Medication wise - Nurses do not have the authority to prescribe medications, with some exceptions. To be able to prescribe they must undertake another learning module/training and be observed and present their studies to peers.
All medications administered by nurses must be from a medication prescription from a licensed practitioner.
Nurses are legally responsible for the drugs they administer and there may be legal implications when there is an error in a prescription and the nurse could be expected to have noted and reported error.
If you are ever visiting someone on a hospital ward and you see a nurse with a red tabard on them, DO NOT interrupt, unless you are about to arrest there and then. (tongue in cheek). They are doing the meds round and every single tablet, capsule, lotion and potion on that trolley they are responsible for.
They have to make sure that the patient and the medication meets the criteria
The "5 rights of medication administration" refers to five checks that nurses should always carry out before administering a drug.
They are:
• Right patient – the dose of warfarin intended for Mrs Jones in bed 2 who is in with a stroke could kill Mrs Smith in bed 3 as she has a gastic ulcer – and this is going to make her stomach bleed more – not good
• Right dose – from my own experience, I was feeling very sick after getting x med 2 mornings running until I realised something and queried the dose and was told it was my normal so I insisted on seeing the chart, of course I was feeling ill as the dose was treble what it should have been and the extra 2 tablets weren’t noticed in the 20+ tablets I take each morning.
• Right drug – in the above case it was the right drug but was too much
• Right time – if as the nurse am you giving up sleeping tablets at 9am and wondering why the patient are sleeping all day
• Right route – this explains the different routes catalogue.pearsoned.co.uk/assets/hip/images/catalog/uploads/Olsen%20-%20Chapter%202%20for%20upload.pdf
Injections – subcutaneous – intramuscular –
Tablets – capsules – caplets – some tablets or caplets are enteric coated so they are not to be chewed or crushed as they are intended to dissolve in the small intestine
Oral drugs also come in liquid forms: elixir, syrup and suspension. An elixir is an alcohol solution, a syrup is a medication dissolved in a sugar and water solution and a suspension consists of an insoluble drug in a liquid base.
Parenteral medications Parenteral medications are those that are injected (via needle) into the body by various routes. Drug forms for parenteral use are sterile and must be administered using aseptic (sterile) technique.
The most common parenteral sites are the following:
✚ intramuscular (IM): into the muscle;
✚ subcutaneous (subcut): into the subcutaneous tissue;
✚ intravenous (IV): into the vein;
✚ intradermal (ID): beneath the skin.
Cutaneous medications
Cutaneous medications are those that are administered through the skin or mucous membrane.
Cutaneous routes include the following:
✚ topical: administered on the skin surface;
✚ transdermal: contained in a patch or disk and applied to the skin;
✚ inhalation: breathed into the respiratory tract through the nose or mouth;
✚ solutions and ointments: applied to the mucosa of the eyes (optic), nose (nasal), ears (otic) and mouth;
✚ suppositories: shaped for insertion into a body cavity (vagina or rectum) and dissolve at body temperature.
Some drugs are supplied in multiple forms and therefore can be administered by a variety of routes. For example, Voltarol (Novartis) (diclofenac sodium) is supplied as a tablet, dispersible tablet, suppository, topical gel or solution for injection.
Verbally: ask the patient their name, date of birth, if an in-patient also the hospital
number, if known.
✚ Visually: check the patient name band (if in-patient) against the name on the prescription
chart.
As a HCA / SN / nurse eventually, on a ward on a day to day basis there will be lots of helping patients with activities of daily living – (ASLs) en.wikipedia.org/wiki/Activities_of_daily_living_assistance
The bare basics of ADLs consists of helping the patient mobilise (because moving around has been proven to help healing).
If the patient is unable to mobilise and is being cared for in bed, the minimum time it can take a bed sore to develop is 2 hours - so for these patients they need their position changed every 2 hours day and night, skin should also be checked many times a day as if a slight redness comes up it is better to get it and treat asa[ before it develops further.
Other basic tasks include bathing (that can cover anything from helping someone have a shower to bedbaths to washing groins ),
Toileting - you will end up helping people to go to the toilet urinary and faecal wise, you will smell some of the worst smells emitting from esp faecal matter - however you put on your PPE and carry on - if at all possible even if your stomach is churning, try not to vomit in front of patient –
imagne if you were the patient and your nurse / hca was to vomit around you as your body fluids was so foul ( a trick to help - put a blob of vicks vaporub or poundshop version under your nose and thats all you can smell). If needed to take a sample from a bedpan - take it to the sluice as then if you puke you have somewhere to do it out of the patients line of sight
Bedmaking, helping people get dressed / undressed and helping to feed those who require help - go slow as I have been fed many times and the speedly ones dont give you time to chew never mind swallow, my last hospital admission I told off a nurse as while he helped me eat cornflakes he would ask me something the second the cereal went into my mouth - I couldnt answer,he just realise what he was doing (by his own admission)
Having 'thick skin' –
This is needed in many jobs but esp nursing, you and your colleages are all under pressure, the Drs are doing a ward round so you as the nurse need to go around so you know what is happening with each patient, the Drs are stressed and snappy, you haven’t had any breakfast, there hasn’t been time for a lunch break and its 5pm, You have been on since 7.30am. Your DS is in the school play that night. The patient in bed 6 is severely unwell and you need to ring her family and ask them to come in. The consultant is arguing the toss with her junior drs and there is a teaching session for physio or OTs going on down the ward. Due to the patient in bed 10 who passed away an hour ago, you are waiting on the family to arrive and have prepared the body with last offices. You have a headache, someone is playing a radio too loud. You have at least an hours worth of charting and you feel like you just want to go out into the car park and scream your lungs out –that would leave the ward uncovered and a drugs round is due. You really want to jack it all in, but you know people are depending on you right now. Thats just an example of a thick skin, a lot of it is out of your control but is affecting you but you still need to remain professional, compassion and take a deep breath (this too will pass) then you get someone to get you something easy to eat and you cram food into you because getting your break isn’t going to happen most of the time due to no staff cover and nip into the staff locker room and stuff yourself before getting back out there to meet the family of the patient in bed 10.
Other things to consider – academic ability
Even though you may be doing 13 hour shifts, you are still expected to be studying, learning on the job, observing and keeping an eye on patients and watching for signs of detoriation of changes of cognitive level or otherwise. As a SN you are also expected to learn about the conditions that the patients on your ward have and what it is, what causes it, what parts does it affect, what is the prognosis, what treatments are available, reasons for one over the other how does the patient see this from their angle.
Personal characteristics and skills
www.healthcareers.nhs.uk/explore-roles/nursing/roles-nursing/adult-nurse/personal-characteristics-and-skills-required-adult-nursing
Info on what the course is, course costs, other info, intakes,
Nursing degrees generally have 2 intakes, September and February/March – there are a minimum of 112 UCAS points needed – info I used is for adult nursing from Liverpool John Moore just as an example
About your course
As part of the professionally-accredited BSc (Hons) Nursing with Registered Nurse Status (Adult) at Liverpool John Moores University you will complete supervised clinical practice within both traditional and community hospital settings as well as outside hopsital environments. Plus you will develop