Prioritizing Multiple Patients Medications

MB37 · Sep 10, 2008

It depends who your patients are, what you get told in report, if anyone is in acute distress, and what their meds are. You do the 30 second, "Hi, I'm Missy, the student nurse who'll be working with you today," and make sure they're breathing and not screaming in pain. There isn't a hard rule that, say, respiratory patients get their meds before renal patients - you have to know what's going on with them, eyeball them, and proritize, unfortunately. Your first priority would be anyone in acute distress. Look at the morning vitals and accucheck (or do them yourself) and glance at the patient and ask how they are. If any of the numbers are really off (blood glucose 47, BP 190/110, etc.) or you have, say, an asthmatic having an acute attack, that's your first priority. If not, you'd give pain meds to the 10/10. If you have a diabetic and breakfast has arrived, and no one has an acute problem, they're first - or anyone else who needs their meds before they eat. Otherwise, you generally want to give q8h meds before tid's - when they order something as q#h, it tends to matter more that it's given on time. If both patients have meds that are just "daily," you go in and assess the more acutely ill patient first. I assume someone has to get the meds for you, and that you don't do it all on your own? Whether it's your instructor or the nurse assigned to your patients, double check with him or her before you start your med pass for the first few times. Don't stress out about it, just make sure you look at both patients and both MARs before you start in the morning. You'll be fine.