lack of confidence on giving meds

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Specializes in Critical Care.

Well I need advice, suggestions, etc regarding meds. You I'm still on probationary period with less than a month esperience in a infectious area.

When I was a student, I'm not very good in assessing patient. Now that I'm a a nurse, its as if I dont know how I changed to being meticulous when it comes to assessment. If a patient feels this and that, Its as if instinct is telling me to do this. Assess this and that.... But I think I'm doing the right assessment! So I was able to relay it to my preceptors.

Yesterday, my preceptor asked me if its ok for me to be alone now. Gee! That really shocked me! I told her that I'm confident with what I'm doing but not the medications! I'm good with IVF but not the PO, SC, MC, IV push meds that are already complicated. I know how to give it but I'm really bad at identifying them! I'm only confident with the antibiotic, OTC drugs. You know, the easy to give that is less dangerous (except if the patient has allergy to it).

Any suggestion, violent reaction, ADDED INFO would really help.... Thank you...

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Specializes in Med/Surg/Tele.

Don't be afraid to look it up. I would rather stand there for 2 mins looking it up than to not be sure what I'm giving. If you're worried about explaining a med to th pt, remember they are not your instructor, they don't care about how the drug works, simplifying it is better. This is your blood pressure med, your cholesterol pill, water pill, or this is for the itching, etc.

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Specializes in Emergency.

I ALWAYS look up meds that I am not familiar with. We have drug books on the unit, as well as access to online databases for drugs.

I work on a telemetry unit that is very busy. Even if I am swamped I still take the time to look up a drug that I am not familiar with. I would rather be late giving a med, than to give a med I know nothing about.

I was on last night and had several drugs I had to look up. It's nothing to be ashamed about. You are not expected to memorize the nursing drug manuals. I work with nurses who have been nurses for years and still look up meds.

Just be safe, and know what you are giving, and what side effects to look for.

With experience comes the knowledge, not the other way around.

Amy

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Specializes in Critical Care.

Thank you very much for all your suggestions....

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Specializes in Adult Acute Care Medicine.

Yes, keep on looking up meds. I have only been a nurse for 7 months and still look up meds daily.

I also try to answer the questions 1) why is pt taking this med? 2) Is there any reason I should not give it?

Ex: I make sure I know pt is not allergic to meds I pass, I check BP before giving lopressor etc....also just last night I has a pt with s/s of new GIB and held her miralax and senna.

Take the time think to keep your pt safe even if meds have to be late. You'll be fine.

Good luck and congratulations!

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Specializes in Hematology/Oncology and Medicine.

My preceptor taught me, and I took it to heart, that you can't give a med not knowing what it's for. BUT... you need to make this easiest on yourself. What he taught me was to carry a PDA, with a drug database in it. This speeds up your ability to look things up considerably once you get the hang of how to use it. I am the only person on my floor who has one, but I can honestly say that I use it everyday, and lookup all the drugs that I am unfamiliar with, and I know how long to give them according to "the book". And once you get the hang of it, instead of 2 minutes fliping through a book, is cut down to about 30 seconds at most. Pretty nice way to build your knowledge base and confidence in giving medication if you ask me.

That's my suggestion anyway.

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Hello all,

I had a serious med error on the job and need to talk with someone some experience with all this!

Im a new working LPN, soon to be RN and would love to talk with some folks about some of my concerns...:w00t:

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hey, ive screwed things up here.

i posted a concern here with out addressing the discussion at hand!

so ill start over:

If im giving a med and i dont know the most basic things about the drug i freak inside. i would prefer to look up all meds on my PDA but the time crunch of passing meds is usually overwelming and i find myself ignorant about my meds more often than i perfer.

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Specializes in Cardiac Telemetry, ED.
hey, ive screwed things up here.

i posted a concern here with out addressing the discussion at hand!

so ill start over:

If im giving a med and i dont know the most basic things about the drug i freak inside. i would prefer to look up all meds on my PDA but the time crunch of passing meds is usually overwelming and i find myself ignorant about my meds more often than i perfer.

Speaking for myself, I will take the time to look up a med I don't know, even if it's just a quick lookup, and be behind and have to stay late to chart, than to save time and pass a med I don't know. To me, it's better that a patient get a med a few minutes late and I know what it is that I'm giving, than to get it on time and I have no clue how to assess for adverse effects. I often look up meds I've passed many times before, just to refresh my memory. Especially important are the IVP meds; knowing if they need to be diluted, with what they can be diluted, what they are compatible with, and what rate to push them. This is stuff I just do not take shortcuts on.

If you look up a med and you still have questions, do you have a pharmacist on the floor that you can ask? I have darkened our pharmacist's door more times than I can count, and they are always willing to help.

Something you might try is looking up meds when you're not at work. Keep a drug book in the bathroom and look up meds while you're on the toilet. Keep your PDA with you and look up a med whenever you have a few spare moments.

Just curious, what med reference do you have on your PDA?

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Specializes in Critical Care.

Oh wow! Very nice suggestions.... thank you so much! I always keep it in mind...

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Specializes in Rodeo Nursing (Neuro).
hey, ive screwed things up here.

i posted a concern here with out addressing the discussion at hand!

so ill start over:

If im giving a med and i dont know the most basic things about the drug i freak inside. i would prefer to look up all meds on my PDA but the time crunch of passing meds is usually overwelming and i find myself ignorant about my meds more often than i perfer.

I try to arrive at work 15-20 minutes before my shift (used to be 30, but I'm getting lazy) and look over my Kardexes with a cup of coffee. It gives me a chance to sort of pre-plan, and while things rarely go as planned, it's also a good time to look up unfamiliar meds. I've heard it said, and tend to agree, that there are about 25 meds you need to know pretty much by heart, because you give them all the time--but it's a different 25 for each unit. So I don't have to fret a lot about nimodipine or Keppra or Ativan, but if I'm giving amiodarone, I'll check and see whether that's the one for overactive bladder, or something else...

(Actually, I remember amiodarone pretty well, even though I've never actually given it. It's the first med I ever held--HR was 50. Held it on the same pt the next night, but thought, hmm--maybe I should call the doc about this... The next time I had it ordered was as an IV push for a different patient, but the pharmacy recommended strongly that we move the pt to cardiac step-down to give it.)

If my patient is alert, I tell them what each med I give them is and what it's for. A lot of patients know their meds pretty well, and while it hasn't happened often, occassionally they'll question one that it turns out they shouldn't be getting.

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good stuff, i appreciate your remarks.

I use a Davis's Drug Guide version 3.1, 2000-2006 PDA program. It's a good and accurate program, it seems.

hey, does anyone have any experience with meds errors they would like to talk about?

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