Home med lists make me crazy.

Nurses General Nursing

Published

I hate home med lists. Hate, hate, hate them. They come up from the ER with no dosages, no routes, and no correct name. "Stool softener" is not an approved med name. The ER MD checks all the boxes to continue, and I know he/she doesn't look at what they're checking. Once the ER MDsigns that form, I can't add or subtract any info even if I absolutely know for sure it's wrong.

The last list was an absolute nightmare. A whole page with every single med missing something.

Ativan prn. :no: NONONONO What's the dose? How often? PO or SL?

Vit D daily :grumpy: Do you know how many different Vit Ds there are in your hospital formulary? Does the pt even know which Vit D it is?

"Stool softener" and that's all.

Ten meds all similar to the above, and the MD checks to continue.

I have to try and clarify it with the pt, and the pt doesn't know. Where I work, the ER MD's responsibililty with the home med list stops once the pt leaves that area. So at 0300 I have to decide whether to call the PCP, or just leave it for the day nurse who already thinks I dump on her.

No way am I calling an MD about a home med at 0300. If I leave it for someone else to clean up, and they don't, then it's back on me and it's incident report time.

The pharmacy bottles would be nice, but that rarely happens. I could just take the orders off the bottles, and double check with the pt. That's when they bring them. But OTC meds are a whole other animal.

The best case scenario is the pt can fill in all the blanks. But I still have to write clarification orders for those ten meds.

Two admits last night took me twice as long as necessary.

There has to be a better way.

another thing turfed off into nursing that imo should not be (at least not sole or primary) nursing responsibility

This is another case of "it falls to the nurses because nobody else wants to deal with it".

I do like hearing that some places are getting pharmacy involved.

I used to work in an area long ago where a some of the older people we worked with had limited levels of literacy. I remember being responsible for getting those long lists of home meds and once talking to a pt's illiterate next of kin on the phone spelling out letter for letter everything that was on those prescription bottle labels. He couldn't really read, but he knew the alphabet. I left work really late that day.

It can be frustrating and can be dangerous since you do not really know the exact meds to give out. Has to have a better system and clear med instruction.

Hope the system will get better.

Specializes in kids.

I could just take the orders off the bottles, and double check with the pt. That's when they bring them.

Yeah, but who says what is in the bottle is what is on the label or that it is current?

Specializes in LTC.

My absolute FAVORITE is getting the LOLs or LOMs from the nursing home with like 5 pages of meds. :banghead:

My absolute FAVORITE is getting the LOLs or LOMs from the hospital with 5 pages of meds.

My 2nd favorite is getting 2 different lists of meds for the same person.

My 3rd favorite is getting a list of meds scribbled onto the bottom carbon copy of the discharge list.

Seriously when discharging a patient to a nursing home how hard is it to send us ONE complete neatly, typed list of discharge meds.

irony...

Whatever happened to the electronic medical record system that was supposed to be able to go as far as crossing state boundaries for patients prescription information?

Oh yeah! had one recently where the patient was mentally compromised and family unable to come. He ended up with no insulin orders for three days....just po meds. In that chart there were three, possibly four listings of meds. the W-10, discharge and home at least.....wasn't on discharge or W10.

My absolute FAVORITE is getting the LOLs or LOMs from the hospital with 5 pages of meds.

My 2nd favorite is getting 2 different lists of meds for the same person.

My 3rd favorite is getting a list of meds scribbled onto the bottom carbon copy of the discharge list.

Seriously when discharging a patient to a nursing home how hard is it to send us ONE complete neatly, typed list of discharge meds.

Specializes in ER, TRAUMA, MED-SURG.

Working in the ER, the home med list was always a pain in the butt. After I started having health issues I wanted to make sure I wasnt one of "those patients". I used my iphone to list my meds on the "notes" app and made a pic. Printed it out, and my docs and the ER staff when I have to go love it.

Anne, RNC

Specializes in PICU, NICU, L&D, Public Health, Hospice.

In my view, outside of the pharmacy setting, reconciliation of medications rest squarely on the shoulders of the RNs. It is a huge problem...but...because it is nurses rather than some professional discipline with actual power within the health system, it stands as unaddressable.

Specializes in Home Health, MS, Oncology, Case Manageme.

I'm a home care nurse. When I admit a patient to home care, I have to try to reconcile their medications. Sometimes it can take hours just trying to FIND all the med bottles in their house! After that, I make a complete med list for them. I always tell the patient to bring that list to their doctors and the hospital. I'm trying to help you guys out.

Specializes in neuro/ortho med surge 4.

I don't mind the people from the nursing home because at least they come to the hospital with a copy of the list of meds they take at the facility. It is accurate and up to date unlike 75 percent of the patients we het on the floor.

I had a patient last evening whose wife told me her husband would need something to help him sleep. I asked her what he took at home and she said Melantonin. I looked on the home med list on the computer and did not see it. I asked her what the dose was and she said she did not know (of course). I asked her why she did not list that as a medication for her husband when he came in to the ED. She said she never tells the ED about this med or his vitamins. I then asked her how were we suppose to know he needed this if we were not told. I was a little aggravated because it was not like this was the first time this man had been admitted. He has been on my floor several times. It just makes unnecessary work and phone calls that could have been handled in the beginning. This happens all of the time. It is so aggravating and very unsafe at times.

+ Add a Comment