Terry Hanley, Nursing Coordinator
One of my favorite aspects of being the nurse at Spring Lake Ranch is working myself out of a job! By this I mean doing everything in my power to support each resident until they don’t need me anymore. Both the mission of Spring Lake Ranch and the core values of the nursing profession support maximum independence.
First Steps
When someone is first admitted to the Ranch, they usually start out with most of their medications procured, stored, dispensed, and documented by staff in the medication room. When they leave the Ranch for the next phase of their journey, many clients will be taking on these important tasks for themselves. As a psychiatric nurse, I believe that understanding the integral role of medications and supplements in healing the body and mind, and practicing the day-to-day tasks of using prescribed meds for their intended benefit, are crucial aspects of rising to the best life we can attain. Studies have shown that adherence to the prescribed medication regimen is one of the top predictors of thriving after inpatient or step-down treatment, so it makes sense that we want to help residents gain knowledge and confidence about their medications while they are here.
To that end, we are constantly listening and observing to find the right time to begin encouraging a resident to embark on the process of Medication Independence Training. Our initial interview in the MedIndie program reviews the participant’s medication regimen, provides fact sheets for each med, and discusses questions the resident may bring.
Establishing Independence
When ready, the resident begins self-administering a portion of their daily medications in the medroom with full supervision and support. Progressively, when the resident, the RN, and the treatment team are comfortable with mastery of each step in the process, the resident is encouraged to take on more responsibility for their medications. For Elliot Aftercare residents who are moving to the next level of the SLR therapeutic program, Medication Independence Training may involve the resident dispensing their own medications from a locked safe in their room, and keeping track, in writing, of their day-to-day meds. Ongoing support from the Case Manager and the RN continue to be important to safety and success at this stage.
There are many variables in an individual’s MedIndie process, and we know that no two journeys toward independent living are the same. The complexity of a resident’s medication regimen, the past experience someonone has had with organizing and dispensing medications, and distractions internal or external are all factors in the level of support needed and the time we’ll spend on each progressive step toward full med independence. The commonalities we strive for are unconditional positive regard for each participant and the continual recognition of the resident as the captain of their own wellness journey. We want to listen, to share information, to encourage, and to empower, throughout the program.
What Comes Next
Currently, about 25% of our resident population is actively involved in some phase of the MedIndie quest, and we are thoughtfully moving toward increasing this. We have seen several pioneers take their acquired skills and knowledge forward to Independent Apartment Living in Rutland, to other therapeutic programs, or to their home environment after SLR. Residents and their families, treatment teams, and medroom staff will continue to collaborate to develop and improve our medication independence training, and to assess its impact in promoting best outcomes.
We believe the SLR MedIndie program is a valuable part of advancing and enhancing recovery and wellness for our residents. I continue to admire the work of all our participants, and I am so grateful that every day I get to be a part of the healing empowerment that is the heartbeat of Spring Lake Ranch!
