Giving meds.

Nurses New Nurse

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I am so anxious that once I become an RN I will make a mistake giving a pt their meds., especially with the high nurse to pt ratio. Any experienced nurses out there have any advice. Also, will we have to convert the dosage or does it come as it is supposed to be given?

Thank you!:uhoh3:

Specializes in Telemetry, ICU, Psych.

My technique is to first look at the MAR before I even go to the Pyxis. I look at BP for HTN meds, labs (K+, Mg, etc.), and write the values on the MAR. This way I'll catch meds that aren't appropriate (K for a potassium of 5.2, colace for a patient with diarrhea, etc.). Secondly, I circle any med that is not one tablet. This reminds me to take two, half, etc. Next I pull the meds from the Pyxis. Finally, I leave the Pyxis, and double check each med and dosage, placing a small dot next to the times that are correct. Then - when I walk into the room and ID the patients, ask for allergies, etc., - I'm confident that I am giving the right meds.

It sound like this process takes forever, but I move pretty quickly.

I think that the biggest culprit is getting distracted while you give meds. Also, I NEVER take out more than one patient's medications at a time.

CrazyPremed

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Specializes in Critical Care.

I think that's the seventh I heard; Right Reason. And Right Documentation does make sense. I know nurses that pre-chart. If for some reason, the med isn't given and they forget to go change the MAR, then the patient is documented as having received a med that they didn't.

Really? When I was in college, we were introduced to 10 R's. That includes right documentation of course. Gee.... BUt the problem is, I forgot the other four. I think the other 1 is something about adverse effect. The rest..... I really forgot what!

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Specializes in Cardiac.

We were told another R was the Right to Refuse...

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Good grief :lol2:

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Specializes in Community Health, Med-Surg, Home Health.

Here is an example of make sure you know about medications:

I am an LPN that works in a clinic. I received a chart and read that the patient has a prescription for Keflex. A bell rang in my head, because I know that if a person is allergic to penicillin, they may also have an allergy to a cephalosporin. But, for some reason, I also had a 'feeling' that this client (whom I never met) would be allergic to one of the drugs. Sure enough, the chart said that she has an allergy to penicillin, breaks into a rash and angioedema. Couldn't figure out for the life of me why the doctor would have prescribed that med because our computerized chart blares allergies right on top of each section we log to. This was a resident who went to lunch, and I had to go to the attending to have the script changed to one of the macrolides.

Do not count on 'feeling' as your only indicator to check things out, but do not ignore them when the situation arises. That is the very thing that can cover your rear in the end. If by some chance that the resident or the attending was not going to change the script, I was going to document who I spoke to, why I inquired, the fact that I looked up the drugs on the micromedex and that I explained to the patient the risks involved.

Consider purchasing a PDA and install a drug guide and a medical encyclopedia in it. It will save your life.

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Specializes in Rodeo Nursing (Neuro).

I once saved the day when my 10 y.o. epileptic patient had an order for clonidine, one night. After seeing all the warnings about sound-alike meds, I immediately paged the resident to see if they meant to give Klonopin (clonazepam). I mentioned that the pt was 10, and had a BP of 100/60 (or something like that.) But the doc said to give it anyway, and explained why. So I took it to the room, and as I was explaining what each med was, when I came to clonidine his mother said, "Oh, yes, that's for his ADD." First I'd ever heard of, but that's what the doc said, too, and it turns out it was listed in my drug guide under off-label uses.

Oh, well. I was trying to do the right thing, and I did pass it on in report, although it turns out the dayshift nurse--and, it seems like, everyone in the world but me--was already aware of it.

If the same thing happened again, I might ask the patient or parent first, but I'm still gonna ask somebody.

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Specializes in Rodeo Nursing (Neuro).
It's so nice to know there are other poeople out there who have nights like that! Is it just me or are they getting much more frequent and closer together??

It isn't just you.

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