Lesson Learned.

24 Feb

yesterday was the day from hell.

I am currently completing consolidation at an amazing not for profit organization. They are pretty huge and own quite a few group homes and run many disability services around the city where I live.  At the location I am working at, we deal primarily in geriatrics.

On any given day, a nurse at my facility is responsible for over 60 patients.Since there are so many, we work with a pre-dispensed medication system (all the meds to be given at a specific time are all together in one pouch)

We are currently in the process of switching pharmacies, which means new med cart, new system, new MAR (the record which we check the med pouches against), new everything.

Yesterday was our first day with the new pharmacy and it was a nightmare. There were medications missing from pouches, there were people who didn’t receive any medications at all, there was even one pouch that had a blood pressure medication that was never prescribed to that person!!! Not only was it in the pouch, they put it on the new MAR too!!  So, needless to say, the medication was given to this person and we didn’t realize the error until the second MAR check (all MARS are usually checked twice, but we were unable to do that with these since we were not given enough time). The patient, who did not need BP meds had to be monitored closely for the rest of the day. If your BP drops too low, you’re at a high risk of going into cardiac arrest.

The pharmacist even pre-dispensed narcotics in the pouches (HUGE legality issue, so we were unable to give those pills!) We also did not receive any PRN (as needed) narcotics!!! We have palliative patients who are in extreme pain without them.

It was a zoo. An absolute zoo. I finished my 7am med pass at 10am.I broke down in tears in the bathroom from stress, residents were mad at me for not getting their pills on time, or not getting them at all (they hadn’t arrived!)

And that’s not all!!! My facility has been in outbreak since January (a full month!). All activities have been cancelled until the outbreak was declared over. (not to mention all the extra work we nurses have to do during an outbreak!) In order for the outbreak to be declared over, it must be five days since the last person was put into isolation.

….With less than 24 hours left to go before the outbreak was officially over, one more resident got sick and was put into isolation. FML!
I swear, I could hear the staff groaning in unison.  Another 5 days (at least).

So…lesson learned…. Make sure you take a vacation the week your facility switches pharmacies.

I was so exhausted… my 8 hour shift turned into a 9 hour shift. By the time I got home, I was so exhausted. I told Britton about my day, had some dinner, and then at about 7pm I layed down to have a nap. I didn’t wake up until 6am this morning!!!

Thank goodness today is my day off!!

Plans for today include:

– addressing more envelopes
– sewing more clips into hair extensions
– Getting my wedding ring ordered
– groceries
– picking up the RSVP cards
– finalizing honeymoon plans (stay tuned to find out the when and where!)

Phew. Busy day. Off to get started!!!

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