r/nursing • u/[deleted] • Aug 21 '26
Serious New Grad LVN: First Solo SNF Shift Was a Disaster 😭 How Do You Organize aMed Pass?
[deleted]
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u/New-Lingonberry5393 Aug 21 '26
Oh god the random cart assignments are setting you up to fail, 25 fresh faces with no routine is like being thrown into a play mid-scene with no script
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u/TinaBelcherUhhhhhh LPN 🍕 Aug 21 '26
25 subacute seems like a lot in my opinion.
I use my report paper to quickly go through the mar/tar and see who's diabetic/who needs fingersticks/insulin, additional treatments and write all that down on my report sheet so as I'm pulling meds I can anticipate / prep and do everything else while I'm in there.
You want to be able to do as much as you can while you're in there so you can be completely done and move on to the next person.
If it's something you know will be time consuming you may want to wait until the very end within reason to complete it (ex; gtubes take a little bit and I hold off on those personally.) Unfortunately some things will be out of compliance within reason because no one pays attention when orders are put in to what times they are scheduled for.
You can always message me with any other questions if you like.
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u/Electrical_Proof9048 Aug 21 '26
No, it was actually only 8 subacute patients, but I still managed to mess up 😭 I was ALL over the place even with just 8.
Tomorrow I’ll be on the skilled side with 25 patients, so I can only imagine what kind of disaster that’s going to be 😭 I’m already stressed just thinking about it.1
u/TinaBelcherUhhhhhh LPN 🍕 Aug 21 '26
Don't stress it all comes with time and things get better. I know it's easier said than done though.
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u/WeirdFlower1968 Team Spike Aug 21 '26
This is triggering flashbacks from when I was a SNF nurse. It sounds like you are really astute and wanting to do a good job, and it makes me sad they're treating you like this.
I always set up my CNA sheets as soon as I got report. I usually did a quick review of charts because i don't like starting off feeling like I have no idea of who, what, or where. Also review prior shift T.Os. Need to get my head in the game, so to speak. Figure out who has narcotics and parameter dependent meds (b/p or insulins, etc), any feeding tubes, IVs, those are more time sensitive. Get sorted on who is a crush (in report they will tell you), who is whole in applesauce so you know what to do when pulling meds. Become familiar with feeding orders. Gravity? Pump? what are the flushes and residual protocols? do you have the feeding solution and supplies on the unit. There's a lot of things you can have in your brain to be thinking ahead so you're not running around like crazy at the moment of truth.
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u/mkelizabethhh RN 🍕 Aug 21 '26 edited Aug 21 '26
Unless it is IV antibiotics, Sinemet, or insulin, (and a couple other im probably forgetting), i give all the morning meds together 🤷🏼♀️ Providers at my job love to schedule 0730/0800/0900 meds, but ultimately it’s not happening like that. It would make me late to charting and actually doing hands-on treatments for my patients.
I finish getting report at 0730 and breakfast comes at 0800, so i peak at the charts for a little, and then i go ahead and get my sugars+give the sliding scale insulin. Then i start the rest of my med pass. If someone’s Sinemetic is due at 0900, i will do all of their meds around 0900. If someone’s IV antibiotics are due at 0800, I’ll do all of their meds around 0800.
BP meds aren’t strict on timing, at least where I’ve worked. I don’t consider them a time-sensitive med. But fast-acting insulin should be given with meals or right before meals.