How To Write The Administering Medication: Fill & Download for Free

Not a new grad, but a nursing student I was precepting. Giving REAL, LIVE patients REAL medications is a huge big deal for nursing students. There is only so much practicing you can do at school sticking each other or pretending to prepare medications. I can’t tell you how many times nursing instructors go over the correct way of preparing and administering medications vs. the wrong way.So, any nursing student who comes to clinicals expecting to give meds is very excited about it, often very nervous, and on her toes eager to do everything exactly right. There can be NO mistakes when you give meds, none.One evening, I was precepting a nursing student who “forgot” to give her meds. She wasn’t horrified, upset, apologetic, or anything else. I kept emphasizing that a nurse absolutely could not “forget” to give her meds all night long.I showed her my “brains” (the written reminders nurses write up for themselves), and went over the details of how I make sure I give all my meds. (It involved writing the times hourly across the top of the page, then writing patient names vertically down the side of the page, then drawing lines so that I made a grid with a box every hour for every patient. After report, I filled in the grid with all medications due for each patient at each hour, along with other needed treatments such as “turn” for patients who couldn’t turn themselves, “change dressing”, “feed”, etc.).This student was completely disinterested in anything I explained to her about organizing ones work. She was just completely apathetic. The patients didn’t miss any meds because by license law, we have 1 hour to administer any med (30 minutes before to 30 minutes after), and when I saw the student hadn’t signed out any meds, I administered them myself. Still, her lack of caring and lack of any sense of responsibility was jarring. I never saw her again after that night, but I fervently hoped she chose a different profession...My controversial posts appear to be edited out of Quora feeds. Please bookmark my Quora profile in order to read them.

As a doctor, what is the worst thing you have seen a nurse do?This will sound like pure fiction to most doctors and nurses who read it—if only that was the case.I was still in my residency and moonlighting in the ER at a small local hospital to augment my meager resident’s salary. My ER coverage also required me to respond to emergency calls in the hospital such as code blues (cardiac arrests, et al.) and to cover any problems in critical care units until the attending physician(s) could be summoned.I was called to one of the floors to see a patient with end-stage emphysema. He was elderly, gaunt, unresponsive to the point of being moribund and obviously in the end stages of his disease. I called the attending internist who asked me to admit him to the medical ICU while he left to come in. I accompanied the patient to the ICU, entubated him per the attending’s request and sat down to write some standard admission orders. The ICU nurses were two Filipino nurses, but both seemed fluent in English. Besides, they were supposed to be trained critical care nurses, right? [Note: some of the most competent and conscientious nurses with whom I had the pleasure of working over the years were from the Philippines—but also some of the worst—and this isn’t a criticism of Filipino nurses per se or in any way racist.]I had instructed them to start him on two liters of supplemental oxygen per minute, a routine rate and the same rate he was receiving on the floor. While I was writing orders, one of the nurses approached me and asked how to hook up the oxygen. I replied “With his endotracheal tube, of course”, meaning “Attach a T-tube with a sidearm and attach the oxygen line to the sidearm”, and went back to writing orders. Remember this was an ICU, and every ICU nurse knows how to administer oxygen—or so I naively thought.A few minutes later I heard excited whispers between the two nurses coming from behind the curtain of the patient’s cubicle. When I walked over and pulled the curtain back, I found they had taken the positive pressure line from the wall and rammed it straight into the endotracheal tube—no sidearm, no way to vent the pressure from the wall. The pressure had obviously blown out his lungs and the patient was literally inflated with subcutaneous air from his neck to his groin and was quite dead, albeit with the pinkest color he’d likely had in years. “Stunned” does not begin to describe my feeling at the moment. I snatched the O2 line out of his endotracheal tube—far too late to do any good, of course—and told the nurses to leave the cubicle and not go near him again. Then I waited until the attending arrived a few minutes later.He asked how his patient was doing and I answered, “He’s dead.” He didn’t look particularly surprised since the patient had end-stage disease, but I then added, “You have to see this.” I took him to the cubicle and showed him the patient while explaining what happened. I’ll never forget the look on his face both when he saw the human balloon his patient had turned into and realized how he got that way. I can only describe it as a mixture of disbelief and shock. I could almost hear him thinking, “How in the hell do I explain this to the family?”.Fortunately, I was called back to the ER. I have no idea what happened after that, but I hope the two “ICU nurses” were never allowed back in an ICU—or any other part of a hospital—again.

Nurses make sure physician orders are executed: they administer medication, they suction out respiratory secretions, start IVs, etc. They also alert physicians to changes in patient’s conditions: pain, vital signs, anxiety, etc. They’re also a great resources for a physician who wants to know more about the patient than strictly what’s written in the chart. They usually have an Associate or Bachelor’s degree education. Your average RN earns about 60 to 70K/year.Nurse Practitioners are equivalent to Physician Assistants. These are called mid-Level providers. They have a Master’s degree level education. What they are able to do greatly depends on the specialty in which they work. Usually, they work in collaboration with a physician. They can evaluate patients, write medical notes, order medication, etc. In a lot of places, they are not allowed to be independent practitioners and need the supervision of a physician. This is changing, as more and more state legislatures are granting them the right to practice independently. Your average PA/NP earns about $100K/year.Physicians have the right to practice independently. In most cases, they have to be not only licensed to practice medicine, but they need a board certification to practice in a specific specialty. “General Practice” is called “Family Medicine” in the US, and it’s also considered a specialty. Physicians are responsible for formulating a diagnosis and treatment plan, based on a patient’s presentation. They have the most education (Bachelor’s degree + 4 years of med school + 3 to 9 years of residency, depending on the specialty). The pay is usually $200K+ in private practice, and $160K+ in academia.