Medication

I don't look up each and every med but that is because I am familiar with many of them. I do look up amyvim unfamiliar with. For instance I had an order to five vitamin k IV the other day in a patient with an INR of 1.7 with no active bleeding. The vit k helps clot the blood and having an elevated INR leaves you at great risk for bleeding. However I've not given vit K IV so I looked up. Turns out you should only give IV vit K in emergency situations (I forget why, I think something like cardiac arrythmias). And vancomycin must be diluted to a concentration of 5mg/ml (our pharmacy does not dilute it for us) and vanco cam cause redmans syndrome and voriconazole has to be over 2 hours and enalPril lowers blood pressure so you want to make sure your patient has a good blood pressure.

So as a new nurse I believe you have to make the rime to look up these meds. We walk our orientees through this practise. If you can't for whatever reason look the meds up as you go along- say your preceptor tells you that you don't have time- then take a list home and study them. It will be overwhelming at first but eventually they will become familiar to you too.

I am totally scared to give out medication. I don't want to give out something which I don't know exactly, but how can I ever remember all the side effects, interactions and dosages.

Just hope that it will get better after a while and my future boss will be patient.

It's our responsiblity as nurses to know about the med we are handing out. Likewise, I think the patient should know about every pill they put in their mouth. I find that so many patients don't know why or what they are taking. Often, I have to teach my patient to know what they are swallowing, what's it's for and why you need it.

The other day.....I was very unfamiliar with a med that I was about to give a pt. I asked him if he knew what it was for, of course he didn't. Well, he got a lecture on the importance of knowing his meds and I told him to ask his doctor why he is taking it. Anyway, I looked this med up and was still uncomfortable giving it. I called the on call doctor and he wasn't sure either, so we held this med until we could find out more from primary doctor.

If I'm unfamiliar with a med, you bet.....I look it up on lexi comp. I don't care how busy I am. You must be safe with these meds and if you don't know a med, look it up! Without a doubt!

During my orientation, I wrote down any meds I came across that I wasn't familar with and looked them up when I got home. If I get a new order for something I am not familar with, I will look it up. Even though I might think I am too busy, I remind myself taking a few minutes to look up a med might save me a lot of time if it prevents an adverse reaction.

In the beginning, you will be looking up meds everyday, eventually the "regulars" will begin to stick in your mind, but it is impossible to know every med. Hopefully you never give a med you are unfamiliar with without looking it up.

There are a few pocket med books that will give you the basics of the drug. Places with computer documentation usually have a way that you can click on the med and look it up which is much faster than the way I have to do it at work (find a drug book which is never in the right place lol). Even though it takes me awhile, I still look up the drug if I'm unfamiliar with it, I mean do you really want to go through a scenario of having to call a doctor and tell them their patient's blood pressure bottomed out because you gave her a beta blocker without checking her BP first because you were unfamiliar with the med and didn't know it could cause that reaction? Believe me, the excuse that you didn't know won't fly.

Please don't cut corners on your med administration, it is one of the things that we do that could kill someone!!!

I would find out what the common meds on your floor are. For example, on our floor, we pass out all the cardiac meds, Metoprolol, Coreg, Lisinopril, etc etc. We do drips of Nitro, Cardizem, Integrilin and Heparin to name a few. We routinely give Morphine, Dilaudid, Phenergan, Zofran etc.

Knowing the basic meds of your floor will greatly speed your medication process. Ask other nurses, make a list and take a little time at home to look at them.

Then, when the time arises that you have something new, Dilantin, Seroquel and many others, you can focus on looking those up.

Generally when I look them up I do a quick scan for the therapeutic reason. I figure out if I am familiar with the action. If so, I move on to double check dose and think of a good way to describe the action of the med to the patient. Aka, Lovenox, this helps keep your platelets from forming clots in your legs.

If I am really lost on a medication route I will ask other nurses if they have given it before. If I am still on the outs then I just call pharmacy.

Best of luck!

Tait