Is this common in an RN program???

[VetTechingWasEasier]

I went to an LPN to RN program. 1st year, did practical nursing jobs...patient care, meds, reports. Next year, the "RN" year, it was a touch of med/surge, some clinpath and a WHOLE lot of theory. Capstones capstones capstones till you scream.

I have a cousin who's been an RN in Florida for 6 years. I guess there must be a huge difference in the education. I didn't exactly go to a top school but I'm getting more and more surprised at students who graduated from more prestigious institutions.

I recently saw her at a family-reunion type occasion in Southern California. She had allergies and wanted some benadryl. We didn't have any, but we had some Nytol which is the exact same chemical (diphenhydramine HCl)

Her being a nurse for that long, I thought she'd know OTC meds like that cold. She was amazed that I knew it. I kind of joked "Long time since Pharmacology classes, eh?" and she laughed "Oh we never had to learn anything like that!"

"Well don't you pick up stuff like that on the job, then?"

"Ah no, I don't know what anything really is, I check the name, patient, dose, (etc) and down the hatch!"

"....you don't know any of the side effects/adverse reactions/unsafe dosages, you know, so you can REPORT them?"

"That's the doctor's job"

(WHAT??????????????)

ok fine, even the girl who got the Nightingale award at my school was far from being a walking Merck's manual but I was surprised that apparently

1) one can pass the NCLEX-RN without even a rudimentary familiarity with basic pharmacology

2) One can competantly pass meds with Nursing Theory alone

3) You can leave the task of checking for med related mistakes to the DOCTOR and not be fired out of a cannon..

[acuariaRN]

I've noticed it's pretty much the same no matter what you study.. you only get from a program what you are willing to put in to it. Some people see nursing as a job. They have very little interest in expanding their knowledge to improve their overall delivery of care... they self-identify as med-passers and bedpan cleaners... for some people that is enough. unfortunately, when the time comes to testify in a lawsuit, the quote "it's the doctor's job" won't cut it. I know too many nurses like that. I don't think you could possibly care about your patients' safety and not care about the "whys" behind your interventions. . . my ...

[BabyLady, BSN, RN]

Be careful...things are fresh on your mind when you are actively learning about drugs and when you get into an "area" of nursing, you'll be the most familiar with the drugs that are given everyday.

In other words med-surg and ICU nurses probably have the best pharmaceutical knowledge because of the vast array of disease processes of the patients that they take care of.

Cardiac nurses...know cardiac drugs the best.

Well-baby nursery nurses....I worked with a lady that was in med-surg for 22 years before doing this...and she said that your drug knowledge gets lost..FAST because the babies are rarely on drugs.

You don't have to have every drug in your working memory when you work the floor, you should look up ANY drug that you have physically not given before and to make sure that how you think it's supposed to be given and how it's supposed to be given...matches. Every floor should have a drug guide readily available.

Different schools focus on different things in pharmacology...mine did not teach us doses of anything...b/c they are generally not on the NCLEX and it is going to vary depending on where you work...what we did learn about is adverse effects...

You are responsible, as a nurse, for knowing if the physician is giving the proper dose and if it's compatable with other medications and any special considerations...you do this through your department drug guide.

[acuariaRN]

I agree with BabyLady that nurses generally have a working knowledge of the drugs they encounter routinely in their area of care. I'd like to add to my previous post that although nurses should not be expected to be an encyclopedia of irrelevant drugs, I have seen some less than professional attitudes regarding personal responsibility for one's area of expertise.

I am a progressive care nurse on a unit with many cardiac patients. I've seen nurses give cardizem with a HR of 45 at midnight and then wonder why their patient needed atropine at 3 am. Why give the cardizem? Because the doctor didn't order any holds. Yeah. Because it was the doctor's responsibility to tell us robots (note sarcasm) when a drug should be held because it could kill a person (cardizem is a very common drug to our unit). That "it's not my job to know that" attitude can be fatal when a situation like that arises. I would love to see the nurse in the above situation realize the relevance of at least striving for mastery of their specialty... but attitudes aren't always so easily changed. Some people are jaded from the start and don't care... don't see that their actions are very very consequential.

It matters that the nurse takes the extra step to make sure that their patient on a narcotic drip has narcan in the room, that their patient on an insulin drip has an amp or two of D50 in the room... that their patient with a recent MI has a 30lb wt gain over 4 days has a nurse on their side to remind the doctor to do something about it before they go home. . . And doctors losing respect for nurses because they call about a patient on a Nitro drip who is having dull chest pain, asking for morphine or nitro paste instead of titrating the drip up! (nitro= very common on our floor, peice of cake... read convo: "she's on a nitro drip right?" "yeah..." "what rate?" "20" "are you serious?!" ***snickers and the story spreads like wildfire among the new residents that nurses indeed cannot be trusted***) ...i could go on..

My point is... i suppose... that it doesn't matter what they teach you in nursing school, you are responsible for what you are expected to know. In the OP's story, that person could very well have been kidding when they said "that's the doctor's job" and they very well could have no experience with administering diphenhydramine... but be forewarned, you WILL come across nurses who don't know what they should know (which is excusable for an inexperienced nurse, believe me I understand, I'm far from arrogant) and worse, actively don't care that they don't know things that they should know.

I apologize for the rant... i talk a lot when I'm sleepy... it's just a pet peeve of mine. I'm a shift charge nurse and I see a lot of the strange things that nurses do and I shake my head in disbelief. Apathetic/cynical personalities cross over into nursing practice and it can get a little scary. I'm not talking about innocent novice ignorance.. i'm talking about people who should know better. I'm also not one of those nursing-must-be-done-by-the-book snobs either. People just scare me sometimes. lol. ok. i'm done now. :-P off to bed...