Only one thing

Melissa Mihalovic

Written Communications

Wed.6:30pm-9:50pm/11/13/13

Instructor: Daykin

                                                                                “Only one thing”

 

                My every day to day work load as a LPN (Licensed Practical Nurse) can be very long, and at times it can be hard to keep up with everything that I have to accomplish in one day.  At the nursing home I work at I actually do everything an RN does, and I am the only LPN that is in charge of her own hallway.  This means I am responsible for 27 residents each day, which includes there day to day health concerns.  Today though, I will tell you the step by step the process I have to go through to insure that each resident receives there medications safely, they receive the correct medications, in the right manner,  and actually this part of my job duties are the least worrisome in my line of work.

                The first thing to know about passing medications to all those residents, and anyone that passes medications to patient, residents or clients is you have to remember your five rights of following medication pass, which are right drug, right dose, right route, right resident/patient/client, and right time.  These five rights are very important when giving someone else medications.  The first thing you want to do is to wash your hands, before any direct contact with medications or with the resident. 

                The second step is to check the medication label with the medication record three times, this means each time you pass out a medication it has to be checked three separate times.  This does become very time consuming when a person just starting to pass medications begins.  At my place of employment only one nurse at a time can be at the medication cart.  This has been made a rule at my place of employment due to having two nurses one time trying to pass out medications on the same cart, a male resident received the wrong medications, which was an actual whole cup full of meds when I say a cup I mean a thirty cc medication cup, and he was given many different heart meds that he was not on and he already had a compromised heart.  This sent him to the ER which in turn sent him to ICU unit for many days.  Thankfully he did survive.  When passing meds the person needs to check the meds three times, including, when taking med from cart, when putting in cup, and just before giving medication to resident.  These helps to insure that nothing was missed and that you have the right person.  This can save many lives.

                The third step is to never leave the medication cart/treatment cart or med room unattended or unlocked.  This is where all the meds are kept, in a locked cart, with only that nurse having the key, and then in a locked room, medication room, and only the nurses and medication techs have the keys.  This is so there is only limited access to the meds.  When passing meds also never leave meds with a resident, make sure they take all meds while you watch, also the medication cart has to be within eye view of the person passing out meds, and if you step away from it, it has to be locked. It is my responsibility to know what meds are to be given before, after and with food, and to give appropriately. When measuring liquids this has to be done at eye level, and has to be given to the resident all liquids, you may have to add water to residue to insure all of the med was ingested.  If the person giving meds walks away before the resident takes their meds they may drop one. 

                There are many other small rules to giving meds to residents, like taking off old pain patches before applying knew ones, waiting 5 minutes between different eye drops unless it is specified to wait longer, and waiting 1 minute between each puff of same inhaler or waiting 5-10 minutes between puffs of different inhalers. This allows the medicine to get into the body and do what it is suppose too. 

                In conclusion, when I pass meds I have to follow the 5 rights of medication pass, which are right drug, right dose, right route, right resident, and right time.  I also need to chart after each medication given because not charting something is just like saying I didn’t do it.  This part of my day is only one small fraction of what I do in a day, but one of the most important things I do.  It is my responsibility to ensure that each one of my residents receives the proper medications that are ordered for them.  After all they rely on me and trust me.