Oops, Now What?

In a previous post, I recommended using a MAR,( Medication Administration Record) to ensure proper  completion of your prescription . Hopefully the MAR will prompt you  to take all of your medication as prescribed, but sometimes the MAR cues you that a dose has been missed.

How to proceed after discovering you missed a dose of medication is one of the FAQ’s prone to show up in my text messages.   Very often the question refers to a missed dose of antibiotic. A MAR is very helpful for determining the best course of correction.

When I miss a dose of antibiotic, I handle the situation this way.  If the missed dose is discovered , and it’s 4 hrs or more until the next dose, I take the missed one immedieately, then resume the normal schedule.  If the error is discovered when  it’s less than 4 hours until the next dose, I  take the next scheduled  dose a little early, then resume the proper schedule. If I  opt to skip the missed dose, and  move on,  I  create an extra box on my  MAR, and take  the skipped the dose as the  new final dose.  The goal is not to  have any partially completed bottles of antibiotics in my cupboard!

The course  of action may vary with different types of medication. A good habit to develop is to ask your provider  what to do if a dose is accidentally omitted.  Pharmacists are also excellent resources for information about medications.

For best results,  try and take your medications just like you provider recommended. Poppet finished all of her antibiotic, and is feeling fine !

I plan to follow the medication theme, antibiotics in particular in my next post. Please check in for more information on  antibiotic why, when and hows !

I’ll Ask Wendy, She’s a Nurse

My family has learned not to cast a  casual glance over my shoulder when my phone dings.  The reason- often someone has just decided,  I’ll ask Wendy, she’s a nurse. Yes, the smartphone has revolutionized opportunities to ask a nurse.  And the best part is often  the message is accompanied by a photo.  It’s a normal day  when I open a text message and view a rash,  a body fluid, a laceration or a  contusion, generally accompanied by the  caption, “I am sorry to bother you, but what do you think I should do about this?”

After  I eliminate “call 911”, I generally fire off a few questions.  Then I do my best to advise what I would do it were me, or my loved one, based on  experience as an  EMT/RN who has seen a few things.  Fairly often I view a picture on my phone and recommend a trip to a clinic or hospital. Also, fairly often, I suggest some basic nursing interventions. Many times  equally  good results can be achieved without leaving home, saving you co-pays and time as well.

Truth time. Not that I wish illness or injury upon anyone, but when the inevitable occurs, I am always happy to eyeball a photo, ask questions  and make suggestions, and my family and friends know it.  If you happen to know a nurse who is like me, I think you would do well to tap into his/her  wisdom and experience. Additionally,  often a nurse is an excellent resource when it comes to choosing a physician.  A word of caution is merited here though, it is crucial that you obtain consent  before you drop a photo of phlegm, into your nurse friends smartphone!

Stay tuned, because very soon I’ll share my answer to what to do when you miss a dose of medication. And in the future I’ll share some of the faq’s I receive, but don’t worry I’ll use discretion when posting the accompanying photo!



Consider a Career In Nursing

At ten years old , I admired my  teachers, and made up my mind I too,  would become an elementary school teacher.

After high school I pursued  my childhood plan, and enrolled in the education program at North Adams State College. Lacking significant merit scholarships and  wealth, I supported myself working as a certified nursing assistant, and commuted to college.  Juggling work and school were challenging, but I persevered for a couple of years, until student teaching was near at hand. At this time I  began to doubt my career choice. My first two years of college  revealed to me how little I actually knew.  What if a student asked a question about geography, or science, or politics and I didn’t know the answer? I feared I would not be a good teacher.

In contrast, working as a nursing assistant increased my confidence that I possessed skills useful to an RN.  A few applications later, I was enrolled in an RN program.  Yes, this was the right path for me.

I  soon learned graduation from  RN school  is more a beginning than an ending. Licensure is the necessary credential to explore  countless employment opportunities. It is true that  entry level shifts and  supervisors may not be the kindest, but I dare say this isn’t unique to nursing.  As experience accumulates, so do opportunities to specialize and find your own perfect nursing  niche.

Ultimately nurses training  is a very useful life skill to have. Most of us will need to access the healthcare system in our lifetime, and it helps to be, or to know an insider.

Without hesitation,  I recommend considering  a career  in nursing, for yourself, your spouse or your children. If it’s the right fit, you’ll be employable, useful,  and mobile!  You will meet so many interesting people, and helping a fellow human is a fulfilling vocation. At minimum your loved ones will have access to their own personal nurse.

Please check back soon, because I have many tips to share about creating a healthy, well stocked home, for wellness and healing.








Poppet’s MAR

Do any of you have family members taking medication? My family is generally healthy, but even so, more often than not someone is trying to complete a course of medication.

As a hospital nurse, I was obsessed with proper medication administration. I faithfully documented medication every time I administered it. This seemed to be an important habit to adopt at home, so I made a simple MAR for family use.

MAR is short for Medication Administration Record. And nurses called it that long before  the texting language of lol and btw arrived on the scene!

My favorite way to make a home medication record is on an index card. As I prepared to write this post, Poppet very obligingly developed a urinary tract infection, requiring a course of antibiotics. So, I have a nice current MAR for you.   Basically, the MAR includes her name at the top, the dose and frequency of the medication, and the duration of the script. Spaces are created for initialing doses as administered.

 I tack this card up in plain sight, usually attached by magnet to one of my cast iron pans. You might tape your MAR to your refrigerator, place it near the medication bottle, or tuck it under a clear placemat at your seat at the table. Put it where you can’t miss it. Once a patient begins to feel better, the medication is at risk for being forgotten. Depending on the medication, a variety of complications may occur if the course isn’t completed, including development of resistant strains of bacteria and even a relapse of illness. 

Now you know what a MAR is. Are you curious about Poppet? She’s our precocious ten month old Golden Retriever. She sports a perpetual smile and a powerful tail wag making our home a bit chaotic and a lot happier. Many people ask about her name, sometimes mistaking her as “Puppet”, believe me she is no puppet ! Here is the back story on her name.

Last summer we downloaded the audio book , “The Night Circus”. In the novel we liked the  character “Poppet” , a young girl who was part of the circus.  The way Jim Dale pronounced “Poppet” in his crisp British accent, made the name all the more delightful. As we pondered dog names, we looked up the definition of poppet. Poppet is defined as a sweet young girl, or a term of endearment, also poppet  sometimes refers to a child’s dolly. Certainly this name fit our puppy perfectly.

I asked her permission to publish her MAR, and she smiled and wagged approval. Although this MAR is intended for two legged family members, it is also great to assure our four legged members have the benefits of proper medication administration too!

There’s a Nurse in the House

Back in Y2K, pregnant with my fourth child, I made a radical choice, (radical for me that is). I resigned my full-time position as a nurse, and became a stay-at-home mom.  I considered it an extended maternity leave, that sounded much better to me than “homemaker” when filling out forms !

In fact, our family shifted gears completely in 2000. We moved to a small farm, grew and sold vegetables and eggs, sawed wood for the massive outdoor wood furnace, and sometimes herded our neighbor’s lost sheep back home. Between growing, harvesting and herding, we homeschooled.  The three  obvious “homes”  of 2000 were  home business, homeschool, and  stay-at home-mom. The fourth “home” was subtle, “Home RN”. The homestead life style, five children and a husband provided ample opportunity for me to keep up my nursing skills. Broken bones, crushed digits and lacerations abounded. Flu, Otitis Media, Gallstones, and Aortic Stenosis lurked in the shadows. Actually, I never stopped being a nurse, I just learned to use my skills at home and more creatively.

For 25 years now, my RN  skills have been incredibly useful  for me, my family,  friends, and even our pets.  My youngest child is now 15. I sense maternity leave may be wrapping up soon. I don’t know precisely what my future holds next, but I am excited about it. As I sort it out, it has occurred to me that I can share some of the ways I was a “Home RN”. I may even have a few stories to tell as I share how your family can have  “A Nurse in the House “.