Struggling with med pass-LPN in LTC

[Mariah Walker, CNA, LPN]

Hello all, I'm a new grad LPN. I am in phase 1 of my RN program (generals for a year). I have worked LTC for 4 years, was a med tech for 1.5 years before getting my LPN. However, I have moved jobs and moved towns. So, my new job has 24 residents on each side. One side is very heavy (a lot of lifts and way more meds). The other side is much easier (less meds, almost all independent residents). I'm always super behind on my med pass and end up doing my meds from like 4-10:30 straight, which is my shift end time. We have a 2 hour time slot to get each med pass done and I had a bad experience where one of the RNs was kind of upset that I had so much meds for her to finish when she came in at 6. I'm trying my best but this is 9 more residents than I'm used to passing meds for. My other RN (preceptor) says I'm doing great. How do I get faster at med pass with more residents? We scan meds && patients so it does reduce med errors. Any advice is much appreciated, thank you! 

[vampiregirl, BSN, RN]

It takes time to get faster. Learning to keep yourself organized and getting a process in place can help. Little things like figuring out a system for yourself to order refills. Making sure the med cart had all the required supplies including fresh water prior to each med pass. Also knowing how to prepare each patient's meds (whole, whole except for the potassium which needs to be split in half, floated in applesauce, floated in pudding, floated in yogurt, who only drinks their miralax in cranberry juice etc) - I made myself a cheat sheet that I just updated and gathered all my supplies prior to med pass. Adding 9 patients is a big deal, especially when it's all new patients. 

Please also remember though that correctly doing all the required steps of a med pass isn't typically a "quick" process. Better to do all the appropriate steps and perform a safe med pass. It's also helpful when a supervisor or regulatory agency is doing observations because you can just do your "normal" routine instead of trying to remember how to do it correctly. 

When I worked LTC, I was NEVER the "fast med passer" because I did all the appropriate steps including any assessments required for meds. But my med error rate was nearly non-existent. Med passes can be critical - so many patients take a number of meds that if not administered appropriately can have serious consequences. 

If your preceptor is giving you positive feedback, please accept it. And give yourself grace as you are learning. 

[Claireofgreen]

I used to be an LPN before going back for RN/BSN. The only unsuccessful med pass is one that involves a big error. It's not your fault there is more work than time at your job. Meds are such a critical area of nursing that have the highest likelihood of causing damage to a patient and it's not appropriate for anyone to cause you to feel rushed doing it. Your colleagues need to cut you some slack. Try not to allow yourself ti become stressed by that RN. She apparently has no memory of what being a new nurse or new to a particular position is like and is focused on her own discomfort with the work load. You will get faster with experience but that should happen organically and not from a sense of being rushed.