Most people assume that nurses just follow the doctors orders, and give the meds that they prescribe. In fact, it is much more of a team effort. I get the impression that the doctors value the nurses' input for their intimate knowledge of a patient's condition. Today I made my first medication decision, that affected the care of a patient.
Part of the nursing assessment is that you have to actually DO something if your patient reports a problem, and then follow-up afterwards to see how the pain-control measures worked. All of this has to be recorded on the record.
I suggested all sorts of measures to her... hot packs, cold packs, changing position ... but none of them would satisfy my patient. Finally, I remembered seeing some medications prescribed for just as-needed pain medications on the back of her med sheet. I suggested this to her, and she seemed to agree that taking a pill might help.
I ran out to find her nurse, and ask if I could give the pain meds. The nurse gave me a blank look ... I don't know if she even knew which as-needed meds were on the prescription. She didn't see a problem with it. I ran to the med room, retrieved the pain medication, and went to my instructor. I told her my patient's status, and that I wanted to give her the extra medication. Great, my instructor said.
I dashed back to the room with the pain meds and a glass of water. I went through the full protocol of checking the patient's name band before watching her take the pills. I couldn't believe that the nurses and instructor had trusted me fully to give as-needed medications like that. I was a little nervous. What if I somehow accidentally gave the wrong thing? What if it was a medication that was contraindicated? What if I gave the wrong dose?
I had to calm my self down and remind myself that I prescribed this medicine for myself all the time. It was Tylenol.