When learning to administer medications, nursing students are expected to learn and apply knowledge about the medications. Healthcare is a whole new world with habits, words and processes unknown to the usual population. The expected activity and associated responsibility of being a nurse is not understood by nursing students or the general public.
It is hard to learn, understand and apply knowledge presented in a foreign tongue, however, nursing instructors expect students to know what it means to "be in a drug category," which side effects are likely, what delivery routes are available, what the expected outcomes are, and what these medications are supposed to cause in the patient receiving them.
During my role as a staff educator within a small community hospital, an area identified as needing improvement during patient surveys was the information provided about medications. Some nursing staff members shared the medication name and why it was being used; others discussed the route and some typical side effects. How could we make the information consistent among all staff members?
Acronyms and association always helped me, so I devised the NURSE medication acronym to encourage consistent medication education to patients from registered nurses. Later, I was able to adapt the acronym to students within a nursing program.
Use of the acronym N-U-R-S-E goes as follows:
N = name of the medication or generic compound
U = why the medication is used
R = what route is being used to administer the medication. If by mouth, associated requirements such as with food, on an empty stomach, do not chew or crush.
S = possible side effects
E = what effects are expected through the use of this medication (i.e., improved breathing, reduced swelling in the legs, or a decrease in cough).
Some of the staff nurses who were introduced to the N-U-R-S-E acronym identified it as a useful tool to organize information necessary to share with patients. They said it reduced omissions of data that patients need to prevent or minimize untoward effects and poor outcomes.
During clinical rotations, first-year nursing students have shared with me their difficulty remembering information about the medications they were administering. Some admitted to using index cards in various colors to help keep things straight. Others had no idea what they should remember, nor did they know a method to use the information practically. The students struggled to remember the information in a useful order. Their answers were disjointed. They were unable to identify the necessary points of the medications as required.
To the same acronym, I added the letter C to represent the category of medication.
Here is an example of how to use C-N-U-R-S-E when discussing furosemide:
C = loop diuretic
N = lasix/furosemide
U = rids the body of excess water and improves breathing
R = by mouth
S = increased urination, reduced potassium levels and associated effects (e.g., low blood pressure, dizziness)
E = increased excretion of sodium and water in distal tubules and Loop of Henle.
Here is how a discussion of aspirin would be delivered by a nurse using C-N-U-R-S-E:
C = NSAID, anti-platelet
N = aspirin/salicylic acid
U = prevention of blood clots
R = by mouth
S = stomach upset, bleeding gums, blood in urine
E = reduces the "stickiness" of the platelets so they do not clump and form clots in the vessels of the lower legs.
A final example is the diabetes medication glipizide:
C = sulfonylurea/antidiabetic
N = glipizide/Glucotrol
U = reduces glucose level
R = taken by mouth
S = indigestion, gas, low blood sugar, flushing
E = increases insulin made by the pancreas. n
Lori Steinhart is a member of the medical-surgical nursing faculty at Joseph F. McCloskey School of Nursing at Schuylkill Health in Pottsville, Pa.