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?
sorry, but I feel like you guys are not hearing me: I DID NOT defiantly ignore her, I didn't even have any reaction in the realm of that. I took the MAR, pulled out my cards and spent another 30min working on it right then and there. I had ZERO problem with that, I did not have an attitude with her in the least. She just seemed under the impression that I had never looked them up. I was just trying to reassure her that I had done my homework. When she suggested it, I most certainly did not have the attitude of "oh, I know this I don't need to do that" which is seems several of you are assuming about me. I never assume I know what I'm doing. I'm typically right on the verge of terrified because I realize just how little I do know.
In our clinical setting there are not "clinical nurses" we just get matched with whoever happens to be there: sometimes it's an agency nurse, sometimes its a staff nurse, but none of them sign up to help teach us and I think a lot resent it. I've literally been paired up with a nurse who was agency working her FIRST day there. She didn't even know where to find anything, let alone have the time to try and teach a student In post conference I found out that my nurse (the one who wouldn't let me pass) did the same stuff to another student, and my clinical instructor made a note to no longer put students with her.
I wasn't posting to know what everyone thought of the situation with the nurse, but I was kind of surprised that she expected a student to know by heart all 35meds, and wondered if that were normal. Some of our clinical stuff is not "normal" compared to what many of you are experiencing so I'm just trying to get a gauge for it. If you're telling me that when you go into clinical you have every med memorized (meaning name, action, side effects, and so on...) than I will work harder on that. But since my instructors don't require it, I'm wondering if that is expecting too much. Or on the other hand, I'm wondering if we are not being asked to work at the same level as other nursing students, you know? If it's standard to know 100% off the top of your head, then I will work to that level. I just hadn't done so because we were specifically told that wasn't what they were looking for.
No, I don't think it is reasonable to know all 35 meds and everything there is to know about them by heart. I think you were adequately prepared. That's my answer to your question.
HOWEVER, I still think you handled the situation wrong, and you seem to want everyone to agree with you that you were right and the nurse was wrong. Maybe she was, but you can't control her, you can only control yourself. As a student, I think you need to get used to that idea. She wanted you to spend some time with the drug book and you didn't. Even if YOU don't think you had an attitude, maybe she thought you did.
(BTW, I'm not being completely heartless. I have been paired with a similar kind of nurse myself in this rotation and it's frustrating. I just try to play her game for my own survival.)
I just find it a bit ridiculous that I'm being told how I acted and what my mental thought process was, when none of you know a thing about me and read the situation and projected your own preconcieved ideas onto it. The interaction between the nurse and I was very friendly, she was a kind, good nurse. I think she didn't realize that we did prep (some of the local schools do it the same day as clinical) and she was too nervous to let a student work under her license and I totally get and understand that. We had no problems personally: we laughed and joked around all shift and I was grateful for her help and told her so. I just thought her expectation that I have my meds memorized in order to pass was a little excessive.
I'm going to bow out now, because I think my question: "are you expected to memorize your drugs?" was convuluted by me adding the extra stuff about the nurse that made it seem like I was asking for a critique about my interaction with the nurse. I already did that in post-conference and it was consensus that this nurse, while nice and very competent, isn't going to be teaching us because she won't let students do what we're there to do.
No hard feelings, I just feel judged and misunderstood and I was trying to ask a simple question (which I obviously didn't make clear at all). Thanks for the replies I'll try to make my post more clear next time.
We have to fill out a medication preparation sheet, which includes both brand & generic names, route, dose, mechanism of action, major side effects, nursing interventions and why you are giving that med. It's a lot of work and it takes forever to fill out those sheets, especially if you have a patient with A LOT of medications. My first patient this semester had 31 medications, all that I had to look up. Looking up all of those medications (and then doing the rest of the "prep work") took me nearly 5 hours to do :angryfire and thank goodness I wasn't doing a med pass that morning - I would have driven myself crazy! But anyway, usually my instructor just asks us about interventions and why we are giving that particular medication. We're allowed to use our sheets but last time I did a med pass she took them from me and was looking at them while I told her stuff, but I had to give Lovenox which I already knew a lot about so it wasn't hard.
One of our clinical instructors at our school makes you know EVERYTHING prior to a med pass and you're not allowed to use your sheets. I understand that is how it is supposed to be but how can you learn everything about a bunch of medications the night before clinical AND get an adequate amount of sleep?
shrimpchips, if you make a template for a med sheet it would take you minutes instead of hours. I saved all my med sheets on the computer and changed the pertinent info each time.
shrimpchips, if you make a template for a med sheet it would take you minutes instead of hours. I saved all my med sheets on the computer and changed the pertinent info each time.
Well yes, I don't look up drugs that I already have on my med sheets :)
I write everything by hand, and when they want us to write down the mechanism of action and all of those side effects, it really does take me a long time. I can type really fast but I learn better when I actually write things down myself.
I think you guys are pretty lucky that you have the ability to look up the meds the night before. We get our assignment upon our arrival, and have very little time to look up meds we don't know before we pass them.
I can type really fast but I learn better when I actually write things down myself.
Me, too :)
If I ever got "stuck" on a test question I could visualize my notes and see the information I needed for that question. Something about the hand to brain connection
If this is first semester I think that the nurse is expecting a lot from you. By second and third semester at my school you are supposed to know the thirty plus meds for your patient, and mechanism of action, side effects, why the patient is getting them, lab tests or vitals that should be checked first other drugs or food that would interfere with drugs and side effects. If you stay on the same floor for the whole semester you will start seeing those same drugs over and over giving you an edge on remembering those same meds. The nurse is within her rights to not allow you to give meds to her patient. She has to make sure in her mind that you are safe...at my school the clinical instructor is your instructor and all questions and drug administration has to be approved by her. I have had students in my group that did not know their meds and were deemed unsafe and the instructor administered the meds; not the student.
Your clinical instructor is the best judge if your performance is satisfactory or not, and what your school expects. The nurse may have different opinions of what is satsifactory but has no bearing on your passing. So if the clinical instructor is satisfied I don't think you have a problem.
I still get a little nervous about not knowing my meds so I get up early and review my drug sheets testing myself over and over in my car before clinical. I think the tip someone else gave you about typing and saving your med info could probably save you some paperwork time. Looking things up on the computer and getting more comfortable with paperwork, assessment and charting and meds will come later in the semester or other semesters. Ju
picurn10
409 Posts
sorry, but I feel like you guys are not hearing me: I DID NOT defiantly ignore her, I didn't even have any reaction in the realm of that. I took the MAR, pulled out my cards and spent another 30min working on it right then and there. I had ZERO problem with that, I did not have an attitude with her in the least. She just seemed under the impression that I had never looked them up. I was just trying to reassure her that I had done my homework. When she suggested it, I most certainly did not have the attitude of "oh, I know this I don't need to do that" which is seems several of you are assuming about me. I never assume I know what I'm doing. I'm typically right on the verge of terrified because I realize just how little I do know.
In our clinical setting there are not "clinical nurses" we just get matched with whoever happens to be there: sometimes it's an agency nurse, sometimes its a staff nurse, but none of them sign up to help teach us and I think a lot resent it. I've literally been paired up with a nurse who was agency working her FIRST day there. She didn't even know where to find anything, let alone have the time to try and teach a student
In post conference I found out that my nurse (the one who wouldn't let me pass) did the same stuff to another student, and my clinical instructor made a note to no longer put students with her.
I wasn't posting to know what everyone thought of the situation with the nurse, but I was kind of surprised that she expected a student to know by heart all 35meds, and wondered if that were normal. Some of our clinical stuff is not "normal" compared to what many of you are experiencing so I'm just trying to get a gauge for it. If you're telling me that when you go into clinical you have every med memorized (meaning name, action, side effects, and so on...) than I will work harder on that. But since my instructors don't require it, I'm wondering if that is expecting too much. Or on the other hand, I'm wondering if we are not being asked to work at the same level as other nursing students, you know? If it's standard to know 100% off the top of your head, then I will work to that level. I just hadn't done so because we were specifically told that wasn't what they were looking for.