March 27, 2008
One of the more annoying things that I think all nurses working in hospitals must do is fill out the Medication Reconciliation form. It's a list of all the medications, OTC, herbals, vitamins, etc. that a patient takes. It's not so hard in OB because the majority of women having babies are healthy, and most aren't taking much more than iron and a vitamin. I can't even imagine the headache on the medical floors. When I worked ICU step-down, those people sometimes were on a dozen meds or more. But, anyway, we ask every patient who comes in what they are taking. I always ask what meds, vitamins, inhalers, OTC pills, because some people would forget about OTC Zantac, or their inhaler they carry just in case. But this past weekend, I had at least 3 patients forget about something they were taking. The worst one was a girl who came in about 32 weeks, not laboring but for spotting. She had been a regular visitor for the last month or so. So I start going through the long list of questions we ask everyone each time they come in and I got to the med rec. part. "Any meds?" She says no. Okay, so we continue on. We get to the health history part and I ask about asthma. She says, "Yes". Me: "any past medications, ever been hospitalized, any inhalers?: "Yeah, I have an Advair inhaler I use everyday." "Okay, that's a medication, so I'll put that on the sheet." So I go back to the med page and jot that down. Moving on, I get to thyroid dysfunction. She says "They put me on synthroid everyday, but I'm not sure if I'm hypo or hyper." I say "Okay, that's a medication also." I grumble under my breath but maintain a smile. I get to blood disorders/anemia. She says "Yes, I take iron twice a day". As I grit my teeth and smile, I say "Well, I'll add that as well to your list of regular meds/vitamins. Do you happen to take a prenatal vitamin?" To which she says "Yes". After the history portion, I do the assessment, in which I eventually ask if she has heartburn. Her mother pipes up and says "Yes, she takes Zantac every night". At this point I'm pounding my head against the monitor. I understand that coming to L&D is stressful, but damn. That's why I give every possible option when I first ask about meds. Most people just forget about the prenatal vitamin, but usually remember daily medications. It is a minor inconvenience, yes, but still a bit annoying.