Pass the drugs

Last night I got to pass medication for the first time..yay!! :D For some stupid reason, I thought we would just get the medication from the nurse and pass it to the patient..um, no. After checking the MAR (Medication Administration Record) for my patient, I had to get the medication from the password-protected medication cart (each patient has their own drawer on the cart)..do the 5 Rights (right medication, right dose, right patient, right time, and right route)..and watch her take it (it being metformin). Not bad! I got to also give her Alphagan, which is an eye drop. Pretty cool! Next week, we'll be practicing giving IM (intramuscular) injections and shortly after, will be giving insulin. Things are rolling right along.

One thing that you will see a LOT are decubitus ulcers (pressure ulcers/sores/wounds)..which is quite sad. I've seen so many of them! They occur over skin that breaks down when you stay in one position for too long without shifting your weight. They are a big problem for people who use wheelchairs or are bedridden, even for a short period of time. The constant pressure against the skin reduces the blood supply to that area, and the tissue dies. It starts as reddened skin but gets progressively worse, first a blister, then an open sore, and finally a crater. Literally a crater. The most common places for these ulcers are over bony prominences (bones close to the skin) like the elbow, heels, hips, ankles, shoulders, back, and the back of the head. A lot of the ones I've seen are the ones over the sacrum. Last night we had 2 patients that had horrible sores..1 of them you could literally stick your whole fist inside. And the other patient had them all over her body! She literally SCREAMED the entire time we tried to reposition her. Her skin was so dry and scaly, it literally flaked off. The hospital staff was suspecting elderly abuse..which is exactly what it is if it results in a pressure sore.

Here are some pics:

So you see why it's sooo important to turn your patients or even family members that are bedridden or in wheelchairs. Nursing homes are NOTORIOUS for bed sores/pressure ulcers..it's soo sad! Even sadder is that it's PREVENTABLE!! Just another thing healthcare workers have to deal with and are serious about...*sigh*

Now that I've ruined your breakfast/lunch/dinner..I'm off to go study! :)