Student reflection on learning and development
Adult nursing students must learn how to manage medications effectively to provide patients with safe care. According to the NHS, medicine management is the evidence-based practice of prescription medications that balance the treatment’s efficacy, tolerability, cost, safety, and ease of use. My experience managing medications in the Acute A and E departments was the basis for my reflection. Medication administration is crucial for patient care, especially in an emergency. As a student nurse, I learned the importance of understanding the ten rights of medication administration to meet these standards. The NMC2018 emphasises the need for explicit knowledge and skills in this area.
Medication rounds are conducted daily in the A and E departments, and I was progressively given greater responsibilities as my placement continued. I was given two cubicles in majors for the day under supervision, and at the end of my shift, I had administered six patients’ medications. I began participating in medication administration for my first two elderly patients who had had falls (Most major patients do not stay long and are moved as beds become available in the ward). My supervisor took advantage of these medication rounds as a teaching opportunity and asked me several questions about the medications being given, including their intended use and potential adverse effects, supervising me in providing patients with the right medicine with the correct dose. Check any health issues in patients after the medicine administration and maintain track of the correct drug dose administered to the patient at the proper time.
Effective communication and knowledge of pharmacology are crucial in medication administration, as patients often have questions or concerns. I reviewed and applied the pharmacology module by focusing on medicinal benefits and potential side effects. The patients were prescribed medications like morphine, paracetamol, ibuprofen, insulin, and ramipril. Morphine is an analgesic drug used to manage moderate to severe pain. Morphine acts on the receptors in the central nervous system, binding to pain transmission and increasing pain tolerance. Common side effects are nausea, vomiting, constipation, and drowsiness, and they can be addictive because there are control drugs that two registered nurses must sign before I can give them to the patients. On the other hand, paracetamol is administered to control the fever in the patients when they need it (PRN). As with all medications, there are different ways of medicine administration that I learned through this medication round. These ways are intravenous, intramuscular, infusion, intrathecal, subcutaneous and epidural processes.
One of my first patients was transferred to the ward in the afternoon, and I had a new patient from Resus. The patients had mental health issues and often struggled to follow medication regimens, requiring a careful balance between autonomy and safety, especially when I had to administer insulin. Mastering safe subcutaneous insulin injection techniques is crucial for this particular patient as safety and minimising needle stick injuries are vital. Neglecting these skills can lead to severe outcomes like inflammation, skin infections, sepsis, and skin lesions. In addition, adhering to trust protocols is crucial before administering any drug. Before any drug administration, I prioritised patient safety and professional integrity, focusing on individualised medical treatment demands.
In medicine management, there are some challenges that students can face, which can affect their progress in their course. The risk factors include insufficient skills and knowledge, training and skill development opportunities within the placement area, and ineffective communication between student nurses and healthcare professionals. Overall, this experience was a vital component of my nursing education. It has improved my medicine administration abilities, knowledge, and understanding of the A and E departments. It has helped me highlight the successful implementation of medication management within person-centred care to enhance the patient care experience.