Nurses don't do their 3 med checks? - page 2

I've been to two higher acutity clinical sites so far on a med-surge/oncology floor and a cardiac observation unit (step-down CCU), and some of the nurses seem to not do their three medication... Read More

  1. by   OsceanSN2019
    Quote from MunoRN
    I don't understand how she was "grabbing meds" without being able to see them, was she blindfolded?
    I dont think that is the case, she was able to see the meds and she knew exactly which pocket in the drawer to grab from. But honestly, it happened so fast that I was kind of blindsided myself and that's when I asked why she didn't read the labels. And she didn't deny it either. I just chuck it up to her being on that particular floor for years and she did say that she knew what to look out for with how specific meds comes and its characteristics.
  2. by   BrandonLPN
    Well, sometimes you learn as much from watching bad practice as you do from watching good.
  3. by   MunoRN
    Quote from OsceanSN2019
    I dont think that is the case, she was able to see the meds and she knew exactly which pocket in the drawer to grab from. But honestly, it happened so fast that I was kind of blindsided myself and that's when I asked why she didn't read the labels. And she didn't deny it either. I just chuck it up to her being on that particular floor for years and she did say that she knew what to look out for with how specific meds comes and its characteristics.
    The time it takes to reach for and pick up the vial is more time than it takes to read the "Heparin 5,000" on the vial, so there's not going to be additional time spent reading the labels beyond just the time it takes to grab them.

    Was she then not scanning the patient or the med?

    Regarding your initial post, heparin actually can be given in an "insulin" needle, since an insulin needle is more correctly described as a subcutaneous injection needle.
  4. by   Mavrick
    Quote from OsceanSN2019
    I was not teaching anything to the charge nurse as I was just shadowing her. Plus, I did all what she wanted me to do. And you are very rude. I guess the saying is true that nurses do eat their young...
    Good gravy. Just STOP.
  5. by   OsceanSN2019
    Quote from MunoRN
    The time it takes to reach for and pick up the vial is more time than it takes to read the "Heparin 5,000" on the vial, so there's not going to be additional time spent reading the labels beyond just the time it takes to grab them.

    Was she then not scanning the patient or the med?

    Regarding your initial post, heparin actually can be given in an "insulin" needle, since an insulin needle is more correctly described as a subcutaneous injection needle.

    I did not know about the insulin needle thing. My classmates acted as if I was stupid to give heparin in a insulin needle. Also the charge nurse did scan the patients bracelet and the label on the package before she administered it at least.Plus, when she scanned the medication label she did have to click "ok" on the box that kept poping up on the screen after every scan, so I guess that also helps.
  6. by   MunoRN
    Quote from OsceanSN2019
    I did not know about the insulin needle thing. My classmates acted as if I was stupid to give heparin in a insulin needle. Also the charge nurse did scan the patients bracelet and the label on the package before she administered it at least.Plus, when she scanned the medication label she did have to click "ok" on the box that kept poping up on the screen after every scan, so I guess that also helps.
    Scanning the patient and medication is checking the patient and medication, there are varying views on exactly how the nurse should double check the scanning, but there was at least one check of both that occurred.
  7. by   BrandonLPN
    Quote from OsceanSN2019
    I did not know about the insulin needle thing. My classmates acted as if I was stupid to give heparin in a insulin needle. Also the charge nurse did scan the patients bracelet and the label on the package before she administered it at least.Plus, when she scanned the medication label she did have to click "ok" on the box that kept poping up on the screen after every scan, so I guess that also helps.
    So she *did* read the labels. This makes more sense now.

    She saw the drug and dose on the MAR. She saw them again on the label when she grabbed the vial of heparin. In real world nursing, the check doesn't necessarily involve holding the vial up to the computer screen, or something super obvious like that. Then she saw the patient's name on the MAR. And again when she scanned the wristband. And she saw everything yet again when the computer prompted her to click "OK" with each medication. Sounds like at least 3 checks to me.
  8. by   OsceanSN2019
    Quote from MunoRN
    Scanning the patient and medication is checking the patient and medication, there are varying views on exactly how the nurse should double check the scanning, but there was at least one check of both that occurred.

    Thank you for clearing that up for me! I thought I was crazy from what I saw.
  9. by   OsceanSN2019
    Quote from BrandonLPN
    So she *did* read the labels. This makes more sense now.

    She saw the drug and dose on the MAR. She saw them again on the label when she grabbed the vial of heparin. In real world nursing, the check doesn't necessarily involve holding the vial up to the computer screen, or something super obvious like that. Then she saw the patient's name on the MAR. And again when she scanned the wristband. And she saw everything yet again when the computer prompted her to click "OK" with each medication. Sounds like at least 3 checks to me.
    Okay, thank you. I'm obviously still learning and I did not know this would be considered 3 checks. And you're right, I did think that she had to read the labels at the pyxis. Also, this is why I like asking certain questions on Allnurses rather than asking my clinical instructor because I was afraid that I might get that nurse in trouble, so I didn't say anything.
  10. by   Crystal-Wings
    Quote from OsceanSN2019
    I was not teaching anything to the charge nurse as I was just shadowing her. Plus, I did all what she wanted me to do. And you are very rude. I guess the saying is true that nurses do eat their young...
    There was nothing rude about what she said. It sounds like you can't take any form of criticism, but are ready to dish it out.
  11. by   OsceanSN2019
    Quote from Crystal-Wings
    There was nothing rude about what she said. It sounds like you can't take any form of criticism, but are ready to dish it out.
    I understand, this was a huge learning experience for me. And I do now see where Sour Lemon was coming from.
  12. by   fibroblast
    Quote from OsceanSN2019
    I've been to two higher acutity clinical sites so far on a med-surge/oncology floor and a cardiac observation unit (step-down CCU), and some of the nurses seem to not do their three medication administration checks. I didn't give it much thought until my second clinical rotation and now I'm wondering if this is considered "normal" for some nurses? For instance, I shadowed a charge nurse in the CCU and she would just open up the patient records on the EMR then take medication out of the pyxis without even reading the labels on them. I asked her why don't she read the labels and she said that she been doing this for a long time and know how each medication package looks like... So then went to each of our patient rooms and gave the medication to them without asking for their name/DOB. She just scanned their bracelet and administered the medication without telling the patient about the meds. Plus, she made me administer heparin in an insulin needle saying it's "fine".

    She is not the only nurse who I've have seen not doing their 3 med checks, and I wonder if this could become a problem?
    I have to admit, I have worked in LTC for years, but also did my clinicals in a hospital.

    I ALWAYS double check, sometimes not in the order that nursing school says, but on that last check, before the pills go in their mouth, I double check every single pill.
  13. by   Rose_Queen
    What you have to also realize is that nurses with experience do things simply out of habit and don't have to make a fully conscious effort. When I was bedside, I didn't take the time to hold each individual vial up and read it after I pulled it out- I did it all in one smooth sequence of tap drug name, reading and picking it up at the same time. Students and beginners tend to need to break things into steps- read the screen for the exact spot in the Pyxis drawer, pick up the vial, read the label, move on to the next drug.

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