The trouble with trolleys

Posted on October 24th, by geoff in Caring Times, CT blog. 1 Comment

By Caring Times editor Geoff Hodgson

Last week I spoke to a nursing home operator who told me that his homes had abandoned the use of the medication trolley in favour of medication cabinets in each resident’s room. Along with this, care workers are being trained to give residents their medication and to perform other duties once the exclusive domain of the trained nurse.

I applaud these initiatives. As a former trained nurse I have many times had the experience of trundling the trolley around while the real care goes on around me. In an acute hospital setting, the drug trolley is a practicable and efficient means of delivering medication to the right person at the right time – it only occupies the time and attention of one member of the nursing staff and there are other nurses to get on with the nursing. Not so in a nursing home, particularly at present where the difficulty of recruiting nurses has seen some operators change their registration away from nursing.

I have long maintained that a nurse’s primary function, in any setting, is one of close observation and early intervention. A good nurse will quickly spot increasing confusion, incipient dehydration, declining mobility, etc, and having close knowledge of each resident, can often institute a nursing intervention to address the problem while she (or he) arranges for a medical review.

Medication administration is an admittedly important aspect of a nurse’s role but in many nursing homes it takes up a disproportionate amount of a nurse’s time, taking her away from those functions where she is better deployed. I know that in some particulars of medical administration there are legal requirements for a nurse’s involvement. I think that in some of these areas, the law needs to be reviewed.

  • The CT Blog is written in a personal capacity – comments and opinions expressed are not necessarily endorsed or supported by Caring Times.

One response to “The trouble with trolleys”

  1. John Burton says:

    I have been advocating this development for many years in articles, talks, training, and as a consultant to care homes. I know that a few homes have adopted it. It is a sigh that a provider of care is thinking differently.
    The question we should be asking is what keeps the medicine trolley and all its associated institutionalisation and waste of resources going? What is it in our system of care and how it is led, inspected and practised that holds such practices in place?
    I think I know the answers to that question but until a substantial number of others break free of their blinkered short-sighted view of surviving and trying to be good or outstanding, we won’t change social care much at all . . . ever.

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