By Jennifer Decker Arevalo, MA, contributor
As more patients are taking multiple drugs at any given time, pharmacology has become a major concern with both student nurses and experienced nurses. In fact, NCLEX-RN has increased the pharmacology content on the exam and The Joint Commission came out with its patient care set of standards.
To accelerate the learning approach to understanding pharmacology and retaining pharmacology information, Loretta Manning, MSN, RN, CS, GNP, decided to help nursing students discover how simple and fun it can be. She published a book, Pharmacology Made Insanely Easy, with co-author Sylvia Rayfield, MN, RN, CNS.
“A large number of nursing students are predominately visual learners,” said Manning, who is the executive officer of I CAN Publishing in Louisiana. “We know that they are very structured, want quick outcomes and want to know the bottom line. As a facilitator, my job is to give them structure and show them how to use it.
Fun, graphic images that correspond with mnemonics, acronyms, storytelling and familiar songs are some of the active processing strategies that help learners visualize the book and make picture links to the context. Favorites include “CEF the Giant” about cephalosporin, the “Amino Mice” with their ‘mycin’ derivatives and “Lizzy Diggy” about cardiovascular agents.
“Too often students are ‘turned off’ or overwhelmed by pharmacology textbooks because of the huge number of different drugs to learn," Manning said. "By using the accelerated learning approach and focusing on the minimal standards set forth by The Joint Commission, which reflect NCLEX-RN, I have given the readers or participants a vehicle by which to reach their destination, that is, remembering which drugs are most important, whether for the classroom or clinical situation.”
Manning added that one of her slides said it all: “REMEMBER!!! It’s not what you KNOW, but what you REMEMBER that counts!’”
As an example, the authors reinforce the use of mnemonic devices, such as “AID.”
Action of drugs/Assessment/Adverse effects.
Identify priority plan/Intervention.
Desired outcome from the drug/Discharge teaching that must be done with the patient.
Manning said that in her experience, students do much better spending less time on rote drug memorization and more time on how to make good clinical decisions, with the intent that nurses would be able to minimize medication errors, while optimizing their skills in leading medication administration.
To inspire nurses to envision themselves as leaders of medication administration and patient care, Manning uses another mnemonic – the “seven Cs.”
C – Collegiality (collaboration with other disciplines).
C – Commitment to developing nurse leasers who initiate safe and effective medication administration.
C – Care for the patient.
C – Critical thinking skills and the ability to make clinical decisions.
C – Courage to speak up and share assessment findings with the physician or provider of care.
C – Confidence.
C – Communication about the situation.
“I want to increase not only their confidence, but also their courage to speak up,” she said. “A critical thinker who doesn’t communicate is ineffective. Too often tough, unnecessary challenges may result.” She said that giving students, both novice and experienced, the visual links and structure to remember the pharmacologic knowledge will strengthen their courage to ask questions and make better clinical decisions.
“I think technology is an excellent tool to help health care providers remember pharmacology, but it is only as good as the critical thinker behind it,” continued Manning. “As nurses, we must be able to integrate the differences between high tech, high touch and high think; that is, be knowledgeable about the information provided via technology, but also experts at assessing the patient on a one-to-one basis.
"Ultimately, I would like to see this program integrated into the nursing school curriculum,” added Manning, who presented this topic at the National Student Nurses’ Association (NSNA) Annual Convention in April. “If we can get students into the habit of understanding the minimum standards of pharmacology and the administration of medications while they are in school, then this will successfully carry over into their clinical practice and may help to reduce hospital medication errors.”
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