The Med Pass is Ruining My Job!

tyvin, BSN, RN · Apr 25, 2011

You are not alone. The med pass from you know where! As a charge I would have to pass anytime someone called in sick and we couldn't get cover. It's an enormous daunting task; never mind all the wound care and other things that need to be done. Some people do it without a thought and fly through the pass and still have time to sit around. That's not me and I left; even though I wasn't doing the med pass that much just the thought of having to do it brought me to tears.

Good luck to you with the Hospice potential; that's a great field to work in.

westieluv · Apr 25, 2011

It's such a relief to find someone else who understands where I'm coming from, thanks so much for your response!

The nurses that I work with fall into one of two categories, it seems; they either hate the med pass as much as I do but just do it and complain about it, or they don't mind it at all and just consider it par for the course. I am not a person who can just continue to do something that I hate for months and years and complain about it. If I hate something that much, I feel like life is too short to waste doing something I hate. Therefore, I am waiting for a call back from the hospice (the HR lady who will call was on vacation this past week) and if they say I can come back, I will quit this job. I am dreading telling them after only four months, but I have to take care of me or I won't do a good job taking care of my patients.

Thanks again for your response and for the good luck wishes with the hospice job. :)

merlee · Apr 25, 2011

Go for the hospice position - you have to take care of YOURSELF first. Believe me, the LTC isn't going to look after you!!!!

MelissaLPN, ASN, LPN, RN · Apr 25, 2011

I feel the same way. I absolutely dread the med pass. Caring for the patients is the only bright spot in my day. I pray and pray some more before I go into work and its mostly about the med pass.. I say keep looking for another job. I am going back to school so until I am done I know I will continue in LTC but I know just what you mean.

gentlegiver, ASN, LPN, RN · Apr 25, 2011

In LTC, Med pass is 85% of your day. You are given 2 hours to pass meds for 25+ patients. meds are usually scheduled for 8AM so you have from 7AM until 9AM to get it done. But, from 7AM until 7:30 you are taking report and making sure your cart is set up. By then your patients are OOB and can be anywhere, so most of your time is spent looking for them. If you have a pt that had fallen and is on Neuro checks, Dr in to check pts, PT wanting to get an early start on thier day so they can get out early, short staffed, looking for that patient who also has meds scheduled for 10AM,or family calling to see how Uncle Fred slept last night, forget it, your going to be behind all day! Then, once you complete your 8AM pass, it's time to start your 12noon pass! OH, I forgot those treatments you have to stop your pass to get done so they can get OOB. Yes LTC med pass is all encompassing, there are many days I feel like a legal pill pusher, but it is what it is. I love it when I come in to work and find out that we have 2 or more admits coming in, it makes me wish I had stayed in the factories!

And yet, strangely, I do love my job.

westieluv · Apr 25, 2011

Thanks again for the support. I can't tell you how nice it is to know that others feel the same way and that I'm not crazy or ungrateful for having a job. I also pray on the way in to work, and I try to tell myself things to make it better like that this is these people's home and they would never take their meds at exactly the same time everyday if they were actually living in a regular type of home, heck, they might not even take them at all! That's what makes it so stressful, that everyone seems to want their pills at the same time, and 25 people + a cupful of meds each, many of which need to be crushed in applesauce or fed through a g-tube, does NOT equal everyone is happy and gets their meds exactly when they want them. People will tell me to just let it go, that I'm only one person, blah, blah, blah, but the bottom line is, I WANT the residents to be happy with their care. Unhappy residents are stressed out, crabby residents.

Another thing that drives me crazy, and this is probably a topic for a whole different thread, is the amount of meds that these poor people are on and how unnecessary some of them seem to be. Seriously, if I've lived to be 105, do I really need a calcium supplement? At this point, my bones are what they are, KWIM? Same goes for the anti-cholesterol meds like Lipitor. If I'm 95 years old and my heart is still going strong, does my cholesterol level really need to be adjusted at this point?

Sorry, just venting...

prinsessa · Apr 25, 2011

I totally feel your pain! I have worked in LTC for about a year and I hate the med pass. I didn't become a nurse to pass pills all day. What about assessments and teaching? Don't have any time for that stuff! I am now working in the hospital and love it. My day is very busy but I'm busy doing stuff besides passing meds. I don't think I could do LTC full time for the rest of my life. I love my residents but I just can't stand passing meds for so long.

Kissameeshirl · Apr 25, 2011

I truly understand your situation. I was mentally prepared as soon as I hit the door and got as much ready for my cart that I could before counting narcs and the review of all my patients. Lord help me if there was any new patient with scheduled meds every 2 or 4 hours because the med pass itself was so consuming.Trying to mark off each person and ready to go give a med and someone wants to talk about their mother, someone wants to go to the bathroom and there is not an aide to be seen( and they are busy too!) Or a doctor calls etc...which all this time my focus is the med pass and those insulin shots that need to be given and i felt I was torn in different directions and very nervous as I wanted to be accurate educational and caring.

I noticed that I was always giving out meds and some nurses was going on breaks or Dinner, and asking me to watch over their patients while they was gone. Of coorifice i said yes, and running to take a bite and back to the cart and on I went . Grumpy clients was angry as to why i got to them later , that they went to bed at that time. I did not know how to explain certain situations that I had to send someone out to the hospital which made the pass longer . I did not have 4 arms. The pass was the hardest and I truly believe that no nurse could go so fast and not make a mistake or almost make a mistake. I remember one nurse who always went to smoke and I was off that weekend and she was on.We had a rehab part also and the client was in a machine to exercise her leg for a certain amount of time and the client and family of the client repeatedly asked for it to be shut off but apparently no nurse came....I found this out later when I came back to work by the fellow room mates. Did not matter, the nurse in question was sorry and now she is in charge of what ever as I now live somehwhere else but keep in touch from time to time.

So I can only say , that speed gets better with time and time for you and me may be different. I still will or would be slow as I like to be accurate. Mistakes happen with speed also. Marking lines through everything and waithing to sign the narcs in the narc book was what i seen alot of nurses do. i was afraid to do that.Because everytime it was time to count , those people (before the relief came in was charting as fast as they could who they gave narcs to.and they was the ones where a narc would be lost or forgotten.....Not saying I never forgot to give a narc or that i DID my share of mistakes. I just think the nurses who was more (by the book ) like me, was way more slowwer. I also seen nurses get into trouble for (memorizing who got what ) and did not look and all of a sudden they seen they gave a med that was discontinued, Or they started to give a new drug and noticed that the one the gave (already was discontinued) which makes calls to the dr. etc...and all is a big worry as it is the safety of the patient first.

If you have someone who is patient, your speed will pick up doing it the (right way). some nurses omit meds like vit,,,,etc because they say "for tonight ,they can miss this one" ..I got to thinking that if every nurse thought "just for tonight" the patient would not get their vitamines on a therapeutic level.

Then there are the dressings and ear drops and eye drops that take tiem as each patient is different and you just cannot shove them down and say open your eye! or open lay down now so I can give your ear med! So all of this takes patience and is time consuming not counting the charting that MUST be done . Very hard work.

As far as Hospice , if You can work there I would go for it. But while you are still at the place you are, remember that those nurses who like you think of you as a member of their team and must like your work. If they want you to stay, they will help you find also ways to make the pass faster.

What used to help me was the meds given in the morning was on one side of the drawer of a patient and since i worked evenings I tried to make the meds for the evening more to the side of night...Hope this helps.. ps for all the nurses who are so fast please give some help so we nurses can get faster...much thanks. :nurse:

westieluv · Apr 25, 2011

Thanks again everyone for the advice and well wishes. I have to go to work in about an hour, so I will try to take most of it with me. Just knowing that other people feel the same way about the med pass gives me strength and makes me feel supported. God bless all of you. :)

LoveMyBugs, BSN, CNA, RN · Apr 25, 2011

Another thing that drives me crazy, and this is probably a topic for a whole different thread, is the amount of meds that these poor people are on and how unnecessary some of them seem to be. Seriously, if I've lived to be 105, do I really need a calcium supplement? At this point, my bones are what they are, KWIM? Same goes for the anti-cholesterol meds like Lipitor. If I'm 95 years old and my heart is still going strong, does my cholesterol level really need to be adjusted at this point?
Sorry, just venting...

I feel your pain!! I hate the med pass, dread going into work becasue of it. I feel like all I do is push pills on people, and it takes me forever.

I agree completely if I live to be over 99, I plan on chain smoking and eating ice cream:lol2:

Tina, RN · Apr 25, 2011

The med passes in LTC are brutal. That was one of the many reasons why I only lasted in LTC for a few months... I absolutely feel your pain!