Trafford Publishing: How to Survive a Stay in the Hospital Without Getting Killed

Here is the full reference card for this book...

If you'd rather place an order by talking to one of our cheerful order desk clerks, please call 1-888-232-4444 (USA and Canada only) or 250-383-6864. From Europe, ring our UK order desk clerk at local rate number 0845 230 9601 (UK only) or 44 (0)1865 722 113.

How to Survive a Stay in the Hospital Without Getting Killed

by Mary Lorrie Davis, LVN

147 pages; quality trade paperback (softcover); catalogue #01-0232; ISBN 1-55212-832-6; US$19.95, C$31.95, EUR20.80, £14.40

How to Survive a Stay in the Hospital Without Getting Killed is an easy to understand hospital survival guide written by a nurse with 20 years experience working in hospitals and other nursing facilities. The guide explains what mistakes can and do happen and how to prevent them from happening to you.

Read more!

about the book about the author Chapter 9: Medications catalogue info

About the Book

How to Survive a Stay in the Hospital Without Getting Killed is an easy-to-understand hospital-survival guide. This handbook explains what kinds of mistakes can and do happen in the hospital and how to prevent them from happening to you. It contains inside information and secrets as told by a nurse who has worked in various hospitals and healthcare facilities in different nursing departments, in two different states, and has "been there and done that." This book will teach you how to protect yourself, from the time you arrive at the Hospital Admissions Office to the time you leave the hospital. The subjects covered include what personal information you'll be asked to provide the hospital, what a routine day in the hospital is like, the importance of not assuming anything, how to prevent being mistaken for another patient, how to talk to the doctor(s) and other healthcare workers, how to prevent medication errors, how to protect yourself from surgical mistakes, and much more. The book also contains an Index, a Glossary of Medical Terms, a Bibliography, and a list of Useful Organizations that can help you with specific problems. This street-smart guide will be useful to patients, would-be patients, and anyone with family, friends or acquaintances they want to protect from medical mistakes or errors.

About the Author

A native New Yorker, Mary Lorrie Davis has been a Licensed Vocational Nurse for 20 years. She has practiced in New York and California in many hospitals, clinics, and nursing homes/facilities. She has been in charge, or supervised, or done bedside care in almost all services.
Ms. Davis has also worked as a performer in New York, and appeared in the Broadway productions of Hair and Bubbling Brown Sugar, among other shows. In 1973, she wrote Letting Down My Hair, about her experiences in the "tribal love rock musical," which was published by Arthur Fields Books. The book is due to be reissued in 2002.
Contact Ms. Davis via email at HospitalBook@earthlink.net

Chapter 9: Medications

Medications
In the hospital, the doctor orders the medication; the pharmacist prepares, dispenses, and sends the order to the floor. The nurse gives it to the patient.
MISTAKES HAPPEN.
I personally discovered only one pharmaceutical mistake, and just recently heard of another one. In the incident I was involved in, the dose on the medication card read one thing, but the actual dose in the packet was twice the amount. I knew this because I'd given the medicine before, and knew there should only be one tablet in the packet, not two. When I pointed this out to the pharmacist, he checked the doctor's order (I already had), took the remaining packets, and put the correct dosage in the patient's medication drawer. When I told the head nurse, she made out an incident report, I made a note on the patient's chart, and the pharmacist had the extra pills. END OF DISCUSSION.
After the doctor writes the order for medicine on the patient's order sheet, the nurse picks up the order, makes out a medication card/computer print-out and sends the order to the pharmacy. The medication card/computer print-out is used by all the nurses to dispense the medicine to the patient. The nurse who picks up the order has to be sure the order is read correctly. Doctors are notorious for their illegible handwriting. To avoid making a mistake, nurses routinely ask the doctors to clarify their orders. By not doing so, the nurse could wind up being charged with criminally negligent homicide, as in the case of three nurses from Colorado. A doctor wrote an order for a baby to receive penicillin and benzathine, 150,000 units, intramuscularly. The pharmacist misread the order and prepared two syringes containing a total of 1,500,000 units--a ten-fold overdose. To spare the child being injected multiple times, two of the nurses researched whether the drug could be given intravenously instead of intramuscularly. Their incorrect conclusion was that it could. (My research showed that this medication should only be given intramuscularly.) That mistake cost the baby its life. The best research they could have done would have been to check with the doctor.
This was a behind-the-scenes incident. The patient and his mom had no control. If the patient hadn't died, no one would have known that it happened if the nurses hadn't reported it.
In the hospital, most patients are on some kind of medication. That's why I feel the chance of an error is greater here than with any other aspect of your care. When an error happens, you might never know, unless...

Someone tells you--which I have yet to see happen.
You have an allergic reaction.
You overdose.
It's life-threatening.
You catch the error.
The person dispensing the medicine to the patient usually makes the error or mistake. It's the wrong patient, the wrong medication, the wrong dosage, or the wrong time. Unless the patient is familiar with the medication, only the person giving it knows an error is made. If that person decides not to report it, who will know? And ethics, honesty, training, title, procedures, and the patient's rights all go out the window.
You don't have to be a pharmacist to monitor your medication. All you need is some inside information.

How you can protect yourself

Before you come to the hospital, make a list of all the medications and/or food supplements you take. The name, the dose, how often and how long you've taken it. Example: Vitamin C, 500 mg., twice a day for four years.
Give a copy of the list to the doctor, and also to the nurse who admits you to the hospital. That way, the doctor can keep you on those medications/supplements he feels you need, and change or discontinue the others. Add to that list all medication, foods, or anything else you're allergic to.
Don't assume that because your private physician knows, the other healthcare workers were also informed.
Do not bring any medicine to the hospital unless your doctor tells you to, and if so, inform the floor nurse.

How medication is given

By mouth (PO) -- taken into the mouth and swallowed
Intramuscular (IM) -- taken into a muscle by injection
Intravenous (IV) -- taken under the skin, into a vein
Epidermal -- applied to the surface of the skin
Subcutaneous -- taken under the skin, by injection
Sublingual -- taken under the tongue
Via an orifice -- taken in through an opening, such as the ears, anus, etc.
You should receive your medication at approximately the same time every day.

Times medicine is given

QD -- every day
BID -- two times a day (morning and evening)
TID -- three times a day (morning, afternoon and evening)
QID -- four times a day (morning, afternoon, evening and night)
Q4H -- every four hours
Q6H -- every six hours
Q12H -- every twelve hours
HS -- hour of sleep
PRN -- when necessary
STAT -- immediately

How to protect yourself from medication errors

With any intravenous (IV) infusion, when the bag/bottle of fluid has about 11/2 to 2 inches of fluid remaining, call the nurse and tell her, "The IV is almost finished." If you wait for the nurse to respond to the alarm, the bag/bottle may be empty. If your blood clots before the nurse adds the additional fluid, you may have to have the IV restarted in another site.
If the IV skin site (where the needle is in your vein) becomes tender, sore, painful, hot, swollen, red, or shows any abnormal signs, call the nurse immediately. The skin is showing signs of irritation, and you may need the site changed and/or treatment to the involved area.
If, during or after you've taken any medication by any route, you feel a need to vomit, or feel sick, headachy, nauseous, dizzy, hyper, depressed, or experience skin irritation, a rash or blotching, you could be having a reaction to the medication. Notify the nurse or your doctor immediately.
Your doctor should tell you the name of the medication(s) ordered, what dosage, and how often you will receive it. If you can't remember the information, write it down, or have the doctor do it.
Ask the doctor to tell you when he/she is making any changes to your medication order.
Buy a guidebook to prescription drugs with pictures to use for reference.

WARNING #8: The first time the nurse brings you your medication, ask its name, the dosage, and how often you'll receive it.
Check your memory or your note pad. Is the nurse's information the same as your doctor's?
WARNING #9: Look at the medicine and check:

How many tablets or capsules
What color -- white, yellow, red, blue, etc.
What shape -- round, oval, square, etc.
How much (if liquid) -- 1/2 cupful, full cup, etc.
How many injections
If you follow this procedure every time you are given your medication, you will avoid mistakes.
What would you do if at approximately 10 a.m. for two days a nurse has given you two small, round, white tablets. On the third day at the same time, a new nurse offers you two small, round tablets, one white and one yellow. THINK. Don't take them. Tell the nurse, "I've received two small, round, white tablets for the last two days. Why are these different?" It could be that your doctor made a change in your medicine without telling you. It could be the same medicine from a different pharmaceutical company. It could be another patient's medicine. It could be that the nurse made a mistake. After the nurse's explanation, you can decide if you need more confirmation, and take the medicine only after you check with your doctor. Or, you can accept the nurse's explanation. I WOULDN'T.
If a nurse brings you medicine that you are not expecting, don't just take it. Make sure it's for you. Don't forget, the most important thing is to get better, not worry about hurting the nurses' feelings because you question them.
Some nurses are going to give you "attitude" if you question them about your medication. Don't take this personally. They'd probably act that way if you asked them, "What time is it?" A real professional would be glad you pointed the difference out to them so that they could doublecheck themselves. On the other hand, don't become a pest. You don't need to ask the same questions about what appears to be the same medicine every time the nurse brings it to you.
Remember

Because of staffing changes, you might not have the same nurse giving you your medicine every time. So always check it before you take it.
If a nurse is giving you your medicine and drops it on the floor, it should be changed. If the nurse tries to give it to you, insist on having it changed. Do I need to tell you, the hospital floor could contain germs you do not want inside your body?
If you find what appears to be medication left on your bedside table or stand (even if it looks like your medicine), DON'T TAKE IT. It's too risky. You don't want to wind up dead, like the patient in New York who drank a glass of highly poisonous chemical mixture known as Zenker's Solution that was left on her nightstand by an inexperienced medical resident.
Remember Warning #5? Assume Nothing. Even though they are not supposed to leave medicine at the bedside, some nurses do. If it happens to you, call the nurse for an explanation, and get new medicine.
Take the medicine when it's given to you. Don't save it. If you are not going to take it, for whatever reason, tell the nurse.
Don't take medicine from anyone except a nurse or a doctor. Many times I've seen nurses hand a patient's medicine to a companion, nurse's aide or even a relative to take to a patient. Not just aspirin or Tylenol, but heart, pain, and bloodpressure medicine, which may need monitoring by the nurse. Non-nursing staff members are not trained to give medication. When your medicine leaves the nurse's hands, it should go directly to you.

Remember
If you have an agreement with your doctor that he or she will not change your medication without telling you, take only what you were told about.

Catalogue Information