Patient asked me what an IV med was for..i didnt know - page 3
by NursingBro | 6,981 Views | 54 Comments
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 has it? She kept bombarding... Read More
- 1Mar 21, '13 by samadams8Uh oh. No way around this one. You are supposed to know the medicine, what's it is being used for (for the particular patient), of course dosage, timing and all the rest--safe administration parameters, which may include recent lab values, and if known, it's also good to know mechanism of action. The very least are the 5 rights + reason for the medication. If I were your nursing instructor or preceptor, or mentor, that's the least I'd want you to know. If you don't know what it is and why you are giving it; really, you shouldn't be giving it. So, whatever the situation, don't feel badly, b/c it's a lesson learned. Next time you will know and be prepared.
Beyond the 5 rights are the following:
Rights of Medication Administration
1. Right patient
- Check the name on the order and the patient.
- Use 2 identifiers.
- Ask patient to identify himself/herself.
- When available, use technology (for example, bar-code system).
2. Right medication
- Check the medication label.
- Check the order.
3. Right dose
- Check the order.
- Confirm appropriateness of the dose using a current drug reference.
- If necessary, calculate the dose and have another nurse calculate the dose as well.
4. Right route
- Again, check the order and appropriateness of the route ordered.
- Confirm that the patient can take or receive the medication by the ordered route.
5. Right time
- Check the frequency of the ordered medication.
- Double-check that you are giving the ordered dose at the correct time.
- Confirm when the last dose was given.
6. Right documentation
- Document administration AFTER giving the ordered medication.
- Chart the time, route, and any other specific information as necessary. For example, the site of an injection or any laboratory value or vital sign that needed to be checked before giving the drug.
7. Right reason
- Confirm the rationale for the ordered medication. What is the patient’s history? Why is he/she taking this medication?
- Revisit the reasons for long-term medication use.
8. Right response
- Make sure that the drug led to the desired effect. If an antihypertensive was given, has his/her blood pressure improved? Does the patient verbalize improvement in depression while on an antidepressant?
- Be sure to document your monitoring of the patient and any other nursing interventions that are applicable.
Reference: Nursing2012 Drug Handbook. (2012). Lippincott Williams & Wilkins: Philadelphia, Pennsylvania.Last edit by samadams8 on Mar 21, '13 : Reason: dropped a word
- 3Mar 21, '13 by kalanel5Wow at some of the reactions here... Well I will admit this happened to me at the beginning of my nursing career but I must say I was paranoid of this kind of thing happening so I would look my meds up before I went to give the patient's meds. OP you are only human you are not going to know everything the key is to never show your patient that you don't know. You are new as you build your knowledge base on various drugs this wont happen but geez you are new. Don't beat yourself up. I know, the majority of the presently used drugs and new ones but often I have 80 and 90 year old patients who take meds that are not used much today so I have no clue about them. That doesn't make me an incompetent nurse you just learn as you go along.
- 0Mar 21, '13 by MayjoyarceoQuote from kellycinalliI just wanna ask who did u get your certification for IV? I just passed my pn exam and j wanted to inquire about certification. Thank you in advance.I've been an Lpn for 21 years and been aloud to hang and start an Iv for 12 years now. I work in New Jersey and I'm Iv certified. I can maintain all lines,hang Iv antibiotic and other meds. I can start a peripheral line too. I would think being a new Lpn that was taught in school, being our scope of practice is now more broad. And always look up all meds you are unsure of!! If you were my nurse I would of felt you were incompetent. And I'm sure she felt the same way being she asked your name. I still look up meds I'm unsure of. Doesn't make you a stupid nurse, just a cautious one!! Best of luck!!
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- 3Mar 21, '13 by nursel56 GuideIt's a little more understandable since he was not administering the patient's meds himself, but he has a plan for corrective action he's already begun to implement and he sought out advice here. Can't ask for much more than that! Best wishes, OP!
- 1Mar 21, '13 by DavidKarlAnother 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.
- 1Mar 22, '13 by 2bFNP4ME2015Nursing 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!
- 0Mar 22, '13 by RNfasterI 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!
- 4Mar 22, '13 by woohQuote from samadams8True. But since OP was NOT giving it, I think he's covered on that front....If you don't know what it is and why you are giving it; really, you shouldn't be giving it...
Quote from DavidKarlWhat on earth? You're now just looking for problems where likely there are none. And have nothing to do with OP's question.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.
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.