When to sign the MAR?

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My instructor told me to sign off on all my meds as I was pouring them. I was conflicted with this because my past instructors told me never to sign off on a med if you haven't given one. The instructor I have now is adamant that I sign off when I pour them, but I don't feel comfortable doing this. What are other students told about this? What do registered nurses do?

You will find that most people sign off as they pour when on the job. Some people go through and sign off the entire book before they even start passing the meds. Although this is not correct, it is faster, and that is why they do it.

In school, your instructor is supposed to teach, require, and reinforce the correct way. You will see all the short cuts when you get to the job. Even then, the supervisor is supposed to require that you follow policy and procedure. Short cuts can come back to bite you in the rear.

If you want to pass your med pass/clinicals with THIS instructor then you should do what he/she says. I was told by ALL my CI's that you don't sign what you haven't done yet. But my instructors aren't grading your clinicals.

I tend to sign them off after I give the meds. Our TAR/MAR are computerized, so after I pull the meds, I leave the screen up for that person, and then give the med and then sign them off.

I agree! That's why I don't want to start signing them off right away. I don't want to get into that habit.

Thanks for your post!

Just wanted to add, my one and only med error occurred because I signed off the med seconds before taking the meds out of my cart and before giving them. Before I was able to pop the meds and give them, I noticed someone walking around who's very unsteady and supposed to an assist x1 w/walker, I locked up the cart, ran to get the person back in their w/c, then a phone call from a doc came in, as I hung up the CNA wanted to show me something, then a family member was chewing me a new one for something another shift did/didn't do..when I went back to my cart, I clicked to the next person and gave them their meds..I NEVER gave the meds to the person who I signed off on. I didn't realize it until the the 2nd med pass at 9pm when the resident said, "haven't seen you all day been busy?" I laughed and said Ms Jones you saw me right before dinner when I came in to give you yourr......" I stopped and realized I hadn't given her the med! Thankfully it was an OTC med that is only given once a day and nothing that would cause her harm if not given or given on time.

I called my super, notified her of what happened. She called our staff doc and informed him that Ms Jones hadn't received her med, he ok'd that the med be given at that time. I was given "verbal education" and not a write up. And of course that education was, don't click off meds you haven't given, because there will come a time you do, you get distracted and you will forget to give the med..and next time it could be a very much needed med (BP pill, insulin, etc)..lesson learned.

Specializes in Neurosciences, Med-Surg-CNA.

I never sign off on my meds until the patient has actually taken it. The patient has every right to refuse the med so I just wait till they have done it. I always put a line through the X on the sheet so I know that I actually have the med with me, and so I can keep up with it, but I just don't think it looks right legally for you to sign off on it and then circle it saying they didn't take it. Just my opinion. But you should always follow your instructors advice, they are the one grading you!!

We are being taught to always ALWAYS sign off after the patient has taken their med, for a variety of reasons people have already mentioned.

Could you nicely mention to her that previous instructors have told you to sign off after and that you are just confused on the right way to do it. (Make sure you don't make it look like you are accusing her.) All of our professors teach a little differently on a few random things and when we nicely point it out, they have always said they will check into it and decide as a program whole how they want us to do it for sure. Then the next time we have class they tell us for sure how ____ should be done.

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