[mysticalwaters1]

Hey everyone! I've been on orientation in the ER from med surg for about a month. Pretty soon I am going to advance to the critical care section and my major concern is knowing all the different drugs, gtts and rates. I don't even now where to begin. My issue is it is so fast paced I can't possibly look up the drug I'm giving. I mean look it up fast but how do you deal with such fast paced routine. I'm reading an ER book but it's more assessment and pathophysiology things. Some of the nurses are handing me little critical care pocket books but once again still takes time to look up plus a lot of it is gibberish to me. How have you all learned it? Some of the medications has right on the box calculations for you for weight but I would like to know what I'm doing before i give it and without memerizing and entire drug book! Thanks!

[FamilyPracticeRN]

Are you, or have you considered ACLS training? Other than that it may take repetition and just sitting home and reading over the meds over and over. You might try index cards for drugs that are given frequently until you get over the hump. Good Luck!

[mysticalwaters1]

Originally Posted by FamilyPracticeRN

Are you, or have you considered ACLS training? Other than that it may take repetition and just sitting home and reading over the meds over and over. You might try index cards for drugs that are given frequently until you get over the hump. Good Luck!

Yea I have acls! I guess it will work out as I work with it. Thanks!

[TazziRN]

I don't care how sick the pt is, I look things up. If I don't I run the risk of killing the pt. If your pt is that sick you will not be working on him/her alone and the other nurse(s) can help you. I have a pocket book and what I did was take little page markers (the sticky kind, from any office supply store) and mark the critical pages. The end of the tab has the drug marked on it so I can just flip right to it.

[mysticalwaters1]

Originally Posted by TazziRN

I don't care how sick the pt is, I look things up. If I don't I run the risk of killing the pt. If your pt is that sick you will not be working on him/her alone and the other nurse(s) can help you. I have a pocket book and what I did was take little page markers (the sticky kind, from any office supply store) and mark the critical pages. The end of the tab has the drug marked on it so I can just flip right to it.

I talked to one of the ER nurses who worked in ICU for 20 years. She says there are usuals like dopamine and nitro gtts but other ones change every 2 years. There's a current drug book by the critical station and she told me could ask and people would help you. So that's better.

[TazziRN]

Originally Posted by mysticalwaters1

I talked to one of the ER nurses who worked in ICU for 20 years. She says there are usuals like dopamine and nitro gtts but other ones change every 2 years. There's a current drug book by the critical station and she told me could ask and people would help you. So that's better.

Any critical cardiac med, I would look up, no matter how many times I've used it and how well I think I know the drip rates. I will never forget, as a nurse with only a year or two under my belt, I thought I knew a nitro drip rate and it turned out the pt barely got any. I was so shook up that I vowed never to take that chance again. I know the drip rate for a 100-kg person, but I will never give it without looking it up.

[vampireslayer]

Gotta agree with the other posters, you WILL have the time to look things up. Really. You take the time. I used to think I wouldn't have the time, or didn't want to look stupid, but I always look things up.

You'll find that you can do it pretty quickly when you become familiar with the format of your department's drug book. Mostly you're looking for dilution and rate of administration. You'll also want to keep an eye out for side effects. The books will list a ton of side effects, some of which may or may not be very common...mostly keep an eye out for heart rate and blood pressure. Know your pt's HR & BP and check to see if the drug may effect those.

VS

[nuangel1]

you make the time.i do.i look up any drug i am not familiar with ,have never given,to recheck side effects ,compatibility,dosage, etc.i have been a nurse 20 yrs.i want to give medications safely.if your unit doesn't have an up to date drug book request one .if your manager can't or won't provide one invest in one for yourself.

[JessicRN]

Originally Posted by mysticalwaters1

Hey everyone! I've been on orientation in the ER from med surg for about a month. Pretty soon I am going to advance to the critical care section and my major concern is knowing all the different drugs, gtts and rates. I don't even now where to begin. My issue is it is so fast paced I can't possibly look up the drug I'm giving. I mean look it up fast but how do you deal with such fast paced routine. I'm reading an ER book but it's more assessment and pathophysiology things. Some of the nurses are handing me little critical care pocket books but once again still takes time to look up plus a lot of it is gibberish to me. How have you all learned it? Some of the medications has right on the box calculations for you for weight but I would like to know what I'm doing before i give it and without memerizing and entire drug book! Thanks!

Been an ER nurse for 20 years and still look up almost all IV meds. Definitely all drip meds. I made myself a book of all the meds we use in the ED with drip charts attached, the staff loves it. I have one for general meds,one for criticle cardiac meds and one for pediatric meds. During a code I keep the book open and available it does not take seconds to look. I do not have to do calculations as I have already done them.

[kat911]

Get yourself a small notebook that will fit in your pocket. Put the drugs you will use most and those for emergent use in the book. List the drug concentration for standard drip, sol to use, standard drip rate. Quik easy reference. Dopamine 800mg in 250ml of D5w or NS, rate 5-20 mcg/kg/min, Lidocaine 2 GM in 500ml D5w 15 ml/hr=1mg/min, 30 ml/he=2mg/min, NTG 50mg in 250 D5W-Glass bottle/spec tubing, 1ml/hr=3.3mcg/min, etc.


Suggest Amiodarone, dopamine, lidocaine, dobutrex, levophed, nitroglycerine, intergrilin, heparin, TPA/TNK, Nipride, Epi.

You can put all kinds of good stuff in that little book, phone numbers you need most, protocols, lab values.