New Grad in PDN!

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Okay so I finally got a case with my agency and I officially started last week. During my shift my client receives a total of 7 meds 4 of which are PO and 3 are nebs at different times. My question is, is it a great idea to prep all of my meds and have it organized? The family looked a little hesitant with me preparing some of the meds early but it really makes things easier.

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Specializes in LTC, Memory loss, PDN.

i'm not sure i follow

how is it unorganized to pour the meds when you need them

how does it make it easier to prepare them early

are you talking about refrigerated nebs

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I meant that if I were to prepare all of the client's meds and organized it by labeling it.

It would make it easier because preparing the meds takes time so I thought if I got all of that out of the way I could spend more time watching the client.

It's fine now though someone sent me a PM detailing why it wouldn't be such a great idea.

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Specializes in Complex pedi to LTC/SA & now a manager.

Not a good idea. Lots of risk and definitely not the standard of care hence why the family looked at you funny. They were likely told that by the RN who opened the case

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Thanks. Now I know. I'm just trying to learn as much as I can so that I can be a great nurse to my client.

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Specializes in Peds(PICU, NICU float), PDN, ICU.

In my state, it's against the law to pre-pour meds. And with one patient, that seems ridiculous. You should have no trouble managing your time with one patient. Also, some meds are meant to stay refrigerated until it's time to use the med or the med can break down. Other meds must be kept away from light which can deteriorate meds. How do you know the med you poured hasn't been tampered with? And if the family has other kids, you run the risk of the kids getting into the meds. Scary! If I saw a nurse doing this, l'd report the nurse to the nursing supervisor. Plus it's a waste of meds if you have to leave early. Other nurses won't give pre-poured meds if they come in to relieve you. What happens to the meds if the kid leaves the home by ambulance? Do the meds just sit there until you work again? I sure hope they don't have a curious dog either. Explaining the dead dog and chewed up syringes or half chewed pills to the parents won't be fun. If I saw a nurse do this in my home, the nurse would be gone! Don't forget that some of the parents we work for are doctors and nurses who know better.

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Scary! If I saw a nurse doing this, l'd report the nurse to the nursing supervisor.

You wouldn't even coach/educate the nurse first.

I didn't say I couldn't manage my time either. I thought it wouldn't be a problem since I prepared the client's 4pm meds at 3:30pm.

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Specializes in Peds(PICU, NICU float), PDN, ICU.

You wouldn't even coach/educate the nurse first.

I didn't say I couldn't manage my time either. I thought it wouldn't be a problem since I prepared the client's 4pm meds at 3:30pm.

Preparing at 330 is fine. You made it sound like you are doing the prep when you arrived to work for the day. But if you prepare it at 330 and the med is due at 4, why don't you just give the med at that point? It's more time wasted to label it and "organize"it.

As for training, there are certain things my agency would expect to be reported to them. Not knowing how to use a piece of equipment is different from not knowing things learned in school. I would certainly teach how to use the piece of equipment. But because the nurses get such a short period of training time, they are expected to have basic nursing skills down.

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Specializes in Peds, developmental disability.

I suggest you make yourself a cheat sheet with times down the left side. I bring one whenever I am going to a patient that is new to me. Write down the fixed- time tasks, such as meds at 8 AM, Noon, and 4PM, bath at 6 pm, nebs, nap etc., based on the MAR, plan-of-care, and what Mom tells you is the daily routine. Then follow your plan, flexing as appropriate.

When I initially oriented, I was at a foster home, and the parents WANTED me to pre-draw up all the meds for the day. They were nuts! Pre-pouring is not legal or at best, ill-advised because it is a med error just waiting to happen!!

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Okay I see what you mean now. Trust me I wanted to give the meds at 3:30. I learned that it was okay to give meds one hour before or after. But the father looked uncomfortable so I decided that maybe they needed to warm up to me first. Thanks.

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You're right it is a error waiting to happen. I was imagine scenarios and thought about what if I was distracted and the younger sibling took the prepared meds. That just gave me chills.

It's so funny because as we speak I am typing one right now. I have paper protectors so I plan on attaching it to my clipboard so that I can always have it with me. Thanks.

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Specializes in Peds(PICU, NICU float), PDN, ICU.
I suggest you make yourself a cheat sheet with times down the left side. I bring one whenever I am going to a patient that is new to me. Write down the fixed- time tasks, such as meds at 8 AM, Noon, and 4PM, bath at 6 pm, nebs, nap etc., based on the MAR, plan-of-care, and what Mom tells you is the daily routine. Then follow your plan, flexing as appropriate.

When I initially oriented, I was at a foster home, and the parents WANTED me to pre-draw up all the meds for the day. They were nuts! Pre-pouring is not legal or at best, ill-advised because it is a med error just waiting to happen!!

When I'm on a new case I use the tab at the top of the notes we tear off to write times down. I know to look at the MAR at those times. I do it at the beginning of the shift and I am organized for the rest of the day. Once I learn the routine, I don't have to do it again.

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