Medication, Medication, Medication

[inthemindofanurse]

So, for today's post I'm going to stick with discussing medications.

When you go to the doctor to verify medications there is actually more than either "yes or no" if you are taking something. Now, all EMR (electronic medical records) systems are different so this might not be true for all places; but either way your doctors office should know this information :)

When I open your medication list it has the medication and 4 boxes next to it. One of them have to be checked next to each med. The boxes are labeled T, N, U, D. The T stands for taking, the N stands for not taking, the U stands for unknown, the D stands for discontinued.

TAKING- this means you are taking the medication as prescribed on the bottle. If you have a Rx for Ambien or Xanax 90% of the time it will say take "blah blah blah" as needed or prn. If you only need this medication once every 6 months and you still have the bottle in your home, it is considered Taking. We will generally make a comment in the nurses section that you take it rarely if that's the case.

NOT TAKING- This is where some folks might not understand this option. There are some of you that if you are given a prescription for pain medication after a surgery and it says "take 1 every 6 hours as needed for 10 days" at the end of 10 days if there is anything left you discard it. Well, more often than not, people keep that medication on hand (I'm not saying there is anything wrong with that!) So when I ask if you are still taking Hydrocodone, your automatic answer may be to say "no" But if you still have it in your home I need to know that and mark that medication as Not Taking.

UNKNOWN- the patient simply can't remember even with helping try to remind them what the medication is taken for, who gave it, when...

DISCONTINUED- the medication is not in your home at all.

Why we need to know such specifics is for a few different reasons
>If a patient has addiction problems, suicidal thoughts, memory issues we know what drugs they have at their disposal.
>If a patient comes in with an injury and they tell us they took one of their old pain meds from hip surgery 2 years ago, we know what that medication was
>If a patient comes in sick and they say they took some antibiotic that they had left over from last year we know what antibiotic that is (they are not all treated the same)
>If a patient comes in with their elderly mother and are in a complete panic because she went into the medicine cabinet and took some medicine and nobody know what because she can't find the bottles and she is now lethargic. We can look at your chart and know what all you have in your home and can decide if there is a major problem.

So, if you are hanging on to that antibiotic or pain med. Let us know! Yes, your doctor will probably tell you to get rid of them. However, you are a grown up and can tell them "no" I want to keep it for emergencies. This way if anything bad happens we have all the information.

Thanks for reading :) Good night

[NYGUY]

Oh, I get it. We are being schooled...should be interesting!!

[billethkid]

Why are we, suddenly viewed, as in need of such schooling?
Second one in a week.
I am not sure who the poster thinks his/her audience is!

[Barefoot]

Why are we, suddenly viewed, as in need of such schooling? Second one in a week. I am not sure who the poster thinks his/her audience is!

Fourth thread on meds, but we all need reminding.

[rubicon]

Dear OP:

thank you

[graciegirl]

///

[graciegirl]

I think it was VERY helpful that you reminded everyone to make a list of medications, but this new post makes me wonder how satisfied you are in your job.

[kittygilchrist]

Note to self...ignore nursemind posts.

Becuzzzz..I know this already....

[graciegirl]

Note to self...ignore nursemind posts.



Good advice Kitty. I think, I'll take it myself.

[golfing eagles]

Dear OP:

I've been defending you so far, your advice has been sound despite wording that could be toned down a bit. But now you are coming off as quite didactic; perhaps you could save the lecture series for a first year nursing class and distill down any information you wish to impart to that which is helpful to the average senior patient. I know it is hard at times, especially once you start typing and get in the teaching mode.

[vorage]

Thank you for posting. I learned something about an annoying process at my dr office and thanks to you, I get it now.

[dbussone]

My wife is an RN (retired nurse). I think your intent is good, but I must agree with golfing Eagles. It comes across as too preachy. My wife says I am a lousy patient but her tone is kind even when she is on my case about some medical issue.

[outlaw]

Uh, this thread is in Medical and Health issues? What do you want a nurse to talk about in this section? Auto transmission rebuild?

[FosterMomma]

I don't really understand why people are offended by the information being given here when it sounds both sensible and important. My guess is that most patients do not answer the drug questions properly, particularly the one relating to whether you still have any part of your prescription left in the house. Now I understand the importance, I will answer differently.

[Mudder]

Ok, I read this post, I felt like it was a class on medication tracking 101. Most of us know it is important to know our medications, etc.... And those who don't probably are not going to follow your advice at this point in their lives. So I'm dropping out of this online class........give me an incomplete .

[outlaw]

I don't really understand why people are offended by the information being given here when it sounds both sensible and important. My guess is that most patients do not answer the drug questions properly, particularly the one relating to whether you still have any part of your prescription left in the house. Now I understand the importance, I will answer differently.

People get offended by the most ridiculous, innocuous things. It's especially bad here. Although seniors, they have embraced the childish PC trend of being offended and outraged. Normal people would just not continue reading a post they don't care about. Sometimes they get into a feeding frenzy when they smell blood in the water. Then it's Katie bar door. Sorta like street gangs.

[Nucky]

I wonder if your the nurse typing on the computer for the last 55 minutes while my Doctors appointment time passed 1 hour 15 minutes ago. Just get me out of the office before I need to add Xanax to my medication list. Work on tomorrow's lesson from home, not on my time.

[inthemindofanurse]

I am very sorry if I am being taken wrong. My intent when starting this was to do a daily post as to something behind the scenes in a doctor office. I don't mean to lecture or upset anyone. I only post things that I have been asked more than once during a patient's visit. I do not think anyone is stupid. I personally am the type of person who would like to know why you need to know what I have if I'm not taking it. I understand that a lot of you already know this so the post is annoying to you. But like I said. I have had patients ask these questions in the past. So, if I have helped at least one person be less annoyed with the process of seeing their doctor because now they know the why behind it, I am happy :)

[golfing eagles]

I wonder if your the nurse typing on the computer for the last 55 minutes while my Doctors appointment time passed 1 hour 15 minutes ago. Just get me out of the office before I need to add Xanax to my medication list. Work on tomorrow's lesson from home, not on my time.

That really isn't called for, she is just trying to help. But if you do add Xanax to your med list, please write alprazolam next to it to avoid "generic confusion"

[golfing eagles]

I am very sorry if I am being taken wrong. My intent when starting this was to do a daily post as to something behind the scenes in a doctor office. I don't mean to lecture or upset anyone. I only post things that I have been asked more than once during a patient's visit. I do not think anyone is stupid. I personally am the type of person who would like to know why you need to know what I have if I'm not taking it. I understand that a lot of you already know this so the post is annoying to you. But like I said. I have had patients ask these questions in the past. So, if I have helped at least one person be less annoyed with the process of seeing their doctor because now they know the why behind it, I am happy :)

I hope you helped more than one! Some people are just a little sensitive if they feel they are being told what to do, I think it's just a touch of transference from their childhood. They're not wrong, it's just the way they feel. I was surprised a bit at the general negative reaction to some pretty good info---info from our side of the stethoscope that most do not know, so I'm guessing they were more offended by the presentation than the information. I've had the same experience now and then, so I just watch my phraseology and throw in a humorous line. But I have been told I'm not as funny as I think I am:1rotfl:

[graciegirl]

We the old, the smart, the sensitive are beginning to fail in a few ways. It HURTS to be lectured like we are old and failing. The whole tone of your posts, well meaning as it is, sounds superior and a bit frustrated.

I taught four and five year olds for thirty years so I consider myself rather patient with people who can't write right and who sometimes cry. We are all just people and we always need to be treated as if we are beautiful and smart and young.

And by the way, I can tell you are beautiful and smart and young.

[golfing eagles]

We the old, the smart, the sensitive are beginning to fail in a few ways. It HURTS to be lectured like we are old and failing. The whole tone of your posts, well meaning as it is, sounds superior and a bit frustrated.

I taught four and five year olds for thirty years so I consider myself rather patient with people who can't write right and who sometimes cry. We are all just people and we always need to be treated as if we are beautiful and smart and young.

And by the way, I can tell you are beautiful and smart and young.

And that's you're a "sage"

[outlaw]

I am very sorry if I am being taken wrong. My intent when starting this was to do a daily post as to something behind the scenes in a doctor office. I don't mean to lecture or upset anyone. I only post things that I have been asked more than once during a patient's visit. I do not think anyone is stupid. I personally am the type of person who would like to know why you need to know what I have if I'm not taking it. I understand that a lot of you already know this so the post is annoying to you. But like I said. I have had patients ask these questions in the past. So, if I have helped at least one person be less annoyed with the process of seeing their doctor because now they know the why behind it, I am happy :)

Unfortunately, your good intentions were met with a much too frequent attack the messenger tactic by a few self anointed PC police. Your honest, and I think accurate, portrayal of a typical patient was appreciated by a few people that can handle the truth without getting all wound up over "tone" or some other BS PC term. If you stay on here long enough, you will begin to see who these people are.

[Suzi]

A lot of us nurses got out of the field (retired) because of the many painful changes to the world of medicine. We remember when you scribbled notes on PAPER to add nursing notes at the end of the day to the patients chart. Alas, that time is gone and this new language (EMR) takes your nurses and doctors hands off you and on-to a computer. When you visit the doctor, many people just "sigh"when asked the same 'ole questions visit after visit. This nurse is trying to tell you the WHY's - the reasoning behind the questions. She is trying to EMPOWER you as the consumer of health care. Please take her advice as it is meant.......this new language isn't easy for any of us.

[graciegirl]

A lot of us nurses got out of the field (retired) because of the many painful changes to the world of medicine. We remember when you scribbled notes on PAPER to add nursing notes at the end of the day to the patients chart. Alas, that time is gone and this new language (EMR) takes your nurses and doctors hands off you and on-to a computer. When you visit the doctor, many people just "sigh"when asked the same 'ole questions visit after visit. This nurse is trying to tell you the WHY's - the reasoning behind the questions. She is trying to EMPOWER you as the consumer of health care. Please take her advice as it is meant.......this new language isn't easy for any of us.



Well said.


Perhaps that could be explained, or a gentle fib that the boss makes me ask.

[golfing eagles]

A lot of us nurses got out of the field (retired) because of the many painful changes to the world of medicine. We remember when you scribbled notes on PAPER to add nursing notes at the end of the day to the patients chart. Alas, that time is gone and this new language (EMR) takes your nurses and doctors hands off you and on-to a computer. When you visit the doctor, many people just "sigh"when asked the same 'ole questions visit after visit. This nurse is trying to tell you the WHY's - the reasoning behind the questions. She is trying to EMPOWER you as the consumer of health care. Please take her advice as it is meant.......this new language isn't easy for any of us.

This is 100% correct. EMRs are both a blessing and a curse. I'm afraid completing all the data fields is becoming the purpose of our work instead of a tool. Regulators love them since they can "count beans", which they believe is a measure of quality care. They cannot possibly understand what we do, so they reduce it to the lowest common denominator. Then they convince themselves how wonderful it all is and demand more and more data, backed by more and more regulation. Who loses?---the patient, whose interaction time with their health care provider is greatly diminished.

When my nurse or I ask you "Is the lighting in your house adequate", or "Do you have enough food in your pantry", or "Do you have a grab bar in your shower" (Yes, these are actual questions), please realize these are not our brilliant idea, they are the brainchild of some rocket scientist in Washington who is growing his own fiefdom of bureaucracy, and are MANDATED. We don't like it any more than you do. If someone is having difficulty managing at home alone, they can easily be referred to Social Services who will do a home assessment and report all the stupid little details to CMS, there is no need to take time away from patient care to answer their questions. Same is true with going over med lists time and time again---if you don't get it by the 3rd or 4th time, we're going to have to find an alternative. Same is true of handing out HIPPA forms everywhere you go. My pharmacy wanted me to sign the HIPPA form for a med the vet gave my dog. (I couldn't resist, I asked the twit if she wanted my dog to sign it herself---she was dead serious and said that would be preferable (they probably gave her a raise, or a new job at HCFA))
And I don't get the impression the OP is dissatisfied with her JOB, just the garbage that has been heaped upon her.

[redwitch]

Dear inthemind, thank you for taking the time to explain the why's. Sometimes knowing how things are run makes it much easier to accept the irritants. Hopefully, by now, we understand your intent and most of us will not take umbrage at the tone and instead be grateful for the time and effort you are making for us.

[golfing eagles]

Dear inthemind, thank you for taking the time to explain the why's. Sometimes knowing how things are run makes it much easier to accept the irritants. Hopefully, by now, we understand your intent and most of us will not take umbrage at the tone and instead be grateful for the time and effort you are making for us.

:agree:

[Carla B]

The nurse asked my husband prior to surgery at Munroe Hospital in Ocala, "Do you feel safe at home?" We were both puzzled. "Finally he answered, "Why yes, I live in The Villages!"

[golfing eagles]

The nurse asked my husband prior to surgery at Munroe Hospital in Ocala, "Do you feel safe at home?" We were both puzzled. "Finally he answered, "Why yes, I live in The Villages!"

:1rotfl:

And of course, you both could clearly see how important this question was for the surgeon to do a good job. If the EMR didn't have this answered, medicare or his insurance company would give him a "black mark" (I hope the surgery indeed went well and your husband is fine)

[Boomer]

I am very sorry if I am being taken wrong. My intent when starting this was to do a daily post as to something behind the scenes in a doctor office. I don't mean to lecture or upset anyone. I only post things that I have been asked more than once during a patient's visit. I do not think anyone is stupid. I personally am the type of person who would like to know why you need to know what I have if I'm not taking it. I understand that a lot of you already know this so the post is annoying to you. But like I said. I have had patients ask these questions in the past. So, if I have helped at least one person be less annoyed with the process of seeing their doctor because now they know the why behind it, I am happy :)


I really like what you said here about being happy if you have helped at least one person. I am sure you helped more than that. You just never know how far your trying to help someone can reach.

But (sigh) you probably feel like a classic example of that old saying, "No good deed goes unpunished." -- I have never liked that expression. But sometimes it plays out. Not always though. And I know that good nurses, by nature, are always doers of good deeds.

In writing, tone and voice are two of the hardest things to teach. Both can be so nuanced.....Actually, tone is the easier of the two, once the writer is aware. But voice is either there in a piece of writing or it is not.

I could hear the voice in your writing. I knew you wanted to communicate to be helpful. I also could hear your frustration with the system. And in your more recent post, I think you are finding the voice you need. Don't give up on your writing. Sometimes you might like to write just for yourself. And sometimes you might want to write for others. But don't give it up.

And now, I probably will take heat for acting like a teacher.

[golfing eagles]

I really like what you said here about being happy if you have helped at least one person. I am sure you helped more than that. You just never know how far your trying to help someone can reach.

But (sigh) you probably feel like a classic example of that old saying, "No good deed goes unpunished." -- I have never liked that expression. But sometimes it plays out. Not always though. And I know that good nurses, by nature, are always doers of good deeds.

In writing, tone and voice are two of the hardest things to teach. Both can be so nuanced.....Actually, tone is the easier of the two, once the writer is aware. But voice is either there in a piece of writing or it is not.

I could hear the voice in your writing. I knew you wanted to communicate to be helpful. I also could hear your frustration with the system. And in your more recent post, I think you are finding the voice you need. Don't give up on your writing. Sometimes you might like to write just for yourself. And sometimes you might want to write for others. But don't give it up.

And now, I probably will take heat for acting like a teacher.

Very possible:1rotfl: