Many may not agree, but I consider the medication pass to be one of the most important parts of the whole shift! If I fall behind on that, I feel like the walls are closing in on me. I begin to panic (although many people say I always appear calm). But mentally, I get very nervous if I am late on any medications.
When I first began nursing, my preceptor always told me that when I start my shifts, I must always look over the orders first, and then start assessing my patients. Now, the shift usually begins at 7:00, then I get a report from 7-7:30, and then the medication pass begins at 8.
I learned very quickly that it is impossible to assess all patients before the medication pass. Most times, the report process takes longer than 30 minutes, especially when I get the report from more than one person. To do all patient assessments, then start the medication pass, is unrealistic.
One method I found helpful was starting with my heaviest medication pass. I pull these medications out, assess the patient, and get them ready for bed, and by the time I get them settled, they are my first medication pass. That helps me start on time and get at least one assessment out of the way.
Another method I found helpful was asking the patient if they needed anything while I was out getting their medications. That way, I didn’t have to make numerous trips back and forth to their room getting things like water, pain medication, snacks, etc. Decreasing the amount of time in the patient’s room makes more time for you to see another patient.
If you happen to be falling behind, it is okay to ask for help. When I begin to fall behind and I happen to see one of my fellow co-workers sitting, I will ask them to pass a medication for me (if I trust that person enough.). Or, if I know that I help that person a lot and they are willing to help me, I ask them to give medication to a patient. If there is no one available, I sometimes lean on the charge nurse, if he or she is not busy. Sometimes the charge nurse can be helpful.
Let’s say all your patients have medications at 0900 or 2100, but one patient has medications at 0800 or 2000. At 0755 or 1955, I will grab all the medications for the patient who has 0800 or 2000 medications. That person will be my first medication. If I have two patients with 0800 or 2000 medications, I will start with the patient who has the most medications or the patient with IV antibiotics. That way, I can either prime the tubing for the IV antibiotics, or start scanning the 19 medications that the patient has to take early.
Tip: Start with your heaviest medication pass. Gather all supplies needed, such as IV tubing for IV antibiotics, water, etc. Or, start with the patient whose medications have to be crushed, or if they take one pill at a time and have 30 pills to take.
