How do I know what BID, Daily Meds to hold before OR?

[mandaaRN]

Hi, I'm a new grad and landed a new job. I'm still on orientation and am slightly confused about medication administration before the OR and dialysis. One of the nurses was trying to explain to me to hold BID meds and give the second dose when the patient returns from the OR, meaning the patient only recieved one dose of that medication for the day. I need help on understanding this concept. Also, which meds to hold or give before the OR? Same for dialysis, since pretty much every medicine gets dialyzed out. This includes, insulin/ IVP/ IV meds/ PO meds. I've been stressing myself out over this, I just don't want to make a mistake. Thanks everyone!

[nurseprnRN, BSN, RN]

i just got asked about consulting on a med error, 5-rights case. for those of you who may not have been watching, there are now 6 rights, the last being "right indication." what this means is you can't just blindly follow a physician plan of care (what we used to call "doctor's orders"-- we are not in the military and, more to the point, they are not our superior officers). you, the rn, are responsible for knowing the drug mechanisms of action, rationale, precautions, and side effects. what if the md forgets to write a med order, or makes an error in one, and when you ask about it s/he says it' fine, and you give it anyway? you think,"i just ask the doctor" is gonna save your butt? nope.

[mindlor]

my book says the sixth right is the right documentation.....in my mind the person with prescriptive authority should issues orders clearly indicating their clinical wishes for that particular client....

[beckster_01, BSN, RN]

The doc should be writing the indication for the med in their order, but we still need to examine whether or not it is still appropriate to give at this time

[jjjoy, LPN]

"Look up the hospital policy" "Clarify the orders with the physician" "Know every med you give, what it's for, appropriate dosage, etc - if you don't, look it up!" ... absolutely! Except that when you're a newbie so much of what one comes across is either completely new, just recently learned (& not yet really retained), or perhaps vaguely remembered from some far off previous experience... If the newbie truly took the time to check the primary source - as opposed to asking a more experienced colleague (nurse, physician) and trusting their call - they'd probably get counseled on "poor time management".... SIGH.... forget "learning curve"... it's a "learning cliff"... if you make it 6 months without falling off the cliff (getting terminated for one reason or another), then you've probably learned what you need to succeed.