I Had an awesome instructor for clinical last semester. Ideal. She had a funky-fresh funny attitude, cute sayings, and wasn't the psych-b^+cH from hell that everybody is scared of getting. Very knowledgeable as well :). Anyway, I loved how thorough she was when it came to passing meds (very thorough with everything actually). she'd ask us the 5 rights (Our school actually has 8 or 10) and also wanted us to look in the drug book to find out it's mode of action, what it's used for, dose range, most crucial adverse effects, and check other pertinent info, such as bp or pulse if giving a beta blocker or check the pts K+ if we were going to be giving lasix, etc, you get the point. I ended up catching two mistakes by doing all of this. In one instance, the patient was mildly hypokalemic and had an order for lasix w/o a K+ supplement ordered... got that corrected, physician ordered k+ supps. Another instance, had a new order for a drug to be given twice a day at 100mg when the max dose was no more than 100mg qday... once again, got everything fixed.
When i told the nurse about the K+ issue she stated "Often times, there's no time to question what's ordered. The doctor orders it and you give it." So i told her i wasn't comfortable giving the lasix. Lo and behold, she found me later and showed me a new order for K+ supplements.
Now this clinical was on a med-surg oncology floor and the instructor works in postpartum outside of school. She checks all of this because she's new at teaching med-surg and doesn't give alot of these meds in postpartum. Once she starts to remember the drugs she's not as thorough. So i guess my questions is:
When starting as a new grad, did you look up all the meds you weren't familiar with until you committed them to memory? Or do you just do the 5 rights, check meds against the MAR and go? There are a lot of meds that I remember, but plenty that i don't know or remember and i don't want to hand out medications of which I know nothing.
Realistically, how did you approach this as a new nurse? Is there enough time to look them up?
We write diagnosis for taking med on new orders and our pharmacy sends us printed monthly medex with diagnosis for every med. And its a good thing because it is impossible to know every med and when you have to float to another floor and you have 40+ patients to pass for, you do not have time to look for the drug book. I do look up a med I am unfamiliar with. But I can not do it during med pass, because I have no extra time. Elderly people take too many pills.
RNperdiem, RN
4,592 Posts
The first time you try to give a drug that you don't know, is the time the patient will ask why they are getting that particular med.
Hmm... Whacha going to do now?