Home med lists make me crazy.

[imintrouble]

I hate home med lists. Hate, hate, hate them. They come up from the ER with no dosages, no routes, and no correct name. "Stool softener" is not an approved med name. The ER MD checks all the boxes to continue, and I know he/she doesn't look at what they're checking. Once the ER MDsigns that form, I can't add or subtract any info even if I absolutely know for sure it's wrong.

The last list was an absolute nightmare. A whole page with every single med missing something.

Ativan prn. NONONONO What's the dose? How often? PO or SL?

Vit D daily Do you know how many different Vit Ds there are in your hospital formulary? Does the pt even know which Vit D it is?

"Stool softener" and that's all.

Ten meds all similar to the above, and the MD checks to continue.

I have to try and clarify it with the pt, and the pt doesn't know. Where I work, the ER MD's responsibililty with the home med list stops once the pt leaves that area. So at 0300 I have to decide whether to call the PCP, or just leave it for the day nurse who already thinks I dump on her.

No way am I calling an MD about a home med at 0300. If I leave it for someone else to clean up, and they don't, then it's back on me and it's incident report time.

The pharmacy bottles would be nice, but that rarely happens. I could just take the orders off the bottles, and double check with the pt. That's when they bring them. But OTC meds are a whole other animal.

The best case scenario is the pt can fill in all the blanks. But I still have to write clarification orders for those ten meds.

Two admits last night took me twice as long as necessary.

There has to be a better way.

[sistasoul]

Everything is the nurses responsibility. From the med list to not having the right cable channels to food not being delivered to MRI not wanting to stay and do the MRIs. I love when phlebotomy asks me if they really need to draw the lab. Are you kidding me I am saying to myself. I tell them it is a Drs order and that would be up to the Dr. Or the MRI people who don't want to stay late and ask me if the MRi can wait until tomorrow. This is another are you kidding me thought. Sometimes I tell them that they can call the MD and ask him/her themselves because I do not have the authority to change an order. Besides med orders not being right I think the MRI department and not wanting to do their job is my biggest pet peeve. I would love to be able to ask if I could part of my job off until tomorrow.

[eatmysoxRN, ASN, RN]

Home med lists are terrible. Especially when a patient comes up with no orders at all and they expect a dose of every night time med. We are permitted to write one time doses of some meds within reason. It would be so great if the ER physician would reconcile them. I know ER staff is busy but the complaints from that are crazy. And I can't call the doc over the patients flomax they "have to have or they'll die" at 2 am. I'd love it if people would use one pharmacy and we could just access it somehow.

[sistasoul]

Great idea to double check the meds. Nursing is so chaotic and busy it can be easy to enter the wrong thing due to being pulled in 5 directions at once. I wish all patients had nice up to date lists. It is scary when blood pressure meds are incorrect. How do we know if the family or the patient has the med listed and it has been stopped by there PCP. This has happened more than once. Sometimes the family tries to blame the hospital but we always keep a copy of the list of meds that was given to us in the patients chart. Most family members don't realize how important it is to get meds correct.

[ayla2004, ASN, RN]

Im in the UK and work in a hospital it might be different if i worked in the community?.

the only time ive ever had issue with a med is a prn for migraine when the patient requested it and it hadnt been prescribed as wasnt on pcp repeat prescription and not med rec done.

The verbal information wasn't enough to get the sho (resident) to prescribe.

[newkidnurse]

Working in the ER, the home med list was always a pain in the butt. After I started having health issues I wanted to make sure I wasnt one of "those patients". I used my iphone to list my meds on the "notes" app and made a pic. Printed it out, and my docs and the ER staff when I have to go love it.

Anne, RNC

Ugh!!

I work in peds and every now and then will have patients whose parents bring in typed up home med lists, alphabetized by generic med name, with complete dosage info, etc. [ side note: I ADORE THESE FAMILIES] These are literally PERFECT lists... Extra copies printed out and all with patient's name, DOB, etc (and they usually will also have a second list of "Meds By Time of Day" as well...).

And despite their complete preparedness, the orders are not entered correctly!! It's beyond me how this happens! It's not just one of the meds is timed incorrectly--that I can understand. The problems I see are with DOSE or FREQUENCY or only a few of the meds being entered!

I've spent over 2 hrs fixing and correcting the PTA Med Lists before...Why should this child have to miss his or her meds because he was admitted to the hospital?

***And the worst was the time I'd called the doc to discuss the med rec... He responded "Oh yea, I heard in report that this kid's meds are probably entered all wrong".... REALLY? Ugh!!!

[Hoozdo, ADN]

Ugh!!

I work in peds and every now and then will have patients whose parents bring in typed up home med lists, alphabetized by generic med name, with complete dosage info, etc. [ side note: I ADORE THESE FAMILIES] These are literally PERFECT lists... Extra copies printed out and all with patient's name, DOB, etc (and they usually will also have a second list of "Meds By Time of Day" as well...).

And despite their complete preparedness, the orders are not entered correctly!! It's beyond me how this happens! It's not just one of the meds is timed incorrectly--that I can understand. The problems I see are with DOSE or FREQUENCY or only a few of the meds being entered!

I've spent over 2 hrs fixing and correcting the PTA Med Lists before...Why should this child have to miss his or her meds because he was admitted to the hospital?

Personally I love med lists that are like the ones above. I use Microsoft Rcvr in a table format and tons of columns for listing generic and patent names, dose and proper routs.

Then i insert another table with my medical hx into a handy dandy table arranged buy earlier childhood Diseases and work it up as times passes

My husband has chronic resp and heart issues and I u the syustem. He got awesome compliments from the ER and ICU,

My DaD is 84 YO and I have trained him to sat nothing without the magic list and say he wants me to be MPOA.

My method works, I havent seen even one med error. Knocking on wood.

[NicuGal, MSN, RN]

We always tell our parents to throw all the mess in a bag or keep a list of them in their wallet. Some I our kids are on as many Meds as an old person!

[Morainey, BSN, RN]

I like it when no one reconciles the meds on day shift, or evening shift, and then leaves it for us at night! Yeah I'm really going to call the doc at 0200 to order all 30 of the patient's vitamins! Why could this not have been done earlier? Like, DURING the actual admission??!?

[gcupid]

The home med lists. The worst part of an admit.

[applewhitern, BSN, RN]

After reading other people's responses, such as those that say the pharmacy dept. pitches in with the med-rec, the more upset I get! Here, it is all on the nurse, period. I have actually been reamed by management because a patient gave me a bottle of medication that she no longer takes. At the time, she acted as if she still used it (this was a "once per month" med) and did not correct me when I was writing it down. At the time of her discharge, she said she no longer takes it, so I got in trouble for putting it on her admission med-rec. Maybe I am wrong, but I thought the whole point of the med-rec was to help avoid mistakes. If a patient hands me the bottle, it has a current date, and I enter it on the computer, and the patient does not tell me she no longer takes it, am I supposed to read her mind? They come in sick, short of breath, etc., and can easily tell me the wrong thing. Again, I thought the whole point was to correct their meds prior to discharging them home. Why doesn't their doctor handle this? I am neither an MD or a pharmacist. Thanks for letting me vent!

[emtb2rn, BSN, RN, EMT-B]

We do our best to get the med rec done in the er. We use surescripts. 3rs party real time download from participating pharmacies and all pharmacies in our area participate. Doesn't work for snf or the va but otherwise, if you fill a rx, we can download it.