Passing Meds Question

[sports2245]

This might sound silly, but our instructors (3 of them) give us different information regarding passing meds & the 5 rights. After verifying the physician's order & checking it against the MAR, is it better to prepare the medication & then enter the pt's room & ID the correct pt or ID the patient before preparing the medication? We have a skills test tomorrow morning on the procedure & most of us are really confused on this. Any help would be GREATLY appreciated. Thanks.

[cardiacRN2006, ADN, RN]

In nursing school, I always had to do the 5 rights, and then ID the patient. Then I could prepare the meds. After I checked the BP, heart rate, allergies, etc...

If you have a cup full of pills, and the patient refuses one of them, what do you do???

[RNin'08]

We were taught to check physician orders, MAR, prepare meds and then take them to patients room and ID pt. I think it would be best to verify with the instructor doing your skills check off just to be sure. Good luck!! I'm sure you'll do fine as long as you check all 5 rights :)

RNin'08

~my reality check bounced~

[southernbelle08]

It really depended on the instructor for me. For PO meds: I'd always check the physician's order and MAR and then go over the 5 rights. After that we'd go to the PT's room and I would always have to do my identification and then I would prepare the medication (remove from blister pack, etc). I, personally, always thought it would be better to have all of the medication out and ready to go beforehand, but they always made us wait till we got in the room to remove from blister pack if the pill was in one.

With IV push or Injection: Everything was the same except I would of course prepare the medication in the medication room before going to the PT's room.

Also - Since a previous poster mentioned it - We have never been told to ask for allergies, in fact...before going in they would make us check it on the chart, but that was it. I even asked once and I was told "No, you have that information from the chart." Seems incorrect to me. I have also given BP meds relying on vitals I took an hour or 2 before administering the medication. Asked about that before going in the room, instructor looked on the flow sheet and said it was fine. Worried me then and now that I saw someone mention that, really does baffle me.

[militaryspouse98]

I saw where you asked the question about what if the patient refuses the med.. Well our instructor told us to document in the notes that pt refused whatever drug it was and put in back in the med cart. I think as long as you document everything you stay in the clear. Of course you would probably have to explain to the patient the need of the med and what it could help but if they still refuse it, I think that is their right.

[taminova]

hey!! so i had the skills test last semester for passing meds. I had to do a P.O. and a supp. i went in to see the patient, ID'd them, did my assessment, then went to pour the meds. checked the doctors orders, checked against the mar, did my rights and checks... basically that part i did by the book. I went back in to see my patient, checked their wrist band again, and then i realized i forgot my gloves for the supp. so i grabbed the meds with me (you're never supposed to leave them, right) and went to get gloves. I came back in and gave the pt his PO med. right there my instructor told me to stop because i failed. I didn't ID the pt IMMEDIATELY before giving him the med. so, goes to show you just have to know exactly what they want from you. in my case i had to just ID once right before giving the med. explanation: pts could switch beds. with their twin. yeah, right.

[APBT mom, LPN, RN]

We had our skill check for med pour last month and our instructors did the same thing, they all told us something different. When it came time to do it I just did it the way the instrutor who checked me off told us and while I was doing it asked if I could do it this way or that way. I passed with no problems.

[cardiacRN2006, ADN, RN]

I saw where you asked the question about what if the patient refuses the med.. Well our instructor told us to document in the notes that pt refused whatever drug it was and put in back in the med cart. I think as long as you document everything you stay in the clear. Of course you would probably have to explain to the patient the need of the med and what it could help but if they still refuse it, I think that is their right.

I know how to document a refused med.

How do student nurses, who have opened up all the blister packs and put all the pills in a med cup, know which med is the one refused? Do you reach in there with your hand and get it? What if you come in, you've checked everything, and you go to give your meds and your patient doens't look to good? Now you have to figure out which med you no longer wish to give.

It's better practice-in nursing school-to lay eyes on the patient before you open the meds.

That's in nursing school, remember it's nothing like real life.