A Message from the Director of Medical Development
A medication pass can sometimes feel like one more item on a very long list of responsibilities: review the MAR, prepare the medications, administer them, document, and move on to the next task. But what if we paused for a moment and looked at what is really happening during that interaction?
A patient tells you, “I don’t think this medication is helping.”
Another says, “I’ve been feeling dizzy since I started taking this.”
Someone refuses a medication because they are worried about becoming dependent on it.
Another patient has several medications on their home medication list, but no one is quite sure why they are taking one of them.
These are not simply medication-pass issues. These are opportunities for clinical assessment, education, advocacy, and intervention.
Imagine a patient admitted to our facility taking several medications. During medication reconciliation, the nurse discovers that the patient has been taking a medication differently than prescribed and recently stopped another medication altogether. That information matters.
It may lead to questions about withdrawal symptoms, potential interactions, treatment effectiveness, adherence, or whether the patient's medication regimen needs to be reassessed. The nurse who asks one additional question may uncover information that significantly impacts the patient's care. This is why medication management starts before the medication is ever administered.
Giving a medication is only one part of medication management. We also need to consider what happens afterward. Is the patient's anxiety improving? Is withdrawal being appropriately managed? Is the patient sleeping better? Is pain improving? Is the patient experiencing dizziness, excessive sedation, nausea, or another side effect?
Sometimes the most important information isn't found on the MAR. It's found by observing the patient and listening to what they tell us.
Our patients may not always use clinical terminology to describe what they are experiencing. They may simply say, “Something feels different,” or “I don't feel right.” Those statements deserve our attention.
Medication Education Can Change the Course of Treatment. For someone in early recovery, this can be particularly important. Patients may arrive with concerns, misconceptions, previous negative experiences, or fear surrounding medications. Education creates an opportunity to replace uncertainty with understanding. And sometimes, a five-minute conversation can prevent a five-day problem.
Refusal Is Information, Too
When a patient refuses a medication, it is easy to think of it simply as something that needs to be documented. But a refusal can tell us something. Why are they refusing? Are they experiencing a side effect? Do they not understand why they need it? Are they afraid of the medication? Are they feeling better and believe they no longer need it? Are they experiencing cravings, withdrawal, anxiety, or another concern? The refusal itself may be the beginning of an important clinical conversation.
Good medication management depends on good communication.
When we communicate clearly and promptly, we give the entire treatment team a better picture of the patient. And sometimes, a small observation from one staff member is exactly what is needed to prevent a larger problem.
At the end of the day, medication management isn't really about medications. It's about people. Every medication has a purpose. Every patient has a story. And every interaction gives us another opportunity to understand that story a little better. So the next time you are completing a medication pass, consider taking an extra moment to ask yourself:
Is this medication appropriate for this patient?
Is it achieving the intended outcome?
Is the patient experiencing any concerns or side effects?
Does the patient understand what they are taking and why?
Is there anything I need to communicate to the treatment team?
Those questions transform medication administration into something much more meaningful.
Medication management is not simply about making sure a patient receives the right medication at the right time. It is about making sure the medication is appropriate, understood, monitored, and integrated into the patient's overall plan of care.
That is the difference between simply passing medications and truly managing medications. The medication pass may take minutes. The impact of how we manage that medication can last much longer.
Thank you to our medical team for the many details you manage every day—especially the ones that may never be noticed but make an enormous difference in patient safety and recovery.
What we do matters. And how we do it matters even more.