On week one of clinical practise unit (CPU) we learned and practised the procedures

of medication administration. Medication administration is not a single task, but a

process, which comprises multiple interconnected tasks, some of which contribute
directly to the act of administering the dose to the patient, and some are defence
barriers against medication administration errors (MAEs). It is therefore important
that multiple components of the medication administration process is measured and
used to evaluate systems-based interventions (McLeod, 2013. p22).
This is a reflection of my experience in the CPU labs, as I was not scheduled for
clinical placement at this time. The reflection is based using the Gibbs cycle of
reflection (1988) (Dempsey, Hillege, & Hill, 2014). It is used to critically reflect on
my experiences whilst practising.
On arrival in the CPU labs, we were asked to form into groups and go to a bedside to
complete the tasks required for the case scenario given, administration of schedule
medication.
I felt very nervous due to being completely unfamiliar of what I was doing in the task
and the minimal knowledge I actually had with regards to medication administration
and the legal requirements, at the same time I felt confident as two peers in the team
(Crisp,Taylor,Douglas,&Rebeiro,2013), were practising Endorsed Enrolled Nurses
(EEN) working in a hospital. Their knowledge and practise methods I believed would
be valuable to me as they would be more familiar with Nursing and Midwifery Board
of Australia (2008), code of professional conduct and code of ethics as well as the
legalities of medication administration, Poisons and Therapeutic Goods Act 1966
(NSW Health, 2013).
Over the lesson we worked together without demonstration from our teacher, any
questions that arose were communicated clearly and effectively and discussed
amongst us (Chang & Daly, 2012). On progression through the lesson and on
discussion with the teacher when she came to our group it was evident that what the
teacher was saying, and what the fellow peers of our team were saying, was different,
which made learning conflicting and confusing for me.
Basing knowledge on peers, who practised this as a part of their job (as EEN not a
RN) seemed positive initially, although this then made me feel it was negative due to
bad habits that these particular students had picked up, leading to short cuts or
workarounds which according to Debono et al., (2013.p2) are observed or
described behaviours that may differ from organisationally prescribed or intended
procedures, which could result in possible medication errors as steps may be missed
in this short cut process.
Learning from the teacher was structured, detailed and methodical in nature, e.g.:
validate order involving all aspects from Drs full printed name and signature to
patient details, allergies, order of generic name, dose, route, time, frequency and
indication for the medication as well as the incorporation of the five rights and three
checks, in comparison to my peers which skimmed over the importance of the
validated order as a legal requirement under Poisons and Therapeutic Goods Act
(1966) (NSW Health, 2013), and gave different input to the five rights and three
checks.

Conflicts of what happens in the hospital - daily practise of my peers - and what the
teacher informed us was correct just caused me confusion as I had already accepted
the statements from the peers.
On analysis of the experience, more preparation and research could have been
undertaken by me to become familiar with legal requirements and competencies
required, rather than relying of teammates just because they work in the industry.
Also, with regard to this, they work as EENs therefore their rights and
responsibilities differ to those of a RN (NMBA, 2010). The teacher should have been
the only one to guide me when queries and concerns were raised, to ensure my work
adheres to correct practise.
As a student soon to be on clinical placement, I would become familiar and confident
with the rules and regulations of the NMBA (2008) and poisons act (1966) (NSW
Health, 2013) and do what is expected of me as a second year student nurse
(administer oral, IM, SD, SC and rectal medication to adults only under direct
supervision of RN, as well as Schedule 8, administration of blood products and
management of IV only according to hospital policy). In the long-term future I would
adhere and practise facility protocol on the administration of medication. As stated by
Cheragi, Manoocheri, Mohammadnejad, & Ehsani, (2013) pp7-8, execution of
medical orders is an important part of the healing process and patient care, it is also
the main component of nursing performance which has a prominent role in patient
safety. Giving medicine is one of the most critical duties as a nurse and since errors
may be unintended can cause serious consequences for the patient.
Becoming familiar and confident with medication administration from the right
source (not peers and colleagues) ensures I am abiding by NMBA (2008)(2010)
national competency standards. By undertaking correct procedures from the right
channels and not letting others knowledge and habits influence me, protects me as a
skilled, professional, practising RN and maximises good outcomes for patients.