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Revenge of the Afternoon Meds

February 20, 2012

A huge part of a nurse’s job is administering medications. In nursing school administering medications sounded so exciting, but truth be told…most of the time it’s just tedious.

I personally take a great interest in the medication management of patients. Too many older adults are suffering from poly-pharmacy (taking more drugs than needed). That’s where being a Nurse Practitioner, Doctor or Physician Assistant has it’s pros because you can prescribe medications to your patients, and also take away medications from the patient’s medication regime.

One of the patients I cared for recently was taking so many medications. Every morning when I handed out his medication, the pills would fill a medicine cup to the top. The patient would groan when I would enter his room and say, “ugh not those pills again.”

Most patients have a lot of medications due in the early morning. As a nurse, you can often look forward to the late morning/early afternoon and know that you will get a break from preparing/administering medications to your patients, which allows you to spend more time assessing, providing education and emotional support to your patients, which is truly what nursing is all about. With the patient I described above, I was unable to do such things. He had medications due every other hour and despite my clustering care and administering medications a little early or late in order to bother the poor man less, I still found myself in his room constantly giving pills that didn’t seem to make him any better (or any worse). It was at this time I found myself so extremely frustrated at the nurses station exclaiming to a coworker, “IT’S LIKE REVENGE OF THE AFTERNOON MEDS! IT NEVER ENDS!” Which subsequently gave me the idea for this blog entry.

It’s times like those where being an RN and not a Nurse Practitioner, Doctor or Physician Assistant has it’s cons. As an RN it is my job to look up and know the medications I am giving and to understand why I am giving a certain medication to a patient. It is even my job as an RN to question (respectfully of course) any medications I believe may be prescribed in error, but unfortunately it is outside my scope of practice (in many situations, not all) to claim a patient doesn’t need a medication. I remember speaking to the physician about the many medications for the patient, and the physician thoughtfully explained, that the medications were indeed necessary for the patient to take. Unless I felt the patient was in great danger of taking those prescribed medications (in which case there is a chain of command for dealing with such situations), I have to respect the knowledge of the person that prescribed the meds and carry out the orders to administer them.

In situations where you don’t see the immediate benefits of administering the medications or when you feel like a human medication dispenser, it’s easy to feel burnt out and wish that doctors handed out meds instead. But there are times when giving medications can be really satisfying. For example, I recently cared for a patient awaiting open heart surgery to repair three of the major vessels in his heart. When he began having acute chest pain and sweating profusely I knew I had to give him IV Morphine and sub-lingual Nitro really quickly in order to relax his arteries and decrease the workload on his heart to prevent permanent damage. In that situation, administering medications was extremely exciting as I was able to watch the medications do their job and work effectively,  if only for enough time for my patient to get to the operating room and have the emergent CABG (Coronary Artery Bi-Pass Graft Surgery).

I guess my point in all of this is there are times when medications are important and as a nurse you can see the benefits of a prescribed medication clearly, and there are times when you can’t see so clearly. All we can do as nurses is always understand why we’re giving a medication and making sure we ask questions when we don’t know.

One Comment leave one →
  1. Joy permalink
    April 10, 2012 10:05 pm

    I enjoyed reading this Lili! It is so true about poly pharmacy! It’s motivating to have a balanced life and be thankful I don’t take meds!!!!

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