I almost looked smart

Because I am a student, I am not allowed to give any patients their medicine without either a nurse or my clinical instructor present. When my instructor is the one there when I give medications, she will ask tons of different questions- why is my patient on this medication, what do I have to watch for after giving my patient this medicine, how does it work, etc. I always look up my patient’s drugs and write down all this information before I call my teacher in to help me administer them. However, there have been very few occasions where I have been able to answer all of her questions. I am starting to notice that my instructors know a lot more than me about these meds, but I still push myself to beat them at this little game.
A few weeks ago, I needed to give my patient a medicine called Toradol. This is a strong anti-inflammatory drug (Ibuprofin-like) used for pain after an operation. I looked everything up in my handy palm computer, and asked the nurse to help me administer the Toradol. She asked me what two lab values I need to look up before administering this medication. Hmmm… that actually wasn’t in my drug book. So I went and looked in another drug book- still nothing mentioning lab values. I tried a few more sources and went back to the nurse and admitted I did not know. She informed me you have to check the BUN and creatinine levels (these indicate kidney function) because Toradol is excreted by the kidneys, and if they are not functioning correctly, the drug could build up and reach toxic levels. After hearing this explanation, I checked the patient’s lab values and went to find a syringe to administer the drug with. My clinical instructor saw me walking down the hall with the bottle of Toradol, and stopped me to quiz me. "What lab values are you going to check before giving this?," she asked with a huge "I am sooo going to stump you on this one" grin. I replied, "His BUN was 8.2 and his creatinine was 1.0, so it is ok to administer the Toradol." Her jaw dropped open, she said she was very impressed, and I smiled politely and walked away. As soon as I was safely out of her site, I did a little celebration dance. Ha! I finally got to look smart!! I know what a few of you are thinking – I should have told her that the nurse had already taught me this. But in all honesty, would you have told her? I didn’t think so. A few hours later, I was sitting at the computer doing some charting with my nurse when my clinical instructor walked up to us. Out of nowhere, the nurse said, "Oh, I taught Katie about checking lab values before giving Toradol."   At this point, I was way too involved in my computer charting to look up at my teacher (at least I tried to pretend I was too involved and didn’t even hear their conversation) but I could feel the burning in my ears and cheeks as they turned bright red. I was caught. One of these days I will look smart. But until then, I’ll settle for just getting through one day without looking like a complete idiot.

10 thoughts on “I almost looked smart

  1. C\’mon, you had to learn it from somewhere. What, did your instructor think you\’d just absorb that information by being in a hospital? Whether you learned from the book or the nurse, it ought to be fair game. Is that so idealistic of me to think so?

  2. You still sound smart to me.
    I\’m so thankful for nurses. I had some of the best care when in the hospital. Nurses are the heartt and soul of a hospital.
    May you be a blesssing to each and every person you meet and care for…
    Blessings, Health, and Prosperity…Greg

  3. YOU ARE SMART!!!  lol!!  You remembered when you were questioned, applying what you had learned!  😀 
    Do you want to come over and have a cupcake?  I made the chocolate frosting myself!  🙂

  4. hmmm. given toradol lots of times … never checked those lab values … ummm … do you guys still operate under the delusion that you will actually have time to check those things when you are the only RN for, say, 10 or 15 acutely ill patients? here\’s a question for you … what do you have to monitor in patients who are on tequin (gatifloxicin) … now … this is something extremely critical … 😉

  5. re: tequin, its an
    antibiotic, one of the ones the docs like to rx these days … it has
    been shown to decrease blood sugars … so, if you have a diabetic
    patient on tequin (also called gatifloxicin) then you should be
    deligently doing accuchecks qid …
    yes, even tho they (they=thick-headed nursing management) set us up
    … we are still responsible … that’s what I HATE about this job …
    fucking RESPONSIBILITY for things way out of my control … grrrr … the
    thing to do if you feel care is being compromised to the point where
    safety is compromised, is call the lug-nut whose the nursing supervisor
    or whatever they call themselves these days and tell them its unsafe …
    then … they should act … of course they don’t always and then that’s
    when you hafta think strategically and start a journal, or taking
    notes, or sthg … just make sure you know what you would tell the judge …

  6. I am glad that (no name) mentioned she never checked those values when giving Toradol.  I do take Toradol(Keterlac is the generic I believe) occasionally for my bum shoulder and although my doctor only gives it to me when I am about ready to die from the pain… she never gives me tests before she prescribes.  Of course, she only prescribes it for a very short period of time (say a week) and knows that I only take it at half dose – for whatever reason.. half dose is sufficient for me.
    Which of course brings me to my pet peeve… why are there so few pain medications out there?  Either am either allergic to them or they don\’t work… or they are drugs that my doctor doesn\’t want to prescribe (narcotics) and I don\’t want to take them.   Which pretty much leaves me to suffer… what do people do that have much much more chronic pain than I?  I can\’t even imagine what their life is like… well ok… this last week I have been imagining it quite well!

  7. Nice!! I hope I get a few breaks like that when I finally go out on
    rotations. (p.s. I still have never figured out how to  post a
    comment  and have my pic show up. *sigh*)

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