Mastering Nursing Pharmacology
Mastering pharmacology is one of the most complicated, overlooked, yet ESSENTIAL components of being a well-rounded, safe nurse.
Read this blog post for tips on learning nursing pharmacology fast . . . click here
One of our primary foci at NURSING.com is teaching Pharmacology. While many nursing programs around the country are cutting Nursing Pharmacology from their curriculum or integrating it with other courses . . . we are doubling down on our focus on Pharmacology.
In fact, within NURSING.com we have several courses on pharmacology.
In this post, we are going to cover a method (system) for learning Pharmacology. After reading this post, I am confident that if you follow this system, you will become a master of Nursing Pharmacology. So sit back, grab a note pad and let’s dive in.
**FOR EDUCATORS: feel free to use the resources in this post. If your nursing program would like assistance in implementing our MedMaster Course into your curriculum please reach out to us via email.
One of the most common questions we get from the NURSING Family is:
How should I study Pharmacology? How can I learn all of this!?
You know . . . most of the time, it feels like learning pharmacology is learning a new language.
At NURSING.com, we’ve already developed many pharmacology resources (listed below), the purpose of this article is to empower you with a framework for teaching and learning pharmacology. Educators are encouraged to implement this method into the classroom setting.
NURSING.com Pharmacology Resources:
The S.O.C.K. Method for Mastering Nursing Pharmacology
When I was 19 I took a job in Los Angeles working with immigrants from Latin America. The majority of our clients spoke no English, and my Spanish was limited to the Taco Bell menu.
This was very frustrating because I wanted to help our clients so bad, but all I could do for the first 3-6 months was smile and nod . . . in reality I had no idea what was being said. I became intensely focused on learning Spanish. I wanted to speak as comfortably as I could speak in English.
Doing this required that I did something more than I was doing. . . . I had to engage in META LEARNING. Meta-learning is defined as “being aware of and taking control of one’s own learning“.
Once I became engaged to this level, my learning exploded and people kept asking where I was from because I looked as “Gringo” as they come, but my accent was spot on.
Let’s apply this to learning Nursing Pharmacology. When you are a brand new nurse or a nurse with limited knowledge of medications, how helpful can you be to your patients?
- My concern is that limited medication knowledge is less helpful and more dangerous than anything else.
- Medication administration is one of the paramount tasks of the nurse.
- In an ICU or MedSurg setting, your patient might be taking 50+ medications.
- It’s vitally important that you understand those medications, how they interact, why they are being given, and how they should be given.
- Without that knowledge, you are like 19-year-old Jon, just smiling and nodding while people talk to you.
So, rather than give you a “fix” or a couple of tips for learning every medication or telling you to not worry because it is a hard task, I’m going to give you a 4 (actually 6) step process for learning Pharmacology that I like to call the SOCK Method for Mastering Nursing Pharmacology.
- For aesthetic reasons, I’ve called it the SOCK Method, but in reality it should be called the O.K.C.S. Method as that is the proper order of the steps.
- The order doesn’t matter as much as knowing the framework as it will guide all future learning. In other words, this isn’t as much a checklist of steps for learning as it is a framework for learning Pharmacology as a whole.
So here is what each letter means . . . we’ll dive in deeper below.
S: Side Effects
O: Organs
C: Classes/Considerations/Cards
K: Know (Must Know)
Let’s dive in a bit more and uncover what each letter actually means and how you can apply this method to master nursing pharmacology.
S: Side Effects
I am a bit crazy about learning side effects (ask anyone I’ve precepted!). In my mind, if you don’t know the side effects of a medication you are giving, how do you know if the medication is working or if the patient is experiencing a severe side effect?
One key to learning side effects is to understand very well what the intention of the medication is in the first place . . . some of your side effects are going to be the opposite effect you were trying to achieve (a patient hypothyroidism might experience a “thyroid storm” while receiving thyroid replacement therapy.
As you are learning medications you should:
- Focus on side effects that are life threatening
- Focus on side effects of major organs
- Focus on side effects that are the opposite of intended therapy
It is possible to get stuck trying to remember 4,348 side effects of Tylenol . . . however, that is not a realistic goal! Instead focus on the handful of KEY side effects.
In our book “140 Must Know Meds” and in the MedMaster Course, we sifted through the myriad side effects to provide you with a boiled-down version that you should remember.
On the clinical floor, I will not let new nurses pass medications if they are not aware of the top/most concerning side effects they should be watching out for.
The best way to think about this is to once again go back to the ABCs. Those pesky ABCs will come back to haunt you often in your nursing career . . . you must always think of them first.
O: Organs
When learning pharm, it’s important to have a macro understanding of the body, the organs, and how they interact with each other. This knowledge should come from A&P and MedSurg. Ideally, a nursing student wouldn’t take Pharm until they have taken and understand Anatomy and Physiology well.
As you study medications, you should also focus on the major organs when it comes to side effects and considerations. This all goes back to the ABCs that we learn from day one of nursing school. For example, giving a CNS depressant for pain is fine, but you MUST understand how that will impact the heart and respiratory drive . . . cause we kinda need those to live. Other side effects, while important, take a back seat to the ABCs.
In general, I recommend learning medications, side effects, and considerations following this order of organs:
This keeps you focused on the ABCs. If you forget that steroids cause “soggy bones” (osteoporosis) that is far less detrimental to your patient than forgetting it will raise blood sugars or depress the immune system.
You should also have a deep basic understanding of what each system will do and why meds would be given to that system.
C: Classes/Considerations/Cards
CLASSES:
In Pharmacology we classify HOW a medication works, either how it WORKS or how it HELPS. These are the pharmacologic and therapeutic classes respectively.
- Pharmacologic Class: how the medication WORKS
- Therapeutic Class: how the medication HELPS
For example:
- Cimetidine (Tagamet)
- Pharmacological Class: Histamine H2 Antagonist
- Therapeutic Class: Antiulcer
I recommend learning Pharmacological Classes when learning pharm for a few reasons.
- This goes hand in hand with learning A&P and focusing on the organs. If you understand the A&P and then focus on the Pharmacological Class, everything starts coming together.
- As you understand how the body works and how the medications work within the body to alter physiology things start to click much faster.
- Most importantly, generic medication names are based on Pharmacological Classes. If you know that H2 antagonists end in -idine, as soon as you see an -idine medication on a test, MAR, or elsewhere, you know exactly what it does . . . on the other hand not all antiulcer (therapeutic class) meds end in -idine.
CONSIDERATIONS:
When learning a new medication, it is important to look at and remember the nursing considerations . . . these include:
- Administration concerns
- Patient education
- Vital information
Some things that might be included in here are: how slow to administer Zofran, how fast to administer Adenosine, pregnancy categories, telling a patient not to eat grapefruit . . . you get it.
Again, you are looking for considerations that could be detrimental to the patient, will allow them to self administer, or interfere with intended results.
As the nurse, you are the one RIGHT there with the patient administering or teaching the patient how to administer the medication.
A prescription or order does not mean you MUST give the medication. Be a clinician!!!!!!!
By this I mean you MUST use nursing judgement. You are the eyes and ears of the medical team . . . you are the one at the bedside! The physician and pharmacist are NOT AT THE BEDSIDE.
You must know your considerations and know the current state of the patients condition and make a sound clinical decision. BE A CLINICIAN!!!! #beaclinician
Don’t be a blind monkey just carrying out orders. Knowing the considerations and assessing are paramount to this.
CARDS:
Repetition is king when it comes to learning new information. Learning nursing pharmacology is no exception. If you were to ask me, “what is the one thing I can do to learn nursing pharmacology?” . . . my two word answer would be “DRUG CARDS” . . . make them, throw them away, and make them again . . . REPEAT.
Working through the SOCK Method, you’ve identified:
- The drugs you need to know
- The things you need to know about those drugs
Now it’s time to start reviewing those medications over and over and over (you get the point).
Many students ask me to create drug cards for them, I’m not gonna do that!! Creating your own drug cards is the best way to learn this stuff.
Here’s the problem though, most “drug card templates” are a goddamn mess. Seriously, they are so unorganized that it’s no wonder students struggle with retaining the information.
So here is what I HAVE done for you . . .
I’ve created a drug card template that is developed with the S.O.C.K Method in mind:
Download the Drug Card Template
Here’s what you need to do . . .
- Armed with your list of Must Know Drugs, start working through this template for EACH and EVERY drug on your list.
- Print out as many copies as you need.
- Create a binder with as many templates as you have drugs on your list.
- Organize them by generic name.
- Once you’ve created a drug card for each drug, start redoing cards for the ones you are using most often.
I know what you’re thinking.
“Jon, you’re insane! I already don’t have enough time to study let alone create 6,435,689 drug cards!”
Spending time studying what REALLY matters saves you time in the end. Your knowledge of the important information grows and you become a more focused nurse.
K: Know (Must Know)
Early on in my career as a nursing student I began to notice some patterns. Some meds are given and tested on far more than others. Why is that? Is it that we just don’t give a damn about patients who take abaloparatide injections?
Of course not!
When it comes down to it, some medications are far more common, taken by more patients, in more situations, and therefore more “important” to know and be aware of. The FDA had approved 1,453 drugs as of 2014, if it were possible to know each of those drugs intimately, you would be the most amazing pharmacist in the world.
This just isn’t possible.
So here is what we have done here at NURSING.com:
- Outlined the most commonly tested medications.
- Cross-referenced that with the most commonly prescribed medications.
Once you get a job in a specialty area, you should add this to the list:
- Add the most common/unique medications prescribed on your unit.
You should begin making the same lists. When you are on the clinical floor, keep a note of all the medications you are giving. As you begin to notice, week after week, that you keep giving Heparin, Insulin, Protonix and others . . . make note of those. These are the medications (and pharmacological classes) that you need to know well.
This method is known as the 80/20 principal. You will give 20% of the medications 80% of the time. And of those 20% that you give, you will administer just 20% of those 80% of the time . . . you see how it works. It’s about focusing your priorities on those things that are most important.
While you COULD try to learn every medication . . . it’s just not possible. Focus your attention on learning those that you must know as deeply as possible.
To make this a bit easier, we’ve already done the leg work on a piecing together the most common and must know medications. However, as stated above, this will vary by unit, by hospital, and by physician so you should also compile your own list.
Download the complete list of the 50 most commonly prescribed medications for free here:
We’ve also compiled a list of the 140 must know meds into a book format that also spells out some of the critical, must know information. You can view that book here:
The Correct Order:
Okay, now that we are clear on what each letter in our SOCK acronym means, I want to cover the correct order for actually working through this method so that you can become a master of nursing pharm.
- O: Organs
- K: Know (Must Know)
- C: Classes/Considerations/Cards
- S: Side Effects
To get the most from this system you should actually start with ORGANS and a solid top level understanding of A&P and ABCs. This will help to keep you focused as you move through the system.
You should then use that base knowledge to help you uncover the MUST KNOW meds using the method outlined above.
From there, you should move onto CLASSES . . . it is so important that you become comfortable with Pharmacological Classes, how they are named, and how they work in the body. If you take the time at this stage to do this . . . you will be light years ahead of your peers.
CONSIDERATIONS comes next. Become a master of nursing considerations for the drugs you give most often.
You are ready to make DRUG CARDS. Use the template offered above and take a focused study session to create a nice pharm binder that includes a drug card for each of you must know medications.
Phew . . . you’re finally ready to dive deep into the SIDE EFFECTS this is the last step in the SOCK Method for learning Nursing Pharmacology and must not be ignored. When you are learning side effects it is important to focus on the method outlined above. If you do this you will be a safe nurse who has a deep knowledge of pharm.
Conclusion
More and more we are seeing nursing programs integrating Pharmacology into much larger courses or cut pharmacology all together. This is a very sad and concerning trend. In order to function as a true member of the health care team, nurses must be equipped to make clinical decision. Much of our time as nurses is spent providing medications. We must understand what it is that we are actually doing.
We have developed the SOCK Method for learning pharmacology to help provide a framework that nurses and nursing students can use in learning pharm . . . ok now dive in!
Giving Meds Safely in Urgent Situations
When a situation becomes urgent you won’t have a lot of time to try to think through and process things. We will help you know how to get through those urgent situations and give medications safely even when rushed.
Tips to Avoid Med Errors
Medication math requires great attention to detail, and math can be challenging. Pharmacology is already very difficult to master with interesting medication names and lists of side effects and contraindications. But, we are here to help with some tips that will help you avoid any med math errors.
How to Handle Med Errors
It is always important to respond appropriately in the face of a mistake. If you handle it appropriately you can minimize problems and learn from your mistake. Learn from an experienced nurse how to handle a med error.
5 Nursing Students Share How to Succeed in Nursing School (Kick this Semester's Ass)
6 Tips to Succeed in Nursing School
- Just Breath
- Learn How to Manage Your Time
- Show Interest in Clinicals
- You MUST Work Hard
- Develop Test Taking Skills
- Discover Your Learning Style
I want to personally thank Jessica, Taylor, Rikki, Luis, and Jenna for being willing to share their advice. We’re all in this together!
In 1998 that sounds so weird to talk about it like that. I promise I’m not one of those people who’s like, I walked up Hill both ways to school when I talked to my kids or anything.
In 1998 when I was a red between my sophomore and junior year of high school. So during that summer I went on a 50 mile backpacking canoe trip. Now prior to this, I had never even backpacked five miles.
So I didn’t have the gear. I wasn’t prepared. But we plan this trip, right? It was, it was me and like five other guys and my dad and a couple of other guys. And we planned this 50 mile backpack trip in the mountains in Arkansas. So I took off with a terrible backpack that I think I got at a thrift store, a cotton sleeping bag that probably weighed 35 pounds. And we took off hiking up these mountains on the very first night of our trip. You know, I was smart enough to not to bring a tent, of course. Uh, but on the very first night of the trip, I laid my sleeping bag down on the grass and went to sleep at about two in the morning. It started pouring. It was a summer rainstorm and it just poured and poured and poured.
When I woke up in the morning, I was about 10 or 15 feet down the Hill from where I went to sleep at night and my sleeping bag was drenched, of course, and I didn’t really sleep that night, but my sleeping bag was drenched. And of course, like I said, it was a cotton sleeping bag. Let’s start it out at 35 pounds. Now I weigh 230 pounds because it was soaked with water. And so for the rest of this backpack trip, for the next four days, the next four nights, I was walking around with this soaked sleeping bag. No tent. What clothes? What everything. Now the reason I tell you this story is because at interest’s in G, I’m very fortunate to hear from thousands and thousands of nursing students around the world, and so we hear a lot of struggles. We hear a lot of of what people struggle with in nursing school and my concern is we start semesters, we start nursing school not knowing what tools we need, not knowing what we need to actually succeed.
So today I’m going to share with you six different tools, six different strategies that you can use to kick the semester’s ass so you don’t end up like high school John stuck in the mountains drenched. Okay? I’m going to give you six tips, six strategies to help you succeed during this next semester, crush nursing school and come out on top. Now the first tip I’m going to share with you is to just breathe. Trust yourself. You’ve done the hardest part of nursing school with is just getting in. So many people apply. So many people don’t get in. You got into nursing school, so take a breath, smell the roses, and trust yourself. Now I want to share with you two clips from members of the NRSNG Academy who share some advice on this. The first one’s from Jessica and she talks about the importance of just breathing, trusting yourself.
I recently just graduated from the university of Texas medical branch in Galveston with my BSN. Um, and I will be working in a mixed ICU in a hospital and seeing Antonio. So I’m really excited about that. Uh, my advice for new nursing students would be just breathe. Honestly, I know that, you know, it just sounds kind of cliche, but it’s so true. I know that when awry Cerner’s in school, I was just so overwhelmed and I was scared and nervous and a lot of the times you just have to take a step back and just realize that it’s already a huge accomplishment to be accepted to nursing school. So I’m just kind of, you know, just take it one day at a time when we’ve got a time, one class at a time, one semester at a time and just focus on what you’re doing at that time.
This next piece of advice comes from Ricky, who’s also a member of NRSNG Academy and she talks about the importance of taking care of yourself, doing new things, making friends, and realizing that your preparing to become a nurse, but you’re also still a person. You have to take time to breathe, to step back, to get out of the books and to just enjoy this portion of your life.
Take care of your mental health. That is a really, really big thing and you’re going to learn that along the way. As important as it is to be a really great student, it’s also important to take care of yourself. You can’t just be in the books all the time. It just isn’t good. And trust me, I’ve, I’ve experienced it. Um, do some extracurricular stuff. Meet new people. Those people are gonna make your experiences with students so much better. Trust me, I’ve met some really cool people in nursing school and I couldn’t imagine my life without them. I think my biggest point here is going to say, get rid of that. I’m just a student mentality. You are a future RN and a professional in training, um, you are going to be that one day that nurse that’s at the bedside and you are going to be the one in charge. You really, really need to get rid of that. I’m just a student mentality. You can still impact your patient’s lives as a student because they’re going to see you as the nurse.
Now, trust me, I know how hard it can be to just step back. I’m very, uh, unifocal type of person. I get very hyper focused on one thing at a time and I did the same thing in nursing school and I’ve shared that story several times about how I became over-focused on nursing and nursing school during school and actually withdrew and then went back and finished. But I don’t want that to happen to you. I want you to take a step back, trust yourself, and just enjoy the process. You can’t study all the time. You need to take some time out, breathe and trust yourself. Tip number two is time management. Time management matters so much in nursing school, you’re going to be given 4 million pages to read 60 assignments and 32 patients to take care of, so you’ve got to learn how to plan and study and budget your time.
I was never really good at time management and and planning ahead so much until I started nursing school, but you have to learn how to do this. There’s a couple of tips I can I can share with you. The first would be to get a planner that works for you. You don’t have to get the same thing that everybody else uses, but you need something that works for you. What works best for me is Google calendar. It’s free. It’s on my phone, syncs with a computer and I can schedule everything in their color code. It had to do list. I really like Google calendar. That’s the best one for me, but we’re going to share another tip. This one’s also from Jessica and she talks about what she uses or what she used in nursing school, a planner and a whiteboard system.
I bought like a jumbo whiteboard that is in my, I’m still in my room and just like wrote out, um, my week, my month, everything. Like it’s really good to just write things down in either like a planner or a whiteboard somewhere that you can see it.
The biggest tip I would give you guys is to find something that works for you. It’s not going to be the same for everybody, even on the floor. And that’s why when we created our, um, nursing report sheet database, we provided 32 of them because what works for one person, what works for one nurse isn’t gonna work for everybody. So find what works for you and then dive into it and make it work even better and better for you. Tip number three is to fall in love with nursing. We all went into nursing for different reasons and then we get to school and reality hits. But it’s important that you fall in love with nursing. What was that reason that you wanted to be a nurse? There were a couple of driving factors for me, and I’ll be honest, one of them was the work schedule that I got to be home with my family more.
Another one was the income that you make with that work schedule, but another reason was that I really love anatomy and physiology. My favorite topic in my bachelor’s, my first bachelor’s was anatomy and physiology. Loved it so much. I love learning about the body. I love what what it is. I love how it works together and I love how disease processes work and how we can treat them and cure them and heal them. So you need to find what it is about nursing, whether it’s pharmacology, whether it’s clinical, whether it’s talking to patients, whether it’s anatomy and physiology, find what it is that you love about it and dive into that and really fall in love with those things. I want to play a clip from Taylor, who’s also a member of the NRSNG Academy and she talks about the importance of falling love with nursing.
The more effort and passion and studying you dedicate to the material, the more you will fall in love with it and the more you will feel confident in your skills that you’re developing and it’s so rewarding. So dedicate that extra time, that extra few minutes, a day to studying and really knowing that material like your patient’s life is on the line cause one day it really will be.
Now one way you can do this you guys is to step up and and open your mouth during nursing clinicals and talk to your talk to your clinical advisors, talk to your preceptors and show interest. This is going to help you in a lot of ways. It’s going to help your instructor see that you’re interested, you’re engaged and I promise you that’s going to pay back dividends when it comes to grading time when it comes to clinical assignments, but also it gets you experienced to see the things that you want to see, to get first choice in clinical and find and learn about things you haven’t learned about yet. Now, Ricky shares with us the importance of doing this. And I like what she says here, where you show interest and you get a chance to do things that you haven’t done yet. So here’s what Ricky says.
So I would say express your interest when you’re in the clinical setting. Let your instructors know what skills you haven’t done, but would like to learn how to do, um, different medications you want to learn about, et cetera. So they can assign you patients, um, to facilitate your learning and make you a better nurse in the future.
No, I agree with that so much. Now being a nurse and being a preceptor, now that I’ve graduated nursing school and work with so many nurses on the floor, those nursing students that come in and show interest in acting engaged and ask questions and ask to see new things are those nurses, nursing students that I love working with the most, I can tell they’re gonna make a great asset on the floor someday. And I can tell they’re interested in, they’re interested in what I’m doing. So I want to share with them more. And I want to find more experiences for them. So when you’re on the clinical floor, show interest, ask questions, ask for difficult assignments. This is the best time to learn. When you have a preceptor, Andrew or a student, find those difficult patients, find those difficult cases and tried to get experience doing those things.
My advice for new nursing students is that you have to work for those grades. They will not be handed to you. Oh my goodness. I’ve seen too many friends and too many nursing peers start off nursing school thinking will be a piece of cake and not really dedicating themselves to the material and watching, you know, just nursing school slip through their fingers so easily. And it is a huge first lesson. I experienced it the first time. I didn’t even get into nursing school. Um, how much more effort and studying you really have to put into it.
Tip number five is take advantage of all the resources that are out there. There’s skills involved with nursing. Obviously, you know, learning how to start a viz and all those types of things are skills, but they’re skills involved with being successful at nursing school. One of those skills is test-taking. Once you learn how to take tests in nursing school, you can then begin to focus more on the content because you have the skill set needed to do well on tests. We’ve actually created a free webinar that goes over 11 steps to taking nursing school exams. If you go to nrsng.com/ test-taking in our sng.com/test taking that webinar’s about an hour long, it’s free. You can take it anytime and it’s going to teach you. It’s going to show you how to do well on nursing school exams. I promise you they’re different than anything else you’ve taken. Taking this one hour to take this test is going to help you so much in so many ways throughout your nursing education. Another thing you can do is find what you’re struggling with, whether it’s test taking, which I truly recommend that everybody take the test taking webinar. That’s an interest in ge.com/test taking. Whether it’s EKG, medications, med surge, whatever it is. We have podcasts on it, we have nursing materials on it. This is a clip from Luis who’s also part of the NRSNG Academy. And he talks about the, the how the inner SNG podcast helped him. So finding that material of what you’re struggling with and then diving into that material is really important. Here’s what Luis said,
I ended up taking from a college last semester and it was very overwhelming, especially for the first exam. Um, and then I ended up finding med master, the podcast and the template for pharmacology. And that ended up helping a lot because they narrowed it down to what I really needed to know about the medication. And I ended up doing much better at, uh, after I started using it, a lot of my friends had used it and I also recommended them the podcast and they loved it. They also did well and I don’t think we would have passed if it wasn’t for those resources that NRSNG has. So I just want to say thank you.
The last if I want to share with you is to figure out what your learning style is. Everybody learns different. Some people are kinesthetic, some people are audio, some people are visual. I’m a very visual learner. I’m also a very kinesthetic learner, so nursing clinicals worked really well for me. I could read about starting an Ivy all day long, but I was never going to remember it until I did it and that’s how I am now. I don’t do well just reading and reading and reading. I dive in and I start doing and that’s how I learned. There’s a way you can learn your learning style. There’s a website called bark. It’s a Varco assessment, V. a. R. K. if you just Google [inaudible] assessment, I think it takes me, no, maybe five, 10 minutes is this assessment that then tells you what’s your best learning style is and then once you know your learning style, you can then begin to find ways to learn that way. What we’ve done within our S and G is we’ve tried to create ways for you to learn in every way. We’ve got audio, visual text, and then we try to show you some of the skills. Now Jenna, who’s a member of NRSNG Academy, she also talks about how this has helped her, how having different modalities and different ways of learning has helped her in her education.
I joined NRSNG Academy last year around the holidays knowing that my second year would be much harder and I tell you I’ve cannot have gotten this far without them. They may think so clear. I love having videos and then things I can print out and I can write more notes on with a teacher. I am my third med surge class and we just get done with ABGs. Everyone else in the classroom looked mortified after the test was over and all I could think of the back of my head was, whew, I got it. And I just got my grade and I did and I couldn’t be happier. And if it wasn’t for NRSNG Academy, I wouldn’t have got there. So thank you NRSNG for making things a little brighter in a nursing student world.
So I strongly encourage you to take of arc assessment, find out what your learning style is, and then find ways to learn that way. So now you’ve heard from five different current and previous nursing students, Jessica Taylor, Ricky Luis, Jenna. These are people who have become very successful nursing students, not just because they spend all this time in the books that are good test takers, but because they’ve adopted a method that’s helped them become successful in so many ways. If you take these strategies and these tips that they’ve shared with you and that I’ve shared with you, you’re going to do very well on nurse’s clearing to do well this semester. Not only that, you’re going to be much more mentally sane, which is very important as well. So I want you to take these tips. I want you to take these strategies and listen to these successful nursing students.
These are five different students from different parts of the country who are all doing very well in nursing school. And what I want you to take from this and and from my experience as well, is that we’ve been where you are. We know how stressful we know how to Mandy, we know how hard nursing school is that you can do it. If we can do it, you can do it. So please trust yourself. These Bree, learn your learning style. Develop a time management strategy. Take care of yourself. Show interest in nursing school, fall in love with nursing. Take the test taking webinar. These things are going to help you. So great you guys. We love you. We’re so excited to have you as part of the innerS and G family. If you would, do me a favor and share this with the nursing student who’s starting their first semester, who’s preparing to go to nursing school, I’d greatly appreciate that. If you’re listening in iTunes, it’s very easy. Or on your podcast app, you just click the share button, share it on WhatsApp shirt, on, tech shirt, on Facebook, whatever it is, please share with somebody who might benefit from hearing some of these success strategies for nursing school. We love you guys. Thank you for being here. Now go out and be your best self today. Happy nursing.
Giving Meds Safely in Urgent Situations
What’s up guys. My name is Jon Haws, RN CCRN within our sng.com where our goal is to give you the tools and the confidence that you need to succeed in nursing school on the in clicks and in your life as a nurse to help you succeed on this journey. We’ve created weekly cheat sheets that we send to you every single Friday to sign up at over to nrsng.com/freebies. That’s interesting. [inaudible] dot com slash freebies and every single Friday we’ll send you a cheat sheet on pediatrics, OB, med surge, mental health, ICU, critical care, every single aspect of nursing care to help you succeed. That’s nrsng.com/freebies all right, now let’s roll into the show.
Hey guys, what’s up? It’s season with NRSNG and I’m going to be talking about giving medications safely in urgent situations. Uh, which is a topic that I really enjoy because, um, I mean it’s part of the reason I became an ER nurse. I enjoy urgent situations. Um, but I to kind of talk about how the process goes for, um, eventually learning how to give meds in urgent situations. And then how to prepare yourself for those situations and prepare yourself for those medications. So, um, it all kind of starts off with the books and I know that’s not something you want to hear, but it does start by reading in a book, um, and kind of getting bits and pieces, learning the names and I know it’s going to be super difficult. I found reading from a book horrendously difficult, um, in the regards of remembering it, especially in an urgent situation.
So yes, I have read about epinephrin but this patient who is coding and everything is really intense right now. Do I remember like all the details and the numbers that are floating around because I also have the numbers in my head for a dentist scene and Amniodarone and I have all of these numbers in my head right now and do what, what all makes sense. So, um, there’s the book reading and then there’s the experience that you get with it and how you start to really form your ideas and your, it’s, it’s almost like the file that you open up in your brain when it comes to that medication or even that situation and the certain medications that go along with it. Um, so if you can memorize drugs, that’s great. And even the, what you can memorize if you aren’t able to memorize all of it like I was, it’s a great start and it’s, most of the time it’s sufficient for administering, like most of the drugs that you’re going to be administering.
But, um, in urgent situations it is the first thing I want to explain to you is that you, um, should always get a double check. Never do that situation alone. Never just go head on, especially if you’ve never done it. Um, just start administering a drug that you have no idea how to administer that you’ve never personally seen administered that you haven’t administered yourself, but you’ve read about it in a book or maybe you’ve seen a YouTube video about it. Um, so ask for help. But if there really truly is an urgent situation, you’re going to have more than one person around you. So, um, a group of people really come to help you out and support you. And there are multiple RO roles that need to happen in order for a patient to be safe in urgent situations. Um, because it’s, it’s not quick enough for the nurse to go to the Pyxis or, or whatever.
Um, medication administration machine you guys have. So go to your, um, area, get the medication, bring it over, draw it up, have all the pieces for drawing it up, including the blunt, a needle and the syringe and the flush and the alcohol wipe. Um, and then also to administer it and then to also write down everything that’s happening and note the vitals and know it’s just impossible. So you have to have a team of people to do it because all of the things that I just described to you has to happen. But it has to happen now. And so you have a bunch of people and they all have their own roles. And it, it’s almost so depending on the situation in the ER, there are actually assigned roles for that. Like if you’re running a code or if you’re doing whatever. Um, but it’s really funny how I’ve noticed that when you are in an urgent situation, people gravitate towards certain rules.
Nurses will notice, Hey, we need to have a, a nurse who’s getting, um, syringes and drawing up the medications. I’m going to take that role. Or Hey, we really need someone who’s going to to chart, I’ll be that nurse. So you’re going to have all these different nurses that come in and they kind of sell it, settle into their roles or they already have preassigned rules. If the situation is something that, you know, in the ER we have certain things set up for it. So, um, if you’ve never given a medication, if you’ve never been in that situation, it’s unlikely that you are going to be participating in that right away. There’s probably going to be other nurses that come in and kind of run that for you, um, or help you along the way. If for whatever reason, giving this, you are put into that situation where you’ve never given that medication and you don’t know about it and you are one of the few nurses that are there and you have to do it.
I highly recommend that you verbalize any concerns you have to the doctor, to the other nurses that are in the room. Um, you question, Hey, how fast should I be giving this med? Um, can I just double check my dosage and that you will hear people shout out, um, Hey, by the way, um, I’ve got this medication going in at this time and it’s another double check. So you have all these ears listening and they’re hearing you say that out loud and they’re like, yep, that is the correct dosage and that this is the time it’s going in and everybody will be a part of that. Um, so you’re going to probably observe for the first time, maybe even the first couple of times depending. Um, but then you will start to participate in the administration process. And again, like I said, you’re not going to be alone, so you’ll have multiple people to, so man, and eventually you just kind of, uh, become more comfortable with it and you start to learn these medications and the process and see these patients like, um, you’re like, Holy smokes, this patient is crashing.
I know I’m going to need the crash cart and I’m going to need to call the charge nurse and the doctor into the room and we’re going to have to set up a team. Um, and people come very quickly. So, um, you’ll start to recognize and be able to see the urgent situations. Um, and then having all of those people also there just really helps you catch any sort of med air, gives you that checks and balances system. So how do you prepare to be in that situation in the first, I mean, I know that we go through the stages where we kind of observe and then we participate and then we become comfortable with it. But, um, I actually have a cheat book and it’s just, it’s a little notebook that it’s, so there are little note cards. Um, that I can pull in and out of a ringed binder.
Um, and you can, I highly recommend you make this for yourself, um, for your drugs, for your hospitals, protocols, anything that you need to know that’s specific to you. Um, and also can be a generalized information as well. Um, that really is a quick reference for you that you can carry around, put it at your desk, wherever you’re charting or um, put it in your pocket if you need to have it on the run. So you just kind of start off with a few drugs and I have a list of drugs. I’m going to name them off to you, um, that I think over you should start, start your book with, um, but then add drugs to it as you go. Um, if you find yourself in a situation and it was a drug that I didn’t put on this list and you need to know about it, write that drug down, create a new page in your book and just keep going with it and organize it in a way that makes sense to you.
Um, maybe you learn something new and you don’t have space on that card to write, start over, rewrite your card out. Always going over your medications is a good thing. So, um, the list that I have, I’m just going to go through the baseless that I think that everybody should have in their book. Um, and there I may be missing some, but I’m pretty sure this is kind of the base. So epinephrin, Amniodarone, Cardizem heparin, nitroglycerin, a dentist seen Livo fed propafol, dobutamine, dopamine fentanyl, verse seven, rock eronium. And um, I never can pronounce this one right, succinylcholine or succinylcholine, but we call it Sachsen. It’s, you know, it’s a paralytic. And then lastly, um, TPA. So w what you would give it’s is clot-buster you would give for someone having a stroke. Um, and I, I’m gonna kind of, those are the, that’s the kind of the list that I really believe that you guys should start with.
Um, read through pages or information about it. Maybe watch a couple of YouTube videos about it and write down the things that you think are important and you may, uh, end up getting experienced with that drug and be like, why would I write it a downer that’s not pertinent to what I need to know. And you cross that out and start your card over again. Um, but giving yourself a little bit of a base reference is something that I highly recommend. And if you don’t give these drugs, let’s say you work, um, you know, on a med surge floor and you’re not allowed to give the, some of the drugs that I gave, I know a lot of nurses are like, Oh, we can’t push leave off that on this floor. Or, um, if there’s a code that’s happening, they have to call a code team and the team comes and runs the code and they don’t actually do that.
Um, so what do I have to say about the drugs that I just gave you a list for? I say start with those drugs anyway. And the reason why is because you may be caring for that patient. Um, post them having any of these drugs while they’re having any of these drugs. And it is very important for you to know what it is that, um, can happen Nishan to your patient. What do you need to monitor for what is, you know, is there a cardiac rhythm that you need to be looking at? Um, vital sign that could, you know, potentially be an alarming thing while they’ve had this medication. Um, when do you need to notify the doctor? Things like that. Um, and of course, you know, for your own sake, like you can write, um, when you’re adding your own drugs, if they are drugs that you’re giving or even if they’re not, um, you want to write indications contra-indications if that’s pertinent to you.
Um, how to administer it. You know, do I give this med fast? Do I give it slow? Is it mixed with something? What can I mix it with? Things like that. Any interactions you need to be worried about allergies to medications, um, labs that you need to watch. Uh, and then of course, side effects. So those kinds of things are really important. And I’m just going to read off. Um, a few things that I wrote down for some of the drugs that we went, that I listed off there. Um, for the first couple I wrote, um, some of the stuff, I pulled it right out of my very own book. So, um, epinephrin you want to remember, there’s two ways to give it. Um, Ivy is for cardiac arrest. You do not give up an Afrin or epi pen or like people think about epi.
They think EpiPen. Um, for an allergic reaction, you do not give that Ivy, you give it Ivy for cardiac arrest. And when you are giving a patient epinephrin Ivy, it will be one in 10,000. That’s the concentration. Now you should in your, um, I call it a Pyxis. Uh, I’ve worked at places, it’s called the Omnicell, but there’s like different ways that you can go get your meds. So wherever it is that you’re getting your meds, both concentrations, both one in 1001 in 10,000, is that those are both going to be in your Pyxis and you need to know the difference and you need to know why you would give one versus the other. So if you’re giving it a for an allergic reaction, you’re going to be giving it intramuscularly, um, like an EpiPen and that is one in 1000. Now, how do I remember that?
I wrote a little note on my note card because I had someone mention it to me. If somebody is having a cardiac arrest, you are going to have lots of people running. So 10,000 people running into that cardiac arrest. Um, but if somebody is having an allergic reaction, and I know that if you’re having Anna Filactic reaction, more people are going to be coming to it. But, um, a cardiac arrest is a cardiac arrest, is a cardiac arrest and allergic reaction can vary. So if someone comes in and they were like, yeah, um, I had some tape on my hand and I’m having a little bit of a rash, now I’m having an allergic reaction to that tape. Um, nobody is really gonna come running. You’re going to have fewer people caring for that patient than you would have for a cardiac arrest. Um, so that’s the one in 1000 concentration and that goes intramuscularly.
Um, and I also consider, I also remember that cardiac arrest has to do with your veins and your heart. So in order to get inside of the veins and inside of your heart, you have to go intravenously. So that helps. So these are the kinds of things that I write in my book. Little tips and tricks for like, what do I need to know about up enough run in a pinch? What do I need to know immediately? Um, for Amniodarone. Um, I mean there’s a lot of things that you can write, but one of the things that I had a patient who got Amniodarone and they were allergic to iodine. It’s contraindicated in patients that are getting iodine. And I learned that. So now that’s one thing that I know very well, but I also wrote it down under my Amniodarone card. Um, you know, it do not give it to patients that have an allergy to iodine or it’s contraindicated.
Um, for Cardizem I wrote it’s a calcium channel blocker. Um, and these, so Stanton’s calcium channel blockers, ACE inhibitors, all of those medications I found super confusing because they kind of sorta did the same thing but in different ways. And um, so I in medications like that, I tend to write out what did, how, how has the mechanism working, um, or the pharmaco or pharmacokinetics or pharmacokinetics or however it’s pronounced. Um, so I did write calcium channel blocker and then in parentheses inhibits cardiacs muscle and smooth vascular muscle contraction. Um, but this means that it’s going to slow your heart rate and lower your blood pressure. So Cardizem lowering BP, uh, lowering your heart rate or slowing your heart rate. Um, for Halperin, I wrote to make sure you get your coagulation studies drawn before you start that because you need to have a baseline.
Um, the heparin is going to be constantly monitoring your PT, your PT Ts, your INR, ours. Um, so you need to know what the baseline is and then in six hours you’ll get it drawn again and adjust that heparin drip appropriately. And if it’s not a heparin drip, um, I wrote, you know, to make sure to alternate spots. Um, that was, I don’t use that in the ER, but um, it was something that somebody said to me and I wrote it down once and I don’t have a lot on my Hepburn card. So, um, to alternate, you know, left abdomen to right abdomen to left arm to right arm kind of a thing. Um, nitroglycerin drip, I wrote that I need to know the max dose that I should give a patient is 200 micrograms per minute. Um, and I mean it’s rare that you’re going to max out on a nitroglycerin drip, but it’s good to know that that’s the point where you’re like, Whoa, I’ve titrated too much.
I need to not go this high or we need to look into something different. I need to talk to the doctor because every time you a drug, um, which I took glycerin is Ty tradable. You’re not gonna alarm the physician by the way. I titrated this drug up or down. Um, it’s a set reason why you would titrate it up or titrate it down. So that just kind of gives you a parameter. Like even if you’re getting close, like if I’m getting super close to the 200, I might mention it before I hit that 200 micrograms permanent. And then the last one I I’m going to talk about, I have written down a dentist scene and this is one of my favorite ones because, um, there’s, there’s a couple parts to it, but it hits on one thing that I found interesting. Um, I know that a lot of people focus on counter indications and dosages and things that you need to monitor for.
But this one, um, I really, I hit on the bags that you need to know the indication for this medication. Um, it is something that you’re going to be giving in an urgent situation and the person’s going to be coming in, in, um, super ventricular tachycardia or SVT. And so their heart rate is going to be super fast. Um, and it’s going to be one of those situations where you’re going to give that med, you’re going to push it super fast because it has a half life of 10 seconds of, or less than 10 seconds. So it’s like a bang, bang, bang. You give it, you draw it, you gave it six milligrams, 12 milligrams, 12 log milligrams, six milligrams of it doesn’t work. You move to 12, and then if that doesn’t work, you move to 12 again. And there is research out there that um, can state, you know, if you are giving six milligrams and it doesn’t work, 12 milligrams isn’t going work.
Um, I’ve actually seen it convert after giving 12 milligrams. Um, so it just depends on the doctor and what they’re going to call out. But the reason why I pointed out the indication is because, um, if you have a patient that is in let’s say a fib, which is another heart arrhythmia identity scene isn’t going to help it. That is not something that you give adenosine for. So it’s, it’s only for SVT. And so I wrote that down only for SVT. Um, and now like when a patient comes in with SVT, is that what I’m thinking? Do I need to stop and look at my book? No, but the fact that I wrote it down, the fact that I have that written on there, it really helped me to remember. Um, and then, um, in regards to the, uh, 10 seconds of half-life, I mean the reason why that’s super important is because you are pushing that medication and you are pushing it super fast with a flush behind it.
That is extremely fast because if it doesn’t reach your heart, it’s not going to do anything for your heart. It’ll convert before it reaches your heart. And then that’s the end of it. So these are just some ideas on how to write out different things for your drugs. And then of course the list that I provided are as kind of where I would start and then add things as you go. Um, not even just new drugs, but new information. If you find yourself in a situation with heparin, let’s say a patient gets um, their, their INR comes back too high and you’re like, Whoa, the doctor was concerned about this and they said that, you know, according to our heparin nomogram, we aren’t supposed to um, be giving the heparin anymore. We titrate it down or however it is. Maybe you want to write that note, whatever that hospital protocol is, um, INR greater than two or whatever it happens to be. So, um, again, I hope this really helps you guys give your medications safely in urgent situations knowing that you are going to be, um, surrounded by a team of people. You aren’t going to be thrown into that situation by yourself and you will have gone through a process of watching it than doing it with the team. And then you eventually become comfortable with it. Um, and then
also with the list that I gave you a place to start and if you have any more to add it on. So good luck you guys.
All right? All right. All right. I hope that was helpful today. Guys. I hope that gave you some motivation, some inspiration to go out and to be your best self, to go out and to become the nurse that you want to be, to make a difference and to do the best work that you can. Listen, we’re here to help you along your way@interestinge.com our goal is to give you tools in competence to help you in nursing school on the in clicks and in life. One of those tools we created is our Friday freebies, these weekly PDF cheat sheets that you can refer to on the clinical floor in the classroom and just throughout your entire career as a nurse. To get these cheat sheets head over to nrsng.com/freebies that’s nrsng.com/freebies you guys, if you need anything, we’re here for you. You can reach out to us on social media or via email@contactatnrsng.com we want you to succeed. We want to help you along the way. We’re here to hold your hand. We’re here to give you the tools, the confidence that you need to achieve success in this journey to nurse or as you guys know what time it is now, it’s time to go out and be your best self today. Happy nursing.
Tips to Avoid Med Errors
What’s up guys. My name is Jon Haws, RN CCRN within our sng.com where our goal is to give you the tools and the confidence that you need to succeed in nursing school on the in clicks and in your life as a nurse to help you succeed on this journey. We’ve created weekly cheat sheets that we send to you every single Friday to sign up at over to nrsng.com/freebies that’s interesting. [inaudible] dot com slash freebies and every single Friday we’ll send you a cheat sheet on pediatrics, OB, med surge, mental health, ICU, critical care, every single aspect of nursing care to help you succeed. That’s nrsng.com/freebies all right, now let’s roll into the show. What’s up guys? This is [inaudible]. This is
Katie Kleber here with the episode of the NRSNG podcast and today I want to talk about a really important topic. This isn’t a, this is a topic that will affect every single one of you no matter what aspect of nursing you work in, and this is medication errors. So I think in school you get this impression that you don’t, when you become a nurse, somehow you’re perfect and infallible and you’ll never mess up. And the only people that do mess up are terrible nurses. Well, I’m here to dispel that, that a thought process. We are human, we are fallible and we will make mistakes. We will be exhausted, we will be distracted or we will. Some people will be careless. I pray that is not the reason behind a medic mistake, but that is the reality of the world that we live in. And if we pretend that we can’t and won’t make mistakes and it’s a lot harder to prevent them.
So let’s talk about ways to avoid them. And I know you get in the in school and people tell you, well, don’t never get distracted and never interrupt, but it’s let’s be real. You’re given meds and seven people walk in the room or you, you’re scanning your meds and four people peek their head in, Hey, your new admissions here. Hey, the doctor’s on the phone. Hey, if family members on the phone, that’s the reality of what we work in. So I’m going to give you some tips to empower you as a nurse, um, and as a student nurse, um, to be the best you can when you’re given meds. And sometimes, sometimes we just honestly, we need permission. I feel like our need to be empowered to say to people, um, to say, Hey, this is the priority right now. Um, I’ll get to that in a minute and focus on what we’re doing.
So I’m going to give you some, some very practical tips on ways to avoid med errors as an IX, as not only as an experienced nurse, but as a nurse that has had many errors before. I have another podcast where I talk about what to do and one occurs, but let’s talk about how to avoid them in the first place. Aside from that very fluffy of don’t be distracted. Let’s talk real specific. So when you’re giving meds, a lot of patients and a lot of honestly, people don’t like silence. They feel awkward and they feel like they need to talk. And I’ve noticed that with so many patients that I have to truly say something. Or, Hey, you know, I’m going to right now, I’m going to be looking at your medications. I just need a couple minutes to make sure I’m focused and I have everything situated.
So if you hang on a second, um, and then we’ll, we’ll chat a little bit more. Um, don’t start conversation or simultaneously do two things while you’re, um, giving meds. You know, the way to survive as a nurse is to be a multitasker, but this is the, the one task where you cannot multitask, if that makes sense. So it’s okay to say to a patient, hold on a second, let me just focus real quick. Many times I’ve said that many times and a lot of times the patient’s like, Oh, you’re right, I’m sorry. You know, they realize, Oh, you do need to focus when, and I didn’t even realize I was talking while you’re doing this because you’re doing it so seamlessly. So do not be afraid to say something to a patient. And another tip too is patients for some reason, um, don’t equate setting up an IV pump or dealing with Ivy stuff as meds.
For some reason, I don’t think I get a lot of patients and family members trying to talk to me while I’m programming and Ivy pump. And, um, that I honestly, I feel like more patients and families understand to hush hush when I’m looking at the computer or dealing with like oral meds. But when I walk over to that Ivy pump, it’s like, okay, let’s talk. And it’s like, ah, I need to focus cause that is just as important if not more important to focus while programming your pump. So don’t be afraid to say it in a very nice, um, polite way that Hey, I’m just going to focus real quick. I really want to hear what you have to say. But hold on, let me just, um, I, I am the tiger for a little bit here and make it into a little joke and then that’ll lighten the mood.
Um, and so this applies when you are scanning in the meds. When your, um, using equipment that has to do with medications and this kinda goes into my next one. So like, especially too, when you’re working with like an arterial line at blood pressure, um, and you’re looking at that to dictate maybe medication that you’re going to give. You know, a lot of us, um, have patients that’ll have, um, PRN blood pressure meds to give. So if the blood pressure, the systolic blood pressure is greater than one 60, I want you to give, you know, 10 milligrams of hydraulic Zane. If it’s greater than one 70, I want 20 milligrams, you know, you, so it’s important to double check those vitals before treating them, you know? Um, so if I have like when I would work on the floor and my CNS would get vital signs and then I’d have one, Hey, I’m bed 72, his blood pressure was one 70.
Okay. Thank you for letting me know. I’d grabbed the med. Uh, um, if, if it was on my way and then I’d go in the room and I would double check the blood pressure or the, the CNA was going back in there. I would say, um, to double check it. Although the CNS on that unit got very used to double checking when they had a higher number just to verify that yes, this is indeed the correct blood pressure. You never know, especially in like ICU when we have leave the blood pressure cuffs on the patients, sometimes they slip down and the blood pressure reading is not accurate so we have to go back and double check before we treat. That can help you prevent a med error by giving a med when it really wasn’t indicated because you’re not, you’re treating a false number or I guess an inaccurate number.
Excuse me. So the number one focus, and it’s okay to tell the patient to be quiet in a very, or that you need that you need to focus, especially when you’re working with equipment and drawing up medications. The second one, double check your vitals before treating them. My third one is to label your tubing and Tracy are tubing on your IV pumps. I know this sounds simple and basic, but when, if you can quickly look at pumps, especially if you have two or three medications infusing via IV or six, seven, eight, nine, 10, you know, if you’re working in an ICU or CVOR are you or something, um, you may have a ton of medications going through and that’s a ton of lines and a ton of, um, opportunity for air really like are with all of those ports. So, um, something I like to do, if I, if I had more than two things running and if I had an IV pump that didn’t, um, flash the name of the medication that was, that’s been given, cause some pumps don’t do that or sometimes they do, but it’s not readily, like you can’t see it real easily.
I would write it on a piece of tape and put it on the IV pump so that when I looked at that, glanced at that tower of, of um, T, uh, not tubing. When I glanced at that tower of Ivy pumps, I knew, Hey, morphine’s on top the salient carriers below verse heads below. Um, then I’ve got my, um, Liva fed, you know, so I could easily see where they were and then, um, I would label them not only close to the patient, so at the port closest to the patient nearby, I would also label it behind the pumps. So that means between the bag of Ivy fluid or whatever it is, and a lot of times a pump, I would label it there as well so that I could easily see up at the top where what each was and make sure when you’re connecting and disconnecting that you’re double checking by tracing the tubing.
And if you have them labeled it is a lot quicker and easier to see what’s what because you, you can tell very quickly, especially a lot of tubing labels are brightly colored, which is wonderful. Um, kind of helps you differentiate a little faster. Um, that way, you know, if you trace before you connect and double check, you know, you trace and double check, you pop whatever it is on or take it off. And then before you leave, you check, you know, or before you let go, you double check again to make sure, yes, I’m disconnecting or connecting this to the correct one. And then you make sure if you’re starting in an IV antibiotic, you’re starting anything that you see that it drips before you leave out of the room. Some, uh, actually many. So a pumps, um, when you’re administering secondary something via secondary tubing, like most frequently an antibiotic, um, if you don’t have it to the appropriate height, it may pull from the wrong bag.
So you have to make sure that, um, the actual antibiotic is infusing instead of like this saline carrier that it’s connected to. So, um, make sure that that is dripping before you leave the room because that’s something that is not going to alarm and tell you, Hey, I’m giving them saline instead of antibiotic cause it’s coming from the same line the pump thinks I’ve given, you know, 250 CCS of vancomycin. So you’ve got gotta make sure that that’s dripping before you leave. So Ivy tubing and Ivy pumps, making sure they’re programmed appropriately. You’re focusing when you’re programming them, you’re tracing your tubing, you’re labeling your tubing, and you’re making your pumps organize. That’s really important. Here’s another great tip, not for Ivy meds. Well for maybe Ivy push meds. So let’s say your skin and your nine o’clock meds and you’ve got 10 pills, um, and two IVs stuff, you know, you’re scanning it.
And usually whenever a partial dose is necessary, or maybe two tabs, three tabs, you’ll scan the one bar code and then it’ll say, you know, partial dose or it’ll give you that little warning to remind you to cut the pill or do whatever. So I encourage you to, cause the tendency is to let me just scan everything real quick and then I’ll go back and cut it. But the more time between all the scanning and then going back and cutting the more room for error, because Hey, when I’m scanning the other ones, that gives, you know, maybe someone’s gonna pop in and say something and then I’m gonna forget to cut the pill, or I’m gonna forget to go grab another one, or I’m gonna forget, um, to do the partial dose. So as that warning flashes up, go ahead and stop scanning, put the scanner down and cut the, cut the pill and make sure your um, your dosage correct, your dosage is correct.
Um, and then my last one is, and I want to empower you guys with never interrupt a med pass for anything. Um, I am a people pleaser. Hi. It is really challenging for me to um, tell people no or to kind of push back a little about what I need. But it’s important to do that when you’re giving medication. So that means I’m in here, I’m giving my patient medications and someone pops in and says the doctor’s on the phone. Okay, that’s great. Even if it’s a doctor that I’ve been trying to get ahold of, um, you know, I’ll say, can you let them know I’m in the middle of given meds. It’ll be a couple of minutes or I can call if they want to give me a number to call them in five, 10 minutes, I am not going to leave that med pass to go talk to the physician or a family member or anyone.
I am in the middle of a med pass. Those typically don’t take too long. But if I stop what I’m doing, leave the room and then come back. I mean that’s definitely huge. Huge room for error. So truly, unless there is an urgent emergent situation going on, um, make sure that you are focusing and finishing what you’re doing and it is okay to tell people to wait. Um, you know, when you’re a nurse, a lot of everyone has to kind of come to you for the patient because you’re home base. But EV, but what happens is everybody thinks that whatever’s going on with them is the priority. And when I say them, I mean members of the healthcare team. Um, so you have to take, you have to understand what is the most important looking at everybody’s requests. Like I know I’ve had times where I had the physical therapist wanted to work with him, the doctor was rounding, um, the case worker wanted to do this, they wanted me to do this and this person.
And then there was a family member on the phone and then it’s like, wait a second, this patient is hypertensive right now and I need to give them blood pressure medicine. So all five of you have to wait because I need to give this patient blood pressure medication. And I’ve had people get frustrated and get mad that I couldn’t attend to their need immediately. But that the end of the day I’m in the middle of a med pass. I’m in the middle of doing what I need to do for the patient and I am the one that can, has the view of everybody really. I have the view of what all needs to be done for this person right now. So I unfortunately sometimes have the not so awesome job of telling people that their need is not the priority right now. Hey, I will get to, I will get to you in a moment or the patient will be ready for physical therapy in about 20 minutes.
I know you came up now, but Hey, they’re in the bathroom. The maybe the physician’s talking to them or whatever, you know. So that kind of falls into the role of the nurse. And you know, it was, it was really tough at me. Tough for me at the beginning cause I really wanted to um, make everybody happy and do everything, you know. So it was like everyone was happy, but at the end of the day and many days that is not possible. And I had to be okay with disappointing some people for the greater good of the patient. So those are my tips. Remember, focus when you’re giving them given meds, double check your vitals before treating them. Label and trace your tubing and making sure it’s dripping. The correct ones are dripping before you leave the room every single time. When you’re scanning those medications, make sure that as you get the warning to cut or do a partial dose or to do whatever you do it when the warning pops up and don’t finish scanning and going back and never interrupt a med pass for anything unless someone is legit, urgent, emergent situation.
So those are my tips. I hope this is helpful to you. Um, you know, and you will do all that. We can to prevent a med error, but sometimes they happen, sometimes it’s are us being, um, too rushed. Maybe we’re not, uh, practicing the way we should be, or maybe there’s a flaw in the system. So if we pretend like we didn’t have a med error, we don’t report it appropriately or we don’t, um, participate in the solution that we’re, um, enabling and potentially others to fall down that same path. So it’s important to address these med errors as they occur and making sure that we’re, um, taking accountability if we have committed one and making sure, um, that we’re doing all we can every day to prevent them. And if it does happen, we learn from it, we move on and, um, um, do what we can. So thank you guys so much for listening today. I hope, I hope this helps and encourages you.
All right. All right. All right. I hope that was helpful today guys. I hope that gave you some motivation, some inspiration to go out and to be your best self, to go out and to become the nurse that you want to be, to make a difference. And to do the best work that you can. Listen, we’re here to help you along your way at interest’s in ge.com our goal is to give you tools, incompetence to help you in nursing school on the end, clicks and in life. One of those tools we created is our Friday freebies, these weekly PDF cheat sheets that you can refer to on the clinical floor in the classroom, and just throughout your entire career as a nurse. To get these cheat sheets, head over to nrsng.com/freebies that’s nrsng.com/freebies you guys, if you need anything, we’re here for you. You can reach out to us on social media or via email, at contact@nrsng.com we want you to succeed. We want to help you along the way. We’re here to hold your hand. We’re here to give you the tools, the competence that you need to achieve success in this journey, to nurse our eyes. So you guys know what time it is now. It’s time to go out and be your best self today. Happy nursing.
