Med passing question from a student

[MsPebbles]

As students, we're taught that when passing PO meds to open them in front of the patient and administer each one individually after explaining what it is. I have witnessed an RN open all her meds away from the bedside and hand the cup of meds to the pt saying "here are your morning meds," and I was told by another RN that our way is only done while in school as it's too time-consuming. She also gives all meds simultaneously in a med cup. Is this the norm?

[FineAgain]

I always tell patients what I am bringing them. I pick up each one, name it, then open and put it in the cup. Giving them individually would take way too much time.

[Jory, MSN, APRN, CNM]

It would depend on how long the patient had been on the meds.

If it was the first time I was giving medications, I would say, "Ok Mr. Smith, I have your Plavix, etc....are any of these new?"

If not, I would administer..otherwise, chances are you are only explaining what is new.

This is also a "check"...you might get a patient that says, "Wait...I'm not on a blood pressure medication." That is why it's good to review it at least once with the patient..if you bring it back a second time during the shift or the next day, then it's redundant.

Keep in mind, there is real life and the "NCLEX" hospital...the one nobody works in. Remember the correct way for testing, do what is the protocol for the hospital, but never reviewing the meds with the patient? That is very, very bad practice and is exactly why med errors occur.

[Lennonninja, MSN, APRN, NP]

I don't give a lot of pills in the ICU but when I do, I first ask how many pills the patient can swallow at once, and then I tell them what each pill is as I open it and hand it to them. If they say they can swallow 4 at a time, I'll take the first 4 pills, and explain them as I place them in the cup. I learned as a new Med/Surg nurse never to open a bunch at once after I opened 6+ and the little old lady said that she could only swallow one at a time.

[loriangel14, RN]

Yes where I work they are all opened in the med room and given all together in a med cup. If the patient asks what each one is I explain otherwise they just take them. Doing it your way would be too time consuming.

[vintage_RN, BSN, RN]

I was taught your way in school as well, but I have never done it that way. Too time consuming. If a patient asks what their pills/injections/iv meds are I will explain them, or if the doc orders a new med I will explain what it is for/why they are getting it etc. Otherwise I dispense into a med cup in the med room and deliver them to the patient.

[loriangel14, RN]

My patients would sigh and roll their eyes if I was going to go through each med each time.

[iPink, BSN, RN]

We have med scanners at the bedside so I tell the patient what meds I will be scanning for them. I always stress the importance to my patients to know their meds. I find it surprising many of my patients who have been taking the meds long term didn't know what meds their were taking and why there were taking it. That's also when I print out information for them.

Med pass will be among other things you won't do completely by textbook once you become a nurse and starting working in the real world. But as a student who wants to pass clinicals, do everything by the textbook.

[Fiona59]

It's accreditation time in my hospital and we are constantly getting emails about opening the pills at the bedside and explaining each and every med incase the inspectors are around.

Now, we all know that accreditation month, the real world and what the patients do at home are all different things.

[applewhitern, BSN, RN]

We have the med scanners at bedside, too. We have to scan their bracelet, then scan the med. It is clumsy and awkward, since I work in ICU. Most of the meds won't scan right, or we have to then leave the room to go back and mix them or draw them up in a syringe. I always tell my patients what I am giving them. Just make sure you do all your safety checks.

[MsPebbles]

I really appreciate everyone's responses. I asked this question because during clinical I'm always in awe of the nurses with 6-7 pts who make things look so easy while I feel as if I'm running around like a mad woman with my measly 2 pts! So, I was wondering if there were certain things I'm required to do now that will become more streamlined/efficient once I'm an RN. I've gotten a bit better in certain areas, but passing meds always seems to take up most of my time. At least once I graduate I will no longer have to write out every med on a med sheet and hunt down my instructor!

[ArtClassRN, ADN, RN]

A very, very important thing to remember that it is your license and your nursing practice.

As always, use your judgement on patient education when dispensing medications.