assessment or meds first?

[serein]

So I started working and the people I work with are amazing and so helpful! I just notice that some of them do things differently than from what I've been taught. I've always been taught to do your basic assessment first beginning of the shift then start on meds because then you know your baseline information. Some people start on their medications first though so they don't fall behind and then they do their assessments when they have time. How do you guys do it?

[xtxrn, ASN, RN]

It depended on where I worked....if acute care or detox, I assessed first (but also had a med nurse there). When in LTC, depending on the resident I brought the meds with me when I did an assessment and knocked them out together (the assessment & meds- not the resident ). But even though I had the meds with me, I didn't give them first- I just had them with me to not make two trips when I knew the meds were "early" and before the regular med pass.

:)

[mbuchanan2107]

It is hard to keep up, so finding ways to do that are always helpful. I am with you on liking to do my assessment first, but then you get behind with giving meds, patients are then needy, procedures come around, or it's bedtime and they don't want to be messed with....then you are behind. I would quickly walk by all of them to make sure they are alive and well first, without saying hi. I would gather my meds for the person I need to see first based upon report, and do my assessment AND give my meds at the same time. It always seemed to work well for me. Good luck with finding a routine that works best for you, because what may work for some, might not work for you.

[Isabelle49]

I always did assessment first.

[honeykrown, MSN, NP]

I've always done assessment first, but then most of the nurses are working off VS that the tech took.

best way no matter real life vs school is always do assessment first. My assessment is usually less than 5mins

[applewhitern, BSN, RN]

I do my assessments first, too. After you have worked awhile, you will be able to quickly assess a patient. I like to check their IV's and 02, because sometimes during shift change an infiltrated IV goes unnoticed, or you might find the wrong fluid/rate hanging. I have even found patients that were wearing their 02, but it was not on! If you wait until later in your shift, it will be on you, so go see the patients first!

[Esme12, ASN, BSN, RN]

Assessment first.....Threre are many meds that may need to be held or given based on vital signs. Assess IV's for patencey before you give antibiotics. You can take your meds in, and I agree with the person that said, do a focused assessment before you give the meds. :)

[nyrn5125]

when in med/surg/tele my assessments are on 8 pt and are expected to be done in 2 hours.yeah right. so vitals are done by the aide and I try to go behind them after they do BP. I do assessment/meds at that time. If meds are not up yet then assessment and then go back to give the meds

[turnforthenurse, MSN, NP]

ALWAYS assess first - it's the first part of the nursing process!! I will take my meds into the room (I lock them in my COW) and after I finish my assessment I will administer the meds to save time, but again, you need to assess first.

Even if you're coming on shift and one of your patients is requesting pain medicine at 1930 - you still need to assess. What is their pain level? Where is their pain? Is it aching, burning, cramping, dull, stabbing, sharp, etc? Does it radiate anywhere? Does anything aggravate the pain or make it better? What are their vitals? Surely you don't want to give morphine if the patient's respirations are