I am currently in an RN to BSN on-line program. I am completing my practicum requirement on a telemetry floor. I have an assignment for school to correspond with another nurse in another region about a current issue in my practicum area.
I am taken back by the paperwork and the research the nurse is responsible for upon the discharge of a core measure patient. The nurse is responsible for making sure the md has checked on the medication reconciliation sheet which medications are to be continued at home. Most of the time, the md does not check the box and the nurse has to call the md. Also, the nurse has to ensure that patient is discharged on a beta blocker and an ACE, or ARB. If they are not, the nurse has to research through the chart to see if the md has charted a contraindication for being on these medications. The nurse then has to call the md to make them aware that the patient is on these medications, and needs a reason why.
This is such a major process. The mds do not take as much responsibility as I think they should. In addition, the nurse also has to reconcile the medications to make sure that they are being sent home on what they came in with. For example, if the pt is diabetic, the nurse has to make sure the md is sending them home on their diabetic medication.
Some nurse have said that they have heard that in other areas of the country that the pharmacist completes the medication reconciliation. This current process leave room for multiple errors.
Is anyone currently practicing a better method at their hospital. I am supposed to identify the nurse and the region that they practice when I post my assignment. I understand if that is a problem, but I do not know where else to communicate online with other nurses. My name is Becky & I practice in Memphis, TN. I have been a nurse for 13 years.
