medications

[horsehobby]

I am a recent LPN grad orientating in a LTC unit and sometimes can't remember everything. I will have 10 days of orientation and feel stupid. I hope I don't forget anymore stuff from now on, what if I forget a med or something, I really don't want to get fired. This is really good experience it is just amazing going from school having one patient to administering meds to 20-30+ patients and keeping track of the different times. I will survive, I hope without too many med errors. How many med errors can happen before one is fired? Just writing this down so I can get feedback from those that understand and understand feeling completely incompetent!

[CapeCodMermaid, RN]

There is no hard and fast rule about numbers of med errors and getting fired. EVERYONE makes a med error sooner or later and you hope the one you made didn't hurt anyone. Many times errors are the result of faulty process. When I was an ADON I had to do a med pass. I didn't know any of the patients. It was a sub acute floor and very busy. I got to the last room thinking it was great until I saw that I had missed someone's Fosamax at 730. Was it life threatening? No. Did the resident suffer? No. But it could have been a crucial med. So I wrote myself up, to the staff's amusement and came up with a plan of correction. From that point forward, we would have an index card in a pocket in front of every MAR. Any early or oddly timed meds would be listed on the card so everyone would know.

You will make mistakes because you are human. Don't beat yourself up if you do. Take your time especially when you are just getting to know the residents. Go by the book...don't take short cuts. Good luck.

[nurseofalltrades]

Well my best advice is to follow the rights...right patient, right time, right med, right dose and right route and document, document,document. Everyone makes mistakes but if you follow the mar closely that should help limit med errors. You dont want to be fired over that because that could haunt you when looking for another job....feel free to message me if you have any questions...I love to talk shop!

[husker_rn, RN]

When I first started in LTC med pass was very intimidating with the meds and times and such. I went to Staples and got a couple containers of BIG colored paper clips. Figured out a color coded system and then " flagged " med times by color; flagged each residents med sheets. Took awahile to get my system down but it worked. Please remember you're still new at all this. Learn to do it right and THEN learn to do it quicker. Start with good habits like the previously mentioned 5 rights. give yourself time. Good luck !!

[florianslove]

My first job after getting my license was in LTC. It is really challenging but you can learn a lot. I always carried a nurse's drug book with me for reference, it really helped. Remember the 5 rights, and do the best you can. A good friend of mine once said "if you do the right thing, you'll never be wrong". Just try your best, pay attention, and remember you are there for the residents.

Roxann:yelclap::redbeathe

[EverNurseRN]

great advice from everyone so far..also, don't be afraid to ask for help from the more seasoned nurses. if you work with good nurses, they'll be willing to help you with treatments, assessments, paper work, etc. till you get your med passes down. you'll have your own system soon enough and won't need as much help.

my first job was also ltc and if it wasn't for the nurse working the floor beside mine i would have drowned..even the little stuff she did like stocking my cart, doing a couple treatments, helping an aid with a transfer, these all gave me that little extra bit of time i needed when i was slow with meds...it's so important to follow your rights so you don't make a tragic error..keep your patient's a priority and you'll never go wrong

good luck to you and keep us posted as to how you're doing!!

[horsehobby]

thanks for all the support and reminding me of the basics. you are all absolutely right about the 5 rights! i am going to triple check and quadruple check my stuff and then i know i will feel better. i didn't get to do that the other night which is what brought this post on. i am also going to take my drug book:wink2:! thanks and i will keep you posted.

[justiceforjoy]

We are taught to do the rights three times. We have nine rights (patient, drug, dose, route, time, reason, education about the drug, documentation, refusal).

First check and second check are back to back. After they are done, we pour the medication and then put a dot in the MAR where we will be signing, then we do the last check, ID the patient, give the meds, watch them take it if applicable, then we go back to the MAR and sign it.

Long story short, we don't sign after they're poured, we sign after they're given.

[dulcemorena]

we always learned 6 rights.. (patient, time, dose, med, route, documentation) and 3 checks. I'm a little nervous about passing meds for so many people but somewhat excited to begin something new. Some of my class mates have already began working and a couple have already made errors as GPN's. I'm getting a little tired of aide work though, its fun at times, but I'm ready to move ahead. Hopefully the nurses I work with will be nice and helpful.