What is the med pass like at your DOC

[newtress]

I just finished reading a post in the general forum from an agency nurse who went in for a shift at a prison. She described "the med pass" and it sounded beyond the beyonds insane. I'm currently registered and on the list for CDC, and now.. well, horrified at the thought of doing any med passes for over hundreds of inmates on one shift. Is it really that way? I did not like LTC because of the turbo med passing to 50 plus pts. Maybe it's facility specific?

[Blackcat99]

A DOC med pass has many advantages over a LTC med pass. When you do a LTC med pass you are constantly interrupted by family members asking questions and making complaints. In LTC, you have constant patient emergency w/c and bed alarms going off and other non-stop interruptions. At a DOC facility, you don't have to deal with any difficult family members and friends. You don't have emergency patient alarms going off every 5 minutes. That's what I loved about DOC.

[newtress, LPN]

To danrodz and the other posters: Is the 2 hr or more med pass to 80 plus inmates when you come on shift, and there's another one w/in your shift and you have prn meds also? What I'm fishing for here is that I can't assume you only have one big med pass to all your patients/inmates. Or are the meds ordered by the physician to be administered q daily?

[danrodz]

The way it works at my county jail is like this: there are 2 shifts for the LPNs. 7-330, 3-1130. There is one nurse in the office from 11-730, a RN or LPN depending on the paperwork involved that day. Day shift has 2 med passes, a large one at 9am (really 8-10) where you will see just about all of the 80+ patients. There is an insulin round at 11am before lunch and can be anywhere from 2 or 3 patients to 10-12. Then at 1pm there is a much smaller pass, usually 15-20 patients but it can go to 45-50 for pain meds. The evening shift does 5pm meds and insulin at the same time and 9pm meds and insulin at the same time. One the 5pm pass you see about the same amount as at 1pm and at 9pm you will see most everyone. Patients know that for prns they need to catch the nurse on one of the 4 med passes. As for the night nurse, this shift prepares paperwork for transfers to other facilities, routine office work, spillover from the previous shifts and the the 7am insulin round. There is always plenty to do so the time goes by fast!

[newtress, LPN]

You're not kidding there's a lot to do! I currently work at a psych hospital and I do meds for the adult unit, adolescent, chemical dep/detox and childrens sometimes. The most I may have on a shift can be 42. But it sounds like your volume or census for med passing is high if it's just one nurse giving all those meds to the numbers you described. My 3-11 shift seems like a chaotic rodeo, so I don't know if I could do my best in a correctional setting but was what I eventually wanted to do. Not so sure after "fishing."

[NURSEPATTY]

I can vouch for nursejudy15209; I work there occasionally thru my agency. The med pass is heavy, and you need to be organized and quick to get all the meds passed before lock down. Some pods have lock down later, and that helps if ya get behind a bit. I enjoy working there, but dont get as many days as I would like. ICONGRATS Judy on the 4th anniversary of being there!

[Chaoticdreams33, MSN, RN]

I'll let you know next week!

[out of place]

Recently began working for a facility in Illinois. The med pass is a mess.

[newtress, LPN]

I wonder if you could elaborate on the mess?

[out of place]

Sure. medications come prepackaged, however loose medications can be found every day strewn about on the bottom of the medication cart/s drawers. These meds are then scooped up into a cup to be picked thru to fill medication needs. Sometimes several hundred pills can be found in cups in various med drawers. There are packages of medications scattered about the medication room, in wash basins, in the sink, on the counter tops and in large plastic bags, usually in no particular order. You may be on the hunt for vasotec, and will locate it amongst cards of zocor, paxil, PCN, and trazadone. Filling for med pass consists of searching through any and all medications wherever you can find them. It is very rare that you will actually find the inmates medication in the correct area filed under their name, and if you do, chances are, several of the medications were needed to fill anothers med order, so most were taken from their packages It may take several attempts, looking in several med carts, drawers, cups etc. before you can fill the need for a prozac....in a facility that can house a couple of thousand, a 20 minute task can take 2-3 hours, and you have not yet started to pass. The actual passing of the medications is dicey depending on where you are assigned. Sometimes it is a constant screaming, swearing, door banging kind of day, while other days it is less deafening.....but it is always unnerving. I have been told that it is like this in every correctional facility, and we just do "what we can to get by" is that true? It seems this is a perfect place to develop "bad" habits, to a point where other facilities, like hospitals, don't warm up to someone who lists a correctional facility on the resume.

[Orca, ADN, ASN, RN]

I used to do HS pill pass in a state facility of about 2,500 inmates. I would prepare my meds before I went out, and I went unit to unit. The yard was approximately a half mile from end to end. About 350 inmates got meds. A typical pill pass lasted just under three hours - and I was not slow.

[Chaoticdreams33, MSN, RN]

Well, I have now seen and participated in the am med pass at four different facilities. It's not so bad. I mean, there are a lot of meds for sure, but it seems like once you get used to it it won't be too too bad. Passing the meds in a minimum or medium security facility, where the inmates come to you, is easier in my opinion. They show you their ID and you get their meds that you poured.

So yesterday, I came in at 7 (my 6th day on orientation) and found out that two nurses had called out, so a nurse floated from another facility and another nurse got mandated to stay from night shift at another facility. So I started pouring the meds. My first time doing it there, and I poured the meds from 7am to 830am with some assistance. Another nurse pulled meds from the pyxis that needed to be pulled. The med pass took about 30-40 minutes since half of the guys didn't show up (raining on an open compound). We had to call down a few for ID meds, and then a few for thier injections. And then go to the RHU. And then I needed to go through the MARs and document all the no shows and sign the back of all the pages I signed. I didn't finish with everything until 1130 or so. But that was my first time. And the MARs were awful. Some of the nurses were still giving meds that expired days ago. So I also spent some time talking with the charge nurse and cleaning things up.

The med pass at the max security is kind of a pain, but good because you get to walk around a lot. But it is hard to see in those tiny windows and sometimes both guys in the room look similar and it is difficult for me to identify them. So I am kinda glad I'll be based at a min security facility, though some people like the max better.

[newtress, LPN]

Thank's so much for your insight into your morning med pass. Appreciate everyone's honesty and posts. But hey, continue on to tell those who don't know what it's like!