Patient asked me what an IV med was for..i didnt know

Sun0408, ASN, RN · Mar 21, 2013

You are the primary nurse so you should know all meds your pt is on and why. The fact that you are not permitted to give IV meds is irrelevant. If you are unsure, state so and tell the pt you will find out for them. I as a RN still look up meds I am unfamiliar with. Please don't read the book to your pts, you read it and explain it to them in terms they can understand. If you have EMAR's, you should be able to look up any drug your pt is on with a click of your mouse.

Happy learning :)

allnurses Guide · Mar 21, 2013

I am a new grad LVN and a IV med was scheduled for a patient. The patient asked me what is the IV med for and I did not know. She also asked why does she need to have this? and Do you know why she has it?
She kept bombarding me with questions I did not know because as an LVn I am not even allowed to give IV meds at my hospital.
She asked for my name so I am sure she will report me. After this I told her i would look up the med and I did. I read exactly what is was from my drug book.
Next time this happens I want to be better prepared with good answers. What is the most professional way to say I do not know.?

I'm not jumping all over you, because you care enough to come here and ask! The answer to the question depends on whether it's something you should know. I think you now realize you should know all of your patient's meds whether you are actually responsible for the administration of the IV med or not.

Then assess what the patient's knowledge deficit is. In this particular case it seems to be a large deficit, indicating that her doctor may not have, or not adequately explained his or her plan of treatment, and would indicate that either the RN or MD needs to address that issue. If the patient asks when the next dose is due, and you say, "let me check" that's fine. If they ask what time the volunteer is going to bring the magazine cart around, saying "I don't know" is perfectly acceptable, and you can offer to find out for them.

It's not a matter of how you say it, it's a matter of appropriately responding to the content of the question. Hope that makes sense!

ktwlpn, LPN · Mar 21, 2013

You can always pull this old trick " Oh,they are calling for me,I'll be right back" and run out the room,do your research and then go back in and say " I'm sorry,what were you saying?" Use this method in the future.

In this case I would really take a minute to explain the LPN scope of practice and then refer her to the primary care RN after applauding her for asking the question in the first place.Too many patients take a passive role in their care.It's their job to get better and it sounds like this patient was going to do her job to the fullest.Don't get defensive when a patient questions you-lots of times they know more about their disease and meds then you do and you can learn from them.

In your setting you really do need to know all of the meds your patient is on even though you can't administer some of them-you need to be alert for possible interactions,assess the site and as a courtesy you should let the RN know when she needs to hang another primary bag

lkulmann · Mar 22, 2013

You can always pull this old trick " Oh,they are calling for me,I'll be right back" and run out the room,do your research and then go back in and say " I'm sorry,what were you saying?" Use this method in the future.
In this case I would really take a minute to explain the LPN scope of practice and then refer her to the primary care RN after applauding her for asking the question in the first place.Too many patients take a passive role in their care.It's their job to get better and it sounds like this patient was going to do her job to the fullest.Don't get defensive when a patient questions you-lots of times they know more about their disease and meds then you do and you can learn from them.
In your setting you really do need to know all of the meds your patient is on even though you can't administer some of them-you need to be alert for possible interactions,assess the site and as a courtesy you should let the RN know when she needs to hang another primary bag

Thanks for keeping it real :)

NursingBro · Mar 22, 2013

Thanks for the tips!

Today I looked up the meds I didn't know in the mars and wrote them down on a brain sheet i have for each patient. There was 3 meds I did not know out of all of them. I just read everything about them before administering.

PAMELA1957 · Mar 22, 2013

I think that you did what you thought was best for the situation. As new nurses we "all" face situations that we have not been in before and the most important thing is to "learn" from the experience; you have.

You can never know everything about everything; though as a nurse with 35 years experience I was blessed to have the experience that I did.

I would advise you to defer to the RN, or give the very basic information ie. "It is an antibiotic, to help your body fight off infection." If your patient has questions after you have told them this, I would again defer to the RN.

Thank you for posting, and I apologize to you for any unsuitable responses you may have received.

Good luck in your nursing career, I think you will be an enhancement to the field of nursing.

drowningdaily · Mar 22, 2013

In an ideal world you should know every med your patient is on. Unfortunately, I have come up unprepared a time or two. I say, "Medications can be prescribed for different reasons. I don't want to give you incorrect information. Let me take a quick peek at your chart and come right back." If you act confident and make eye contact it can buy you time to look it up. I have had to do that with meds given on other shifts. Never had a problem. I did hear a nurse try to bs her way through explaining why a person was taking aggrenox for diabetes. It wasn't pretty.

tewdles, RN · Mar 22, 2013

You are doing great! The fact that you are seeking more information tells me that you will be fine.

When there are RNs and LPNs practicing together it is a team effort.

The RNs on your team should let you know if there are specific concerns that they have with a patient and POC.

They are paid to have a broader base of knowledge, more technical skills, a firm grasp of the nursing process, and critical thinking skills. RNs, as you are aware but your patient may not be, are differently educated and prepared than you are.

That doesn't relieve you of the responsibility to educate yourself, but they should also be a resource for you.

So, if a patient asks you a question about a medication relative to their disease process or the management of their illness, it is perfectly acceptable to defer that to the expertise of the RN. If it is a straight forward "what is it for" and/or "what are the side effects" question, you will be a better LPN if you know the answer.

Good luck!

Guest343211 · Mar 22, 2013

Uh oh. No way around this one. You are supposed to know the medicine, what's it is being used for (for the particular patient), of course dosage, timing and all the rest--safe administration parameters, which may include recent lab values, and if known, it's also good to know mechanism of action. The very least are the 5 rights + reason for the medication. If I were your nursing instructor or preceptor, or mentor, that's the least I'd want you to know. If you don't know what it is and why you are giving it; really, you shouldn't be giving it. So, whatever the situation, don't feel badly, b/c it's a lesson learned. Next time you will know and be prepared. :)

Beyond the 5 rights are the following:

Rights of Medication Administration

1. Right patient

Check the name on the order and the patient.
Use 2 identifiers.
Ask patient to identify himself/herself.
When available, use technology (for example, bar-code system).

2. Right medication

Check the medication label.
Check the order.

3. Right dose

Check the order.
Confirm appropriateness of the dose using a current drug reference.
If necessary, calculate the dose and have another nurse calculate the dose as well.

4. Right route

Again, check the order and appropriateness of the route ordered.
Confirm that the patient can take or receive the medication by the ordered route.

5. Right time

Check the frequency of the ordered medication.
Double-check that you are giving the ordered dose at the correct time.
Confirm when the last dose was given.

6. Right documentation

Document administration AFTER giving the ordered medication.
Chart the time, route, and any other specific information as necessary. For example, the site of an injection or any laboratory value or vital sign that needed to be checked before giving the drug.

7. Right reason

Confirm the rationale for the ordered medication. What is the patient’s history? Why is he/she taking this medication?
Revisit the reasons for long-term medication use.

8. Right response

Make sure that the drug led to the desired effect. If an antihypertensive was given, has his/her blood pressure improved? Does the patient verbalize improvement in depression while on an antidepressant?
Be sure to document your monitoring of the patient and any other nursing interventions that are applicable.

Reference: Nursing2012 Drug Handbook. (2012). Lippincott Williams & Wilkins: Philadelphia, Pennsylvania.

kalanel5 · Mar 22, 2013

Wow at some of the reactions here... Well I will admit this happened to me at the beginning of my nursing career but I must say I was paranoid of this kind of thing happening so I would look my meds up before I went to give the patient's meds. OP you are only human you are not going to know everything the key is to never show your patient that you don't know. You are new as you build your knowledge base on various drugs this wont happen but geez you are new. Don't beat yourself up. I know, the majority of the presently used drugs and new ones but often I have 80 and 90 year old patients who take meds that are not used much today so I have no clue about them. That doesn't make me an incompetent nurse you just learn as you go along.

May Rceo, BSN, RN · Mar 22, 2013

I've been an Lpn for 21 years and been aloud to hang and start an Iv for 12 years now. I work in New Jersey and I'm Iv certified. I can maintain all lineshang Iv antibiotic and other meds. I can start a peripheral line too. I would think being a new Lpn that was taught in school, being our scope of practice is now more broad. And always look up all meds you are unsure of!! If you were my nurse I would of felt you were incompetent. And I'm sure she felt the same way being she asked your name. I still look up meds I'm unsure of. Doesn't make you a stupid nurse, just a cautious one!! Best of luck!![/quote']
I just wanna ask who did u get your certification for IV? I just passed my pn exam and j wanted to inquire about certification. Thank you in advance.
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allnurses Guide · Mar 22, 2013

It's a little more understandable since he was not administering the patient's meds himself, but he has a plan for corrective action he's already begun to implement and he sought out advice here. Can't ask for much more than that! Best wishes, OP!