PO medicine administration

nurseprnRN, BSN, RN · Nov 29, 2012

It'll get better. Practice, practice, practice. By the time you graduate you'll be better at it. That's why you are in school, nu? If you were good at everything already, well, why would you need to be in school?

:)

Stephalump · Nov 30, 2012

The skill I'm not sure I'll ever get the hang of is opening packages! I can barely open band aids at home for my kids without scissors,much less open all kinds of weird things with patients and my instructor stating at me. So I totally understand.

Hopefully next time you'll be less nervous. Every time you succeed you'll grow a little more confident and things will go a lot more smoothly. Congrats on getting through the first time alive!

LobotRN, BSN, RN · Nov 30, 2012

Mugs, GrnTea is right, it gets easier. Here are some observations I have about those lovely little unit dose packs, how I tend to do it, and other such stuff:

1. First, your hands gotta be clean. Seriously. Sanitize or wash just before getting ready to open those packages!

2. Make sure you have some nice little Lister/bandage scissors on you, just in case.

3. After doing all your medication administration checks, organize those pills so they are in little groups. For example, if you're giving two tabs of some pain med and two tabs of some BP med, group those little guys together.

4. Get a little med cup (some places call them "souffle" cups).

5. As you get to know your meds, you'll know which pills are the hard and which ones are soft (AND which ones you shouldn't touch except with gloved hands!). By that I mean, you'll just know if you can push them out without destroying the pills, or....

6. ...which ones you need to look for the tabs to peel back a protective layer to either expose the pill or get to a little lite foil layer. So for now, start looking at the actual unit dose pack. If it has a tab, use it!

7. When you are at the bedside, you can say, "I have your morning medications and some pain medication Mr. Patient. Can you tell me your name and date of birth?" Check the armband. Now....

8. Identify each medication as you open the pack and place the tab/pill/whatever in the med cup, for example, "I have your two tablets of oxycodone for pain relief (push straight out of packages into the cup, plop plop!), and next I have your 1 capsule of omeprazole to prevent stomach ulcers (this is a peeley one! push a capsule through the package and and best you'll have a squashed capsule and at WORST you'll wind up with time release beads EVERYWHERE!), and last I have your docusate, it doesn't make you go but keeps your stool soft until you can (gelcap! push straight out of the package, plop! HAHA that is perhaps a little humorous...).

9. Now sometimes you just gotta slit the side of package open with your scissor, but you took care of that in step 2! Preparation is key...

Now, for any nurse wondering why I do #8...well, we are just in LOVE with HCAHPS here, and it is "important that I communicate with you about your medications and the reasons they were prescribed for you." And seriously, I find it works out well.

Lobot, RN

littlepeopleRNICU · Nov 30, 2012

Lobot gave very good, step-by-step advice lol.

But like the others said, it will get better with practice! Some of those packages are done up so weirdly, and it doesn't help that you're still new at this and you've got an instructor breathing down your neck, and a patient that is probably asking after each medicine, "now what am I taking that white one(which one?) for again?"

It gets better, and soon that will be the very least of your worries!

PinkCupcake · Nov 30, 2012

also it doesn't hurt to take a peak in their mouth to make sure they swallowed all of their pills. I'm amazed at how many times I've gone to clinical and found pills in the bed, on their gown, and on the floor. Even worse it was documented that the pt took those meds when in fact they didn't :no:

KelRN215, BSN, RN · Nov 30, 2012

Some packages are IMPOSSIBLE to open. Depending on the patient, I would sometimes open all the packages into a med cup in the med room (if the patient had previously old me he/she swallows all pills at once) that way I didn't have to fumble with packages in front of the patient. Just be sure you remember which med is which in case the patient questions you. A pill that's blue at home for them could be yellow in the hospital and if it's not in the package, they could very well say "I don't take any yellow pills... where's my blue one?"

hodgieRN · Dec 6, 2012

Pop it you with your thumb as you hover it over the medicine cup. Push it into your index finger until the edge pops open. That way, it will never fly out. If you can't pop it, then you peel it. Some meds that are peeled are on the bottom half of the foil. You can get a nice grip of the peeled tab before the med comes out.