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Reconciling
April 11, 2017 --
Reconciling the meds (that is, answering the question, what is the
patient taking?) is one of the maddening, time-consuming,
excessively-repeated tasks nurses must often do and rarely get
right. My friend Claire writes:
I have been an inpatient in 4 institutions in the last 6 months, and
the quality of care varies wildly.
I take several meds in the morning and several in the evening. I
take pain meds PRN 3-4 times per day. But I also have two glaucoma
drops, a shot for bone density, and inhaler, and a few OTC meds,
and they started me on vitamins and iron because I was anemic.
I always bring my own meds because I know that they will not have
them all for at least 3 days. I surrender my meds to the pharmacy
and then they dole them out to me. In hospitals it's a giant pain
in the ass to dispense even an aspirin. The problem there was
always just getting the meds at all. At the rehab place, where I
was an inpatient a much longer time, I had to insist that they put
each med in a separate cup, labeled. They still left out half the
meds and/or gave me the wrong dose most of the time. I was able to
insist that they do it right even if it took 3 trips.
Now just imagine I was one of the typical elderly patients there.
If they are of our parents' generation, they ask no questions, and
many don't even know what meds they take or what they are for. It
won't happen to me because I am on the ball. But most inpatients
aren't! They trust that they will be given the right meds at the
right time, the right dose. My experience was that only by the
third week did they finally do that. It took two weeks of doing it
wrong before they learned. I was also there for 5 weeks last year,
and in order to get the right drugs, I had to email upper
management.
Shame on us!
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