, etc. With 6-7 patients receiving oral meds, IV antibiotics, IV bags, and pain/nausea meds PRN, we are not too sure how that's going to affect workload. And safety for all.

And ignoring that part, how to keep the meds safe? We are a medsurg floor in a big hospital, so meds are in single dose packets. But without a drawer, they just sit on the flat top of the workstation. In perfect world, fine. But they're going to roll or slip off. And we can't be with them from med room to administering in patient room 100%. What do we do if a family member approaches as asks for water, or an emesis basin for another patient while we are in the hallway? Or what if I am in a patient room with them and family, and they ask to go to the restroom? How can I help the patient while leaving the meds exposed on the cart, opened or unopened? What if there's a narcotic? What if I am drawing vial or preparing to give an oral narcotic or patch like Fentanyl and a bed alarm goes on down the hall? Before, we could drop in a drawer, push to automatically lock, and scramble to find patient before they fell. I can't leave it on top, can't be like "here take this!" and wait, nor shove it in my pocket, or waste time taking the cart when we keep our patients safe by literally running to a bed alarm (which isn't going to help since it's loose on top, or open in a cup if I got that far).

Besides writing to our director laying out some of these concerns, and finding one article to print out about workflow with carts that have lockable drawers or none concerning going back and forth, what can we do in the meantime? Oh yeah, the carts have an open basket near the floor we have some few supplies in ziplock bags, but a lot less than before, so we'll still have to make extra trips to med/supply room even then.

I work on an Intermediate Step Down unit. We have to go to the med room and pull each patient's meds individually. You can't leave meds sitting around, period. If you have to, you place them on the counter in the med room (for a very short period of time) until you can go back and give them. In a pinch, you can ask another nurse to watch your meds while you take care of something else. If you pulled a narcotic, put it in your pocket and don't even leave it laying on the counter in the med room or with another nurse. You never leave meds like that in the room with the patient or the patient's family or on an unattended computer cart. It's nice that you all are even going to have carts with computers and scanners. We only have two such traveling carts on my unit. The rooms have computers and scanners. Imagine trying to put on PPE and also balancing the meds you've pulled without a traveling cart. It's doable, but not ideal.

Yeah. As a matter of fact I did. I was going off what I read in the OP:

my apology, I usually am a much better reader than this.