When to sign MAR

[nursedarrah]

I graduated in 1994. We were told that after many deaths they were changing the way we charted our meds, effective that year. Problem was: Nurse gave Morphine-went to lunch-was hungry didn't initial- buddy who was covering, goes in to checks on patient who still complains of pain because morphine has not kicked in yet- covering nurse gives morphine. Original nurse comes back from lunch and patient is Dead. That's a problem. We were told to initial the medication at the pull down in front of room (or whatever system is). Then if for some reason it is not given then you go back and circle your initials. (Meaning medication was never ingested). Think about it what would be the rational for a circle around initials that wouldn't be there if you charted after they took it. You would simply put an R for refused or something. I have been teaching this to unlicensed personnel in the Community setting for years. And, It works. They have the MAR open, the bubble pack in front of them, they pop out the med, sign their initials, pop the next med, initial the MAR. Then count all the pills in the cup with the patient as a 4th check. Then patient swallows all at once. If phone rings now, or client has to go to bathroom, or kid gets sick, or someone codes, then MAR is signed, and charge nurse doesn't pass your pills while your doing CPR.

[Double-Helix, BSN, RN]

The systems that I've used are more technologically advanced now, but the process is that same- sign the MAR prior to administration while verifying the drug with the order. If the medication is refused, dropped, etc. you amend the documentation.

[Sour Lemon]

It's somewhat strange for a patient to die from two doses of morphine ...even if given in close succession ...especially a patient awake and aware enough to complain after the first dose had been given.

[Double-Helix, BSN, RN]

I suspect that this story is just one of those exaggerated "wives' tales" of nursing used to scare students into remembering the importance of correct practice.

[ArtClassRN, ADN, RN]

The scenario sounds extremely fishy.

[CoffeeRTC, BSN, RN]

Pop the pills out of the bubble while checking against the MAR. Initial MAR, walk in room to give to patient. If they take all of them...good. If not, we circle initial and not on the back of the MAR why it wasn't given.