I am in my first semester. I do not have trouble with passing meds or doing calculations. I just haven't figured out the best way to carry and label everything. I am a PCA and shadow RN's where I work, but at clinical they do things very differently and my instructor doesn't let us use the computer work station.
Where I work vials are keep with syringes and scanned/verified at the bedside. At clinical they are tossed in the med room, which isn't even a room its an area right in the middle of the hall. The RN's on my clinical floor keep the vials and organize the meds on their WOW.
So how does a student just learning, trying to carry everything (syringes, water, med cups, flushes, alcohol wipes, gloves etc) by hand do this?
If I have 6+ PO's, 3 syringes and my instructor tossed the vials as I draw them up, I only have so many pockets. I am learning more and more meds but I don't have everyone pill shape and color memorized, after I fight with the foil there isn't always much left to read. I went to the practice labs and tried to get tutoring. I have arranged more shadowing at my job over the break, but I still have two weeks of clinical left. All my school said was apply the concepts I have learned to new situations. Anyone have any real advice I am completely frustrated right now?
I have tried to use the computer workstation, but my instructor refuses to let us, she also rushes us and skips steps. I have a marker and tape I can label things with.
PS I really hate that she tossed the vials before I give the injections is that normal?
Dec 6, '11
We have to scan each medication into our computer system before we give it, and this usually has to be done at the patient's bedside (we also have to scan the patient's wrist band prior to administering a med). Because of this, we save the vial until we have administered the medication and left the patient's room. If the vial is empty, there is no reason that you have to toss it. Tape the empty vial to the syringe with the medication it belongs to, or place a piece of tape on the syringe and write the medication name, dosage, and route with a sharpie on the tape. As for PO meds, keep them in the foil until you go into the room to administer them. If your instructor is fast, then you have to be fast too. Learn to draw up your meds quickly after you remove them, and get them labeled and drawn up before she/he comes to find you. In our clinical, our instructor lets us draw the medication up and give it without her supervision, but we've been giving meds for eight weeks now. Eventually, your clinical instructor should let you start giving meds independently and it shouldn't be an issue anymore.
Dec 6, '11
Thanks, there is always next semester and a new instructor. I appreciate your feedback.
Dec 6, '11
Stick all the pills in a med cup (or two, or three...) UNOPENED, that way you know what you are giving. And you never know, the patient may refuse a medication and then you can easily return it to the Pyxis or med cart.
At my facility, we do medication scanning. This includes scanning vials for IVP meds. Before we implemented scanning, I would always draw up my meds in the med room and throw away the vials. Now, I take the unused vials/syringes to the patient's room (because if I did it the way I use to, I would automatically throw the vial away in the sharps container).
If I'm drawing up more than 1 medication, I label my syringes. I never draw up multiple medications for multiple patients - too much capacity for a med error that way.
Dec 6, '11
I just did meds and sort of demanded the wow to keep my stuff on. We never open pills outside the room and the pt refused one. I did Vanco, contact precautions. It went well, and I got my semester eval.
Dec 6, '11
we have like quart size ziplock bags and put the PO's in there.. the other stuff like etoh wipes, flushes etc, throw those in my pocket.
the IM/IV syringes if possible i put in the ziplock too. if i have drawn a med up i tape it to the syringe.
we use either the scanner in the room or a mobile med scanner to scan meds at the bedside.
what ur instructor does is just sloppy and JCHAO (sp) will ding u hard if they catch u doing crap like that.
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