how much are you expected to know about your drugs before you pass?

picurn10 · Feb 15, 2009

I should also add that this nurse wouldn't let me take vitals and only let me do my assessment after she'd done hers.

dana0509 · Feb 15, 2009

wow that's a lot of meds for one patient! My experience as a student was i have to do evrything for the patient i was assigned to (assessment, patient care, med and so on). It was'nt easy at first, it took me a while to get evrthing set up but i manage to keep at the end.

But that was not fair, she could have at least let you admisnister the shots! Did try to talk to your instructor about it.

picurn10 · Feb 15, 2009

I know and that's was just her 10am's :bugeyes:

We also do total pt care for the two days we have the pt. We're supposed to go in do our vitals, assessment, am care, charting, any treatments, and so on. But are you expected to memorize all the pts drugs for each week?

picurn10 · Feb 15, 2009

oh, I did talk to the instructor in post-conference. She made a note not to put students with her again (apparently she'd done the same to another student last week). So I get that it's likely this nurse just doesn't want students, but I'm just trying to understand what other students are expected to know?

truern · Feb 15, 2009

We go up the night before clinicals and pull our pts chart, including all the drugs. Then go home and make up drug cards or read through our drug card for the pt. One day we pass with the instructor (1x per week) and the other day we pass with our nurse. Our instructors have said we don't have to memorize each one, but we should have a basic knowledge about the side effects and so on.
So when I was with my nurse this week, she said "go use your drug book and look these up before you pass them" I explained to her that I had already done so, and I had my drug cards, and then went and sat down with the MAR and reviewed. I wasn't being argumentative, I just wanted to be sure she knew this wasn't the first time I'd seen the pts. MAR. So she watched me pull everything from the pyxis and get everything ready. When we got into the pts room I set the meds down and went to grab gloves and the nurse said "so do you know what all these are?" and I said "well I don't have each one perfectly memorized, but I know them" (we were passing literally 33 meds to the pt) and at that point she just took over. She gave the pt each med and then went and gave both subq injections. Come to think of it, she didn't let me draw up the insulin either. It was pretty frustrating. I was upset because I feel like she assumed I didn't know my stuff, but I had done my homework. I was well in the range of what my instructors expect of me, and had my instructor been there, there is no doubt she would have let me pass after a little quizzing, as she always does.
So what does your instructor expect? Do you have to memorize each one, or do you just need to have a general knowledge of each one, along with the drug cards on you to review before passing?
It already takes me a good 5hrs to prep for clinicals, not including the 2hrs it takes to go up to the hospital and get everything from the chart. I'm a pretty good memorizer, but I have zero medical background so most of the drugs on the MAR are the very first time I've ever seen them
Am I not preparing enough? What is your clinical set up like?

NOT saying that you did, but don't you see that you could have been viewed as argumentative?

She was within her right at the primary RN to give the meds herself if she didn't think you were prepared adequately.

gaajr1, RN · Feb 15, 2009

Our instructors want to know how a particular drug works in the body (action), why is the patient getting it and what are the imp s/s seen. Also, if there is a drug interaction what is it that you have to be aware/do before giving the meds. Example, if your giving Digoxin you check the HR, K level etc.You may be very good at memorizing but also make sure you understand the action of the drug, that way, you also reason out the expected s/s. Also learn the endings of the drug class.

I don't understand when you say, "most of the drugs on the MAR are the very first time I've ever seen them". From what I gathered you go the night before and get your patient info. I'm confused, however by the time you go next morning there could be some changes in the patients MAR. If you don't recognize the drug there is nothing wrong in looking over the drug book.

Don't take it to heart if your nurse wants to do her assessment first. Remember ultimately she is responsible for that patient. Instead take it as a learning opportunity and observe the nurse.

Any problem you have at the clinical site talk to your instructor. She is the best person to guide you. Lastly, remember we are students and learning things at every step. Good luck!

picurn10 · Feb 16, 2009

I guess I'm not making myself understood: From her comment, it sounded as if she thought I had literally never seen the pts. MAR, and had no idea what she was taking. I just explained to her that I was aware of the pts meds, had done the research the night before. She wanted me to pull out a drug book and look them up, which I obviously had already done. I think her exact words where "here why don't you look up these drugs before you give them" So I assumed she thought I didn't have a clue what any of the drugs were. I just let her know I was more prepared than that.

We are also expected to know the drug action, interactions, side effect, nursing implications, etc...

Here's what I'm asking (and obviously I did a bad job of it in the first post): are you expected to memorize all 35+ of your pts drugs the night before? How much are you expected to know off the top of your head?

For example, if I jog my memory by glancing at my list, off the top of my head I can tell my instructor what the drug is for, it's classification, what the major side effects are, any critical pt. teaching, and anything else major that is related to it. (like taking an AP with dig. or something) but I typically can't look at all 35meds and know by the name what it is. To me they all are still like a different language, but once I look and say "oh, that's a antihypertensive" then I can rattled off the side effects, drug interactions, toxicities, pt teaching, and so on. Does that make sense?

picurn10 · Feb 16, 2009

Our instructors want to know how a particular drug works in the body (action), I don't understand when you say, "most of the drugs on the MAR are the very first time I've ever seen them". From what I gathered you go the night before and get your patient info. I'm confused, however by the time you go next morning there could be some changes in the patients MAR. If you don't recognize the drug there is nothing wrong in looking over the drug book.

What I meant was, when I sit down at the nurses station the night before, that's often the first time I have ever seen a particular drug. And when I go home and start working on my med cards, it's the first time I'm ever reading about it. Most of my classmates have worked in a hospital setting or even passed meds as a medication aide, so most of the meds they've at least heard of before.

missjennmb · Feb 16, 2009

I guess I'm not making myself understood: From her comment, it sounded as if she thought I had literally never seen the pts. MAR, and had no idea what she was taking. I just explained to her that I was aware of the pts meds, had done the research the night before. She wanted me to pull out a drug book and look them up, which I obviously had already done. I think her exact words where "here why don't you look up these drugs before you give them" So I assumed she thought I didn't have a clue what any of the drugs were. I just let her know I was more prepared than that.

Since you admit that you don't know them by heart, and she was suggesting you do something and you were supposed to be folowing her lead, I would go ahead and look them up again. If I was the nurse I would probably do the same thing. Even if you did look them up the night before, a refresher right before giving them the first time to this patient is NOT a bad idea. She didn't ask you to make new drug cards or copy the info for 33 drugs out of the book or anything, just suggested you look them up. I don't see the harm in doing so, but I can see how her feathers would be ruffled if she suggested that and you basically told her no, you werent going to do it.

Just my 2 cents.

NightOwl0624 · Feb 16, 2009

I think the amount of preparation you did was fine.

HOWEVER, from your posts you seem very defiant regarding your decision NOT to spend some time with the drug book. I can tell that nothing anyone here will say will change your mind.

I think the nurse was reacting more to your attitude. She may not like working with students, or she may be really nervous handing off her patients to students. But to completely disregard her suggestion for a quick review probably irritated her, and you admit you didn't have the information down cold. Perhaps a better response would have been, "I looked up all of the medications last night and have my drug cards, but I'll review them again before we see the patient"

When you are working so closely with nurses, you really have to do it THEIR way, even if it seems silly or a waste of time to you. Maybe, just maybe they have a reason for what they are asking of you.

I think you should stop being so defensive, chalk this one up to a learning experience, hope you don't get paired up with her again, and move on. It's not worth obsessing over it.

NamasteNurse, BSN, RN · Feb 16, 2009

My problem with your scenario is that the instructor passed the meds that YOU had prepared?? That's the first thing we learned NOT to do! If she didn't trust you why did she pass the meds you had pulled?? Makes no sense