Bedside medication summaries

bjwojcik · Feb 13, 2018

I am not sure what the nursing crowd uses, but as a pharmacist I used Lexicomp. I just looked at the app and it has a patient education section which is probably what you are looking for. It is not free, or very inexpensive, but a great resource.

Brad Wojcik, PharmD

KrCmommy522, BSN, RN · Feb 13, 2018

Personally, I would just use my drug book if I were you. Just shorten each down. But there are a lot of good free resources out there if you just Google something like, "Nursing Drug Guides" or something. I love Lexicomp and use it at the hospital! It is a wonderful resource. If you are willing to pay, it is definitely worth it!!

Here are a couple free resources that might help:

Davis’s Drug Guide

MED DECK

CaliforniaPoppy · Feb 13, 2018

Thanks! Lexicomp looks great, 'though I certainly cannot afford it right now. And of course I have Davis' Drug Guide to hand all the time (on my phone, I'm looking at it so often). The Med Deck link was really wonderful, I like the format and will be sharing that with my class!

But what I am looking for is how to deliver a one or two sentence synopsis at the bedside when I am handing out meds - frequently stuff they have been taking for a while, with a few new things thrown in. Ten, maybe twenty seconds long? I tend to want to give a thorough teaching with everything, but my instructor keeps instructing me to keep it short(er), tell them the absolute basics of what it is, why they are taking it, and what to expect/when to let us know about a reaction. I'm overwhelmed by the need to distill a ton of (to me) relevant information down to a sound byte!

An example? Giving dronabinol... "This is your dronabinol, it is to help your appetite so you will be able to.... Let me know if you experience...."

For experienced nurses (and pharmacists) this probably seems beyond silly to be worrying about, but I am feeling so awkward that it is a big thing right now. I know we will each figure out our own ways to do it, but some examples to help us format our own explanations would make life so much more pleasant. :-)

emmjayy, BSN, RN · Feb 14, 2018

I usually just give the bare bones. "This is your carvedilol, it lowers your blood pressure. If you need to get up after you take this, ring the call bell because this can make you very dizzy and you could fall."

ItsThatJenGirl, CNA · Feb 14, 2018

I print out the med sheet for my patients, then I sit down with my MedScape app. That tells me what it's used for, and the things I need to look out for (adverse effects tab). MedScape breaks down the adverse effects by % reported, so I pick the top one or two for my "FYI", then I go to the warnings tab and take a quick glance at it to see what could be reported by the patient. Then of course I review it for my RN or Clinical Instructor.

The MedScape app is free.

neuron · Feb 15, 2018

I usually just say, 'I have your meds, do you know what you are taking. Then if they say no I say this is your Carafate, it is for your stomach, this is your Lipitor, it is for your cholesterol, etc. and explain each pill. I even show them the meds if they do know. If I have been given them meds for the past 2 years, then I just give them their cup of pills, however, if they are on a new antibiotic or med, I say or point out what is new.

CaliforniaPoppy · Feb 15, 2018

This is exactly the kind of summary our instructor seems to want us to do (and it makes sense)...now, any chance there is somewhere that people have compiled a collection of nice succinct descriptions like this so we know we are hitting the REALLY important points? :-D

neuron · Feb 15, 2018

This is exactly the kind of summary our instructor seems to want us to do (and it makes sense)...now, any chance there is somewhere that people have compiled a collection of nice succinct descriptions like this so we know we are hitting the REALLY important points? :-D

Poppy, there are a lot of drugs. For example, not everyone is on rifampin. I'm assuming you MUST know that for your pharm. But there are many patients on Metoprolol or Lisinipril. The important points come with experience. With the 10's of 1000's of meds that I have given, I still don't say that Metoprolol is a beta blocker and Lisinipril is an ACE inhibitor. I simply say Metoprolol is for blood pressure, Lisinipril for blood pressure, etc. etc. If they ask for specifics, I will go into detail.

But if your instructor wants to see you do teaching, say for an antibiotic, vancomycin (oral for example -solution), 'have you ever taken Vancomycin, do you know what it is for' it's for bacterial infections and you have to take it for the 10 day duration' or something of that effect. I just don't mention any unpleasantness unless they ask (c-diff).

NICUmiiki, DNP, NP · Feb 15, 2018

IDK if what you are looking for exists. I may present the same med differently depending on the patient and what the med is given for.

I may give phenobarbitol to three different babies. The first is in liver failure and the parents are highly educated. The second has seizures and has teenage parents. The third is withdrawing from opiate use/abuse during pregnancy and the mother is in denial. My description is going to be very different different despite them all taking the same medication.

Here.I.Stand, BSN, RN · Feb 16, 2018

My hospital uses Lexicomp, linked from the MAR. There's a great link for "pt ed" which has great info at the layperson level. I'll print it out if the pt/family member has many questions or it's a new med.

I typically just hit the main points... your instructors have their standards, but in real life? There's no way a pt is going to remember the entire drug commercial list o' side effects.

I do keep the pt's specific condition in mind -- for example, metoprolol is sometimes given for HTN, sometimes given for rate control, sometimes to prevent ventricular remodeling post MI... Also, parameters: I have seen orders to hold metoprolol for a SBP

If it's a new med, obviously I'm going to talk about side effects more than if the pt has been on it for decades. Again, I stick to the major ones. -- particularly ones that could make it difficult for the pt to adhere to the med. So in the case of metoprolol, they may feel lightheaded as their body adjusts to lower BP -- this is often temporary, but the pt should rise carefully/slowly so they don't collapse. Diarrhea with metformin can be a concern for the pt as well. And then I encourage them that if they experience any intolerable side effects -- **tell their provider!!** Lots of times they'll try a different med or a different dose or schedule -- something that would achieve the desired effects but not make them miserable. If they say nothing but stop taking the med, the pt's health is at risk AND the provider doesn't know.

Years ago in subacute, I had a pt who was on a sizable amount of Lasix.... and she hated her KCl supplements!! So much so that she was cheeking them (the giant tabs) and then hiding them in her eyeglass case. When I realized this we had a chat about WHY the KCl was important, and about alternatives. She really just had a difficult time swallowing them...and breaking them in half wasn't much easier. The NP switched her to the powder packets which she was able to tolerate mixed in a bite of applesauce, followed by juice or a cracker to cleanse her palate. Had she been at home and continuing to skip it, she could well have developed severe hypokalemia and arrested.

This will get easier with practice!!! In the meantime, have you asked your instructor for pointers? That would show proactivity and the desire to improve, vs waiting for critique. During downtime, perhaps you could ask the staff nurses or a pharmacist what resources they have available for med education too.