Week Seventeen: March 8-9, 2010

This week at clinical was very exciting. The first day was an orientation day and we were able to meet a few staff members and find all the important things we will need on a day-to-day basis. Our teacher also gave us a few handouts labeled "passing meds with ms. breed." This was entirely helpful because it gave a lot of us an idea of what the process would look like. On Tuesday I was assigned to one patient and would be responsible for his total care...including his medication!!! As freaked out as I was I remained calm and tried to focus on time-management. When we got on the floor I immediately went into my patient's room, took his vital signs and did an overall assessment. My patient was an 84 year old Hispanic man who was a "frequent flyer" at Coastal, in other words he was often in and out of the med-surg floor. He had most recently been admited due to a urinary tract infection, dehydration, and sepsis (infection all throughout the bloodstream) but he also had an extensive medical history including dementia, hypertension, atrial fibrillation, and more. Once I had charted the vital signs, I looked at his MAR (medication administration record) to find he had a 0730 medication to be given. This was childrens aspirin 81 mg. given to prevent any future heart complications, in order to administer this medication I needed to check his lab results, more specifically his platelet count. It happened to be low but I double checked with the nurse and she wanted me to still give it to him. I showed my teacher the correct medication, we went to the room, identified the patient, spoke a little spanish, and before I knew it I was feeling more and more like a future nurse! After I documented this had been completed it was already time to prepare his 0900 medications. Thankfully, he only had three and a supplemental dietary drink. He was on Flomax for his benign prostatic hypertrophy (a condition caused by an enlarged prostate gland that often appears in older men) to increase his urine output, an Anti-Alzheimers agent to manage his dementia in the form of a transdermal patch, and another medication for his gastritis (gastrointestinal irritation). It was really fun getting all the information and getting quized by my teacher and it made me really feel like an intelligent, responsible, almost-nurse. After I documented the adminisration of his medications I was ready to give his am care; including his oral hygeine, bed bath, and new bed linen. After that was all complete, I charted and was already off to lunch. When I returned there had been a new order for a drug called Digoxin which helped him with his heart condition and I needed to make sure his apical pulse was greater than 60 before giving it to him. Considering his apical pulse at 1130 was 62 (borderline) I needed to take it again prior to giving the med. It turned out to be 65 and I went with my teacher and gave him his last medication. The day went by so fast and turned out to be pretty smooth, at least for me. I know a lot of the students in my group were very overwhelmed with more medications and the overall stress of giving meds for the first time. I had an awesome clinical week and am excited to see what next week brings me!