Patient asked me what an IV med was for..i didnt know - page 3

I am a new grad LVN and a IV med was scheduled for a patient. The patient asked me what is the IV med for and I did not know. She also asked why does she need to have this? and Do you know why she... Read More

  1. Visit  2bFNP4ME2015 profile page
    1
    Nursing bro,

    Congratulations on becoming a nurse! It is very overwhelming when you go through your first year as a novice. Ignore the self-righteous comments from your peers. Unfortunately, the culture of nurses eating their young is not a myth. Keep your head up and use any experience as an opportunity for professional growth. Good luck!
    ethiopia likes this.
  2. Visit  RNfaster profile page
    0
    I have come across some medications that I have been uncertain about. I look them up in the computer. I have even (on a busy shift) asked a patient about a med (particularly if it's from home and not available from our pharmacy) and I have said to the patient, "let me look this up for you..." I then discuss the med, its rationale, side effects. I am truthful with patients... if there's something I don't know, I say, "let me find out for you." New drugs are constantly hitting the market. New indications emerge...and there is also off-label use. Don't be too hard on yourself, OP!
    On the other hand, it is good to know common meds. Know meds that are incompatible (while IV is not your scope, some PO meds must be spaced apart) and/or given with or without food... Know side effects...(does one med lower BP and heart rate while another lowers BP and raises heart rate?, does a med contribute to postural hypotension?) and things you must check before drug administration... You might also study narcotic equianalgesic tables (I find this helpful to consider when giving a patient multiple narcotics)....
    I think it's okay and even smart to admit if there's something you don't know, provided you know where to get the answer...and that you do it (get the answer). Good luck!
  3. Visit  wooh profile page
    4
    Quote from samadams8
    ...If you don't know what it is and why you are giving it; really, you shouldn't be giving it...
    True. But since OP was NOT giving it, I think he's covered on that front.

    Quote from DavidKarl
    Another thought- who ordered the IV med, and who started the IV, and who started the IV med via the IV? Two, possibly 3 healthcare workers involved (aside from the LPN) were treating a patient with an IV, without possibly obtaining consent, but obviously without bothering to tell the patient what was going on, and why the IV was needed. And, also- why didn't the patient ASK the ordering provider, or the nurse while the IV was going in, or what the medication was when it was hanged, since she appears to be alert, etc., and taking notes? Lots of potential liability in this scenario- especially if the RN made a med error that wasn't caught by the LPN, eh? I've seen an awful lot of nonchalance, and lawsuits about IVs.
    What on earth? You're now just looking for problems where likely there are none. And have nothing to do with OP's question.

    As for the original question...
    Longer I've been doing this, the more comfortable that I am saying, "I don't know." I learn something new everyday, so obviously there's going to be something that I don't know. You learn to sandwich the admission of ignorance into other things that assure your patient that you're a competent nurse, but sometimes you just won't know.
    Now in this case, you should have known. Even if you aren't giving meds, if your patient is on them, you should have a basic idea of what they're getting. Not just in this type of scenario (LPN who doesn't give IV meds) but even in situations where the patient gets a med that's not on your shift. It's just a good idea to have an idea of what the patient is taking, no matter who will be administering it. You want to always have an overall picture of your patient's plan of care. Depending on how many patients you have, your detail on this will of course vary. An ICU nurse with two patients is of course going to have a more detailed picture than a LTC nurse with 40 patients.

    But we aren't all perfect and I'll freely admit, there are times that my patients ask me a question that I should know the answer to, and yet I don't. Then I'll even admit, "I should know that."

    So how to gracefully say, "I don't know." You'll come up with your own way of making it sound like you're still competent. I usually go with a, "That's a good question, and I'm not 100% sure on why we're doing x for YOU. Let me check the chart/drug guide/with the MD and I'll get back to you." Then I make sure to get back with them.

    Reasonable patients don't expect you to be omniscient or perfect. If you're otherwise competent and knowledgeable, the occasional question that you say you'll have to get back to them on? They'll appreciate you being honest rather than trying to fake your way through it.
    tnmarie, psu_213, Vespertinas, and 1 other like this.
  4. Visit  Vespertinas profile page
    1
    Quote from Fiona59
    Weren't you exposed to IV meds during your education? Usually it's antibiotics and the names are the same.
    Huh??

    I thought one inconsiderate and misguided response was an anomaly but there are... many! I'm surprised.
    psu_213 likes this.
  5. Visit  Esme12 profile page
    3
    OP.....The patient caught you off guard. It's OK to say.....I am an LPN and I am not familiar with that med, as I do not give them, but I will check with the RN and get the information for you!

    It is important to know all of the meds your patient is on so that you can best care for them and look for side effects/reactions to the meds even if you don't give them.....you are doing a good job by looking them up and eventually they will become familiar to you. It's a pain at first..but your learning didn't stop at nursing school.

    Patients are like animals....they can smell fear/nervousness a mile a way! You are doing fine. ((HUGS))
    psu_213, Altra, and Vespertinas like this.
  6. Visit  ktwlpn profile page
    0
    Quote from DavidKarl
    Another thought- who ordered the IV med, and who started the IV, and who started the IV med via the IV? Two, possibly 3 healthcare workers involved (aside from the LPN) were treating a patient with an IV, without possibly obtaining consent, but obviously without bothering to tell the patient what was going on, and why the IV was needed. And, also- why didn't the patient ASK the ordering provider, or the nurse while the IV was going in, or what the medication was when it was hanged, since she appears to be alert, etc., and taking notes? Lots of potential liability in this scenario- especially if the RN made a med error that wasn't caught by the LPN, eh? I've seen an awful lot of nonchalance, and lawsuits about IVs.
    Exactly-some patients go on the offensive with every staff member they encounter.We weren't there so we don't know.You bring up alot of valid points.I have a feeling that the patient had questioned the RN who hung the first dose and was just busting the LPN's balls for some reason,maybe the patient sensed fear.I'm pretty sure this person would not have let an RN admin the med without asking the same questions.
  7. Visit  netglow profile page
    1
    Eh, as others have said state that you do not administer these medications that you will get the RN and she can explain. Hey, if you don't know you don't.

    Now, here is a tip. If you know what your patient is "in" for, and have looked at the chart for CC, dx, tx, etc. Really most of the time if you think back to your dx knowledge and your basic medication groups you should be able to say, "this is for your infection", "this is for your low potassium", or "this is because you are NPO, but you still need to get your fluids...", "this is here to keep a ready IV access so we can come in and give you your #$@ medication - it is a med that has to go into a vein" etc.
    wooh likes this.
  8. Visit  Altra profile page
    0
    Quote from NursingBro
    Thanks for the tips!

    Today I looked up the meds I didn't know in the mars and wrote them down on a brain sheet i have for each patient. There was 3 meds I did not know out of all of them. I just read everything about them before administering.
    There is a huge learning curve when you're new ... but this post troubles me ... as it indicates that you have been administering meds without knowing what they were for / potential side effects, etc. Please, please do not do this -- look it up before giving.
  9. Visit  NursingBro profile page
    2
    Quote from Esme12
    OP.....The patient caught you off guard. It's OK to say.....I am an LPN and I am not familiar with that med, as I do not give them, but I will check with the RN and get the information for you!

    It is important to know all of the meds your patient is on so that you can best care for them and look for side effects/reactions to the meds even if you don't give them.....you are doing a good job by looking them up and eventually they will become familiar to you. It's a pain at first..but your learning didn't stop at nursing school.

    Patients are like animals....they can smell fear/nervousness a mile a way! You are doing fine. ((HUGS))

    Thanks for all of the tips. I have been writing down many meds I pass daily even the ones I already know just to learn any new side effects or new information about the medications.
    Sun0408 and Esme12 like this.
  10. Visit  psu_213 profile page
    0
    Quote from jadelpn
    As an aside, it IV's are not within your scope, why were you the patient's primary nurse? And further, if you have an RN who hangs IV meds for you, you need to be learned in ALL of the meds that your patient is getting, as you need to assess a number of things when one gets IV meds.
    At my former hospital job there was still an LPN who had be "grandfathered" in after the hospital would only hire RN. This LPN would be the primary nurse, just not push meds (or any other duties LPNs are not allowed to do by law). So he would get an RN to push the IV med even though he was the pt's "primary" nurse.
  11. Visit  psu_213 profile page
    2
    Quote from DavidKarl
    And, to read a patient a drug drescription from a... BOOK? OMG.
    I don't really see why this is such a big deal. It would be wrong to administer a med when you don't know its purpose. While I might change the wording a bit to eliminate technical language, I don't find any issues with reading the pt the answer right from the book.
    Last edit by psu_213 on Mar 22, '13
    Vespertinas and Altra like this.
  12. Visit  psu_213 profile page
    1
    Quote from DavidKarl
    Another thought- who ordered the IV med, and who started the IV, and who started the IV med via the IV? Two, possibly 3 healthcare workers involved (aside from the LPN) were treating a patient with an IV, without possibly obtaining consent, but obviously without bothering to tell the patient what was going on, and why the IV was needed. And, also- why didn't the patient ASK the ordering provider, or the nurse while the IV was going in, or what the medication was when it was hanged, since she appears to be alert, etc., and taking notes? Lots of potential liability in this scenario- especially if the RN made a med error that wasn't caught by the LPN, eh? I've seen an awful lot of nonchalance, and lawsuits about IVs.
    Rereading the OP, it seems the pt was asking the purpose for a particular IV med. The pt was not asking why she had an IV. I'm really not sure where this is all coming from...it is important to know if the pt consents to the IV before putting inserting it, but that it is a bit irrelevant to this specific situation. Plus, (at least where I work), the pt does not have to sign a special consent before an IV is placed.
    Last edit by psu_213 on Mar 22, '13
    Vespertinas likes this.
  13. Visit  psu_213 profile page
    1
    Quote from wooh
    True. But since OP was NOT giving it, I think he's covered on that front.


    What on earth? You're now just looking for problems where likely there are none. And have nothing to do with OP's question.
    Double like for these parts
    wooh likes this.

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