SlideShare a Scribd company logo
Transcribing
Doctor’s
Order
By: Pamela M. Veroy RN, MAN
CARRYING OUT OF MEDICAL ORDER:
Objective: To be able to interpret intelligently doctor’s
order
Scope: This work instruction is to be done by a nurse
Medical Order – an order (written or verbal) made by
the physician pertaining care or management.
Work Instructions Detail:
1. Transcribes medical order to nursing Kardex.
2. Fills up instruction sheet, medication cards or ticket
and appropriate forms for laboratory and diagnostic
requests.
CARRYING OUT OF MEDICAL
ORDER:
1. If the nurse have any doubt regarding the
medical order, she will clarify it with the
attending physician who made the order.
2. Affix initials including date and time below it
has been carried out already.
How to interpret drug orders?
Make sure that the 5 rights are there in the
doctor’s order.
- right name of the drug
- right name of patient
- right dosage
- right time, frequency
- right route by w/c the drug
administered
Example 1:Procan SR 500 mg p.o. q. 6 h
1. Procan SR is the brand name of the
drug
2. 500 mg is the dosage
3. p.o. is the route
4. q. 6h is the frequency
This order means; Give 200 milligrams of
Procan SR orally every 6 hours.
How to interpret drug orders?
Example 2:Dilantin 100 mg p.o. t.i.d.
Read:___________________________________
_____
Example 3: procaine penicillin G 400,000 U IM
q.6h
Read:___________________________________
_____
Example 4: Demerol 75 mg IM q.4h, pain;
Read:__________________________________
Example 5: Pen-vee K 1 g p.o. 1h pre-op dental
surgery
Read:__________________________________
Other Doctor’s order for treatment:
1. 2/3 strength solution Ensure. Give 90 ml qh
for 5 hours via NG tube.
Read:___________________________________
____________________________________
2. 5/8 strength solution Isomil 36 ml via NG tube
hourly for 8 feedings.
Read:___________________________________
____________________________________
3. Acetaminophen 240 mg. p.o. q4-6h p.r.n.,
pain or T>38⁰C.
Read:___________________________________
____________________________________
3 Common Errors in Transcribing Medication
1. Incorrect interpretation of order due to
misunderstanding of traditional time.
• SITUATION:
• A physician ordered a mild sedative for an anxious Patient
who is scheduled for a colonoscopy in the morning. The
order read “Valium 5 mg orally at 6:00 x 1 dose.”
• The evening nurse interpreted that single dose order to be
scheduled for 6 o’clock PM along with the enema to be
given to the patient.
• The doctor meant for the Valium to be given at 6 o’clock AM
to help the patient relax prior to the actual test.
• 2. Failing to clarify incomplete orders.
• SITUATION:
• Suppose a physician ordered Pepcid tablet p.o. h.s. for a
patient with an active duodenal ulcer. You will note there Is
no dosage listed.
• The nurse thought the dosage came in only one strength,
added 20 mg to the order, and sent it to the pharmacy. The
pharmacist prepared the dosage written on the physician’s
order sheet.
• Two days later, during rounds, the physician noted that the
patient had not responded well to the Pepcid. When ask
about the Pepcid, the nurse explained that the patient had
received 20 mg at bedtime. The physician informed the nurse
that the patient should have received the 40 mg. tablet.
• 3. Not checking the correct dosage.
• SITUATION:
• A nurse flushed a triple central venous catheter (an
IV with three ports). According to hospital policy, the
nurse was to flush each port with 10 ml of normal
saline followed by 2 ml of heparin flush solution in
the concentration of 100 units/ml.
• The nurse mistakenly picked up a vial of heparin
containing 10,000 units/ml. Without checking the
label she prepared the label with all three ports. The
patient received 60,000 units of heparin instead of
600 units.
Critical Thinking Analysis
Reading the labels of
medications is critical, Make
sure that the drug you want is
what you have or hand before
you prepare it.
COLOR CODING OF MEDICINE TICKETS
COLOR FREQUENCY TIME
WHITE O.D. / STAT
PINK BID
YELLOW TID
BLUE QID/EVERY 4
HOURS
GREEN EVERY 6 HOURS
RED EVERY 8 HOURS
ORANGE PRN
HS
6-6/12-12
6-12-6
6-10-2-6
6-10-2-6-10-2
6-12-6-12
6-2-10
9 PM
MEDICINE TICKET
Objective: To be able to guide the nurse to follow the
doctor’s written order indication the drug to be given
the frequency of doses the amount of each dose and
the method of administration.
Scope:1. name of patient 5. name of drugs
2. age 6. route
3. room no. 7. time frequency
4. date 8. doses
(doctors’ name, NOD signature)
SAMPLE OF MEDICINE TICKET
MEDICINE TICKET
Date:_________________ Rm no.______ Bed no.______
Name:______________________________________
Drugs
Ordered:______________________________________________
____________________________________________________ .
Dosage:___________________________________________
Frequency:________________________________________
Route:___________________________
Dr:________________ NOD Sig.:_______________
Give me the color code….
Example:
1. Lasix 40 mg. IM stat --------------------
2. Motrin 600 mg. p.o. b.i.d. ------------
3. Tranxene 7.5 mg p.o. q.i.d. -----------
4. Tylenol w/ codeine gr. I p.o.
q. 4h p.r.n. for pain ---------------------
5. Inderal 50 mg. p.o. t.i.d. --------------
6. Amoxicillin susp. 100mg p.o.
q. 6 hrs. ------------------------------------
7. Oxacillin sodium 0.25 g p.o. q. 8 hrs-
Sample of Medication Sheet – MMGH
MEDICATION SHEET
NAME: ___________________ Room:_________ Bed No:_______ Chart No.:______
NURSE’ FULL NAME/SPECIMEN SIGNATURE
Date Medication &
Treatment
Freq
PRN
STA
T
SAMPLE DOCTORS’ SHEET
_____________________________________________________________________
First Name Given Name M.I.
WARD:_________ROOM NO._______BED NO._______PHYSICIAN_________________
______________________________________________________________________
Date and Time: Time Remarks:
Ordered: Signature: ______
PROGRESS NOTES DOCTOR’S ORDER
SAMPLE DOCTORS’ SHEET
_Panduco Pedro__________________________P.____________
Last Name Given Name M.I.
WARD:_Wing A_ROOM NO. 212 BED NO._2__PHYSICIAN__Dr. Roberto de la Cruz_
______________________________________________________________________
Date and Time: Time Remarks:
Ordered: Signature: _____
PROGRESS NOTES DOCTOR’S ORDER
7-04-2008 - Give Lasix 40 mg. I.M. stat
(+) edema lower - Start Motrin 600 mg. p.o. b.i.d.
extremities ¥æ€
(+) rales on boths Dr. de la Cruz
Lungs; RR-26/min; BP 110/80 2:45 p.m.
7-05-08 - Tylenol w/ codeine gr. I p.o. q. 4h p.r.n. for pain
Complaint of headache ¥æ€
5:30 p.m. Dr. de la Cruz
Example: Transcribing Doctors’ Order in Medication Sheet
MEDICATION SHEET
NAME: _Penduco, Pedro__ Room:_212_ Bed No:_2_ Chart No.:_000123_
NURSE’ FULL NAME/SPECIMEN SIGNATURE
Date Medication &
Treatment
Freq 4 5 6
7-4-08 Motrin 600 mg. p.o. b.i.d. 6 ffl
6 ffl
7-5-08 Tylenol w/ codeine gr. I p.o. PRN
q. 4h p.r.n. for pain 6pm ffl
STAT
7-4-08 Lasix 40 mg. I.M. stat 3 pm ffl
ffl - Florence Nightale RN
SAMPLE OF DOCTORS’ SHEET
Panduco Pedro__________________________P.____________
Last Name Given Name M.I.
WARD:_Wing A_ROOM NO. 212 BED NO._2__PHYSICIAN__Dr. Roberto de la Cruz_
______________________________________________________________________
Date and Time: Time Remarks:
Ordered: Signature: _____
PROGRESS NOTES DOCTOR’S ORDER
7-06-08 - Tranxene 7.5 mg p.o. q.i.d.
Leukocytes –CBC result - Oxacillin sodium 0.5 g p.o. q. 8 hrs-
- D/C Motrin ¥æ€
9:30 a.m. Dr. de la Cruz
Example: Transcribing Doctors’ Order in Medication Sheet
MEDICATION SHEET
NAME: ___________________ Room:_________ Bed No:_______ Chart No.:______
NURSE’ FULL NAME/SPECIMEN SIGNATURE
Date Medication &
Treatment
Freq 4 5 6
7-4-08 Motrin 600 mg. p.o. b.i.d. 6 ffl D C 7-6
6 ffl
7-5-08 Tylenol w/ codeine gr. I p.o. PRN
q. 4h p.r.n. for pain 6pm ffl
STA
T
7-4-08 Lasix 40 mg. I.M. stat 3 pm ffl
ffl - Florence Nightale RN
Example: Transcribing Doctors’ Order in Medication Sheet
MEDICATION SHEET
NAME: ___________________ Room:_________ Bed No:_______ Chart No.:______
NURSE’ FULL NAME/SPECIMEN SIGNATURE
Date Medication &
Treatment
Freq 6 7 8
7-06 Tranxene 7.5 mg p.o. q.i.d. 6
10 ffl
2 ffl
6
Oxacillin sodium 0.5 g p.o. q. 8 hrs 6
2 ffl
10
ffl - Florence Nightale RN
SAMPLE OF DOCTORS’ SHEET
Panduco Pedro__________________________P.____________
Last Name Given Name M.I.
WARD:_Wing A_ROOM NO. 212 BED NO._2__PHYSICIAN__Dr. Roberto de la Cruz_
______________________________________________________________________
Date and Time: Time Remarks:
Ordered: Signature: _____
PROGRESS NOTES DOCTOR’S ORDER
7-06-08 - Tranxene 7.5 mg p.o. q.i.d.
Leukocytes –CBC result - Oxacillin sodium 0.5 g p.o. q. 8 hrs-
- D/C Motrin ¥æ€
9:30 a.m. Dr. de la Cruz
7-07-08 - Continue Oxacillin 0.5 g p.o. q8h for 4 doses and D/C
¥æ€
12:30 a.m. Dr. de la Cruz
Example: Transcribing Doctors’ Order in Medication Sheet
MEDICATION SHEET
NAME: ___________________ Room:_________ Bed No:_______ Chart No.:______
NURSE’ FULL NAME/SPECIMEN SIGNATURE
Date Medication &
Treatment
Freq 6 7 8
7-06 Tranxene 7.5 mg p.o. q.i.d. 6 ffl
10 ffl ffl
2 ffl
6 ffl
Oxacillin sodium 0.5 g p.o. q. 8 hrs 6 ffl
1 – 2 – 3 - 4 2 ffl ffl
10 ffl
ffl - Florence Nightale RN
SAMPLE FORMAT OF MEDICINE TICKET-MMGH
Room No. ________________ Date:_______________
Name:_____________________________ Age:______________
Order:_________________________________________________________
Route: ________________________________________
Frequency:____________________________________________
Dr.___________________________ Sig.__________________________
SAMPLE FORMAT OF MEDICINE TICKET
Room No. ________________
Name:_________________________________________________________
Room No.______________________ Bed No._______________________
Drug:__________________________________________________________
Dosage/Freq:____________________________________________________
Route:________________________ NOD:_________________________
SAMPLE FORMAT OF MEDICINE TICKET-MMGH
Room No. _212-2__ Date:___7-06-08______
Name:___Penduco, Pedro__________ Age:__22_________
Order: __Tranxene 7.5 mg p.o. q.i.d. ____
Route: __per orem_____
Frequency:_______6 – 10 – 2 - 6______________________
Dr._Dr. de la Cruz_______ Sig.___ffl______
SAMPLE FORMAT OF MEDICINE TICKET
Date __7-06-08_____
Name:___Penduco, Pedro__________________________
Room No.__ 212____ Bed No.__2____
Drug:_Amoxicillin susp.100mg p.o. q. 6 hrs._
Dosage/Freq:__6 – 12 -6 - 12________________________
Route:___oral______
NOD:____ffl_________
Irregularities in Transcribing MT
• If the order is PRN with varied time frequencies
• If the order is stat and then with regular time
frequency
• To indicate dosage; you can write – name of drugs,
strength (dosage), time frequency
• Stat order to be administered less than 1 hr. on a
• Medicine ordered with a series of doses should also
write no. of dosage done on the ticket
Example situation
Date __7-06-08_____
Name:___Penduco, Pedro__________________________
Room No.__ 212____ Bed No.__2____
Drug:_Amoxicillin 500mg IVTT q. 6 hrs. x 6 doses_then shift to
p.o.
Dosage/Freq:__6 – 12 -6 - 12__________________
Route:___IVTT______
1-2-3-4-5-6 NOD:____ffl_________
Keys to Remember:
1. Never transcribe doctors’ order in a medicine ticket with
erasures or tampered.
2. Always write legibly, neatly, and correctly.
3. Do not recycle the used medicine ticket. (as much as
possible)
4. A new doctors’ order is a new medicine ticket.
5. Endorsed to your charged nurse the old ticket that has
changed order in; (increase/decrease dosage; route)
6. Do not revise/rephrase what have written in the doctors’
order. Rewrite completely what have written in the order.
7. If in doubt; check your ticket from the doctors’ order sheet
first before in the medication sheet.
8. Arrange your drugs according to their color coding if for 1
patient with lots of drugs in different frequencies/timing.
9. Make an indication/marks on the medicine ticket for stat
orders; to prevent from administering twice.
10. Signing the medication sheet as prompt as possible after
administering/given a due medicines.
11. Do not sign the medication sheet in advance; without
administering the drugs yet. Especially IVTT meds.
12. Always coordinate with the charge nurse with regards to
new orders; new drugs ordered; etc.
13. Be mindful always……
Drugs just like a
sword that has two
sharp edges;
Whether it heals
you, or kill you for
just a minute from
miscalculation.

More Related Content

What's hot

Change A Shift
Change A ShiftChange A Shift
Change A Shiftpreet kaur
 
Issues and problems in nursing
Issues and problems in nursingIssues and problems in nursing
Issues and problems in nursing
Reynel Dan
 
PUBLIC HEALTH NURSING IN THE PHILIPPINES.pptx
PUBLIC HEALTH NURSING IN THE PHILIPPINES.pptxPUBLIC HEALTH NURSING IN THE PHILIPPINES.pptx
PUBLIC HEALTH NURSING IN THE PHILIPPINES.pptx
KathrynDetablan
 
Maternal and child health nursing
Maternal and child health nursingMaternal and child health nursing
Maternal and child health nursing
Ruby Shelah Dunque
 
Fdar charting
Fdar chartingFdar charting
Fdar chartingkataliya
 
Documentation - Case Presentation 2015
Documentation - Case Presentation 2015Documentation - Case Presentation 2015
Documentation - Case Presentation 2015
Rozelle Mae Birador
 
Focus Charting adapted ZCMC Pedia
Focus Charting adapted ZCMC PediaFocus Charting adapted ZCMC Pedia
Focus Charting adapted ZCMC Pedia
iteach 2learn
 
Fdar
FdarFdar
History of Department of Health
History of Department of HealthHistory of Department of Health
Community Health Nursing
Community Health NursingCommunity Health Nursing
Community Health Nursing
RoxanneMae Birador
 
Nursing case study Pre eclampsia
Nursing case study Pre eclampsiaNursing case study Pre eclampsia
Nursing case study Pre eclampsiapinoy nurze
 
Patient's Bill of Rights
Patient's Bill of Rights Patient's Bill of Rights
Family Case Study.pdf
Family Case Study.pdfFamily Case Study.pdf
Family Case Study.pdf
MixcyMabatid
 
99997548 case-study
99997548 case-study99997548 case-study
99997548 case-study
homeworkping7
 
Tips on proper endorsement
Tips on proper endorsementTips on proper endorsement
Tips on proper endorsementchrissie argana
 
Gordons 11 functional pattern (seizure disorder)
Gordons 11 functional pattern (seizure disorder)Gordons 11 functional pattern (seizure disorder)
Gordons 11 functional pattern (seizure disorder)
Reihchelle Bayad
 
NCP Ineffective Infant Feeding Pattern
NCP Ineffective Infant Feeding PatternNCP Ineffective Infant Feeding Pattern
NCP Ineffective Infant Feeding Pattern
Paula Sarmiento
 
Nursing care plan (hypertension)
Nursing care plan (hypertension)Nursing care plan (hypertension)
Nursing care plan (hypertension)
Faye Austero
 

What's hot (20)

Change A Shift
Change A ShiftChange A Shift
Change A Shift
 
Issues and problems in nursing
Issues and problems in nursingIssues and problems in nursing
Issues and problems in nursing
 
PUBLIC HEALTH NURSING IN THE PHILIPPINES.pptx
PUBLIC HEALTH NURSING IN THE PHILIPPINES.pptxPUBLIC HEALTH NURSING IN THE PHILIPPINES.pptx
PUBLIC HEALTH NURSING IN THE PHILIPPINES.pptx
 
Maternal and child health nursing
Maternal and child health nursingMaternal and child health nursing
Maternal and child health nursing
 
Intravenous therapy
Intravenous therapy Intravenous therapy
Intravenous therapy
 
Fdar charting
Fdar chartingFdar charting
Fdar charting
 
Documentation - Case Presentation 2015
Documentation - Case Presentation 2015Documentation - Case Presentation 2015
Documentation - Case Presentation 2015
 
Focus Charting adapted ZCMC Pedia
Focus Charting adapted ZCMC PediaFocus Charting adapted ZCMC Pedia
Focus Charting adapted ZCMC Pedia
 
Fdar
FdarFdar
Fdar
 
History of Department of Health
History of Department of HealthHistory of Department of Health
History of Department of Health
 
Community Health Nursing
Community Health NursingCommunity Health Nursing
Community Health Nursing
 
Nursing case study Pre eclampsia
Nursing case study Pre eclampsiaNursing case study Pre eclampsia
Nursing case study Pre eclampsia
 
Patient's Bill of Rights
Patient's Bill of Rights Patient's Bill of Rights
Patient's Bill of Rights
 
Family Case Study.pdf
Family Case Study.pdfFamily Case Study.pdf
Family Case Study.pdf
 
99997548 case-study
99997548 case-study99997548 case-study
99997548 case-study
 
Tips on proper endorsement
Tips on proper endorsementTips on proper endorsement
Tips on proper endorsement
 
Gordons 11 functional pattern (seizure disorder)
Gordons 11 functional pattern (seizure disorder)Gordons 11 functional pattern (seizure disorder)
Gordons 11 functional pattern (seizure disorder)
 
NCP Ineffective Infant Feeding Pattern
NCP Ineffective Infant Feeding PatternNCP Ineffective Infant Feeding Pattern
NCP Ineffective Infant Feeding Pattern
 
Patient's Bill of Rights
Patient's Bill of RightsPatient's Bill of Rights
Patient's Bill of Rights
 
Nursing care plan (hypertension)
Nursing care plan (hypertension)Nursing care plan (hypertension)
Nursing care plan (hypertension)
 

Similar to Transcribing doctors order

The prescription, An important topic of pharmacy, Pharmaceutics 2nd, Prescrip...
The prescription, An important topic of pharmacy, Pharmaceutics 2nd, Prescrip...The prescription, An important topic of pharmacy, Pharmaceutics 2nd, Prescrip...
The prescription, An important topic of pharmacy, Pharmaceutics 2nd, Prescrip...
RajkumarKumawat11
 
Practical Prescribing Guide
Practical Prescribing GuidePractical Prescribing Guide
Practical Prescribing Guide
SCGH ED CME
 
Criticise rewrite 1
Criticise   rewrite 1Criticise   rewrite 1
Criticise rewrite 1
Archana Dhavalshankh
 
Prescription raman
Prescription ramanPrescription raman
Prescription raman
RAMNIVASRAMAN
 
MEDICATION Rajendra keer
MEDICATION Rajendra keerMEDICATION Rajendra keer
Prescription
PrescriptionPrescription
Prescription
Pallavi Sangave
 
Prescription - Day-2.pptx
Prescription - Day-2.pptxPrescription - Day-2.pptx
Prescription - Day-2.pptx
BasitShafi6
 
pharmacology ospe
pharmacology ospe pharmacology ospe
pharmacology ospe
Ekansh Agarwal
 
Prescription.pdf
Prescription.pdfPrescription.pdf
Prescription.pdf
Dr. Harshil Patel
 
Chapter 5 prescriptions
Chapter 5 prescriptionsChapter 5 prescriptions
Chapter 5 prescriptionsAnn Bentley
 
Prescription
PrescriptionPrescription
Prescription
SantuMistree4
 
Chapter 5 prescriptions
Chapter 5 prescriptionsChapter 5 prescriptions
Chapter 5 prescriptionsrr0006
 
Basic principles of compounding and dispensing (Prescription) MANIK
Basic principles of compounding and dispensing (Prescription) MANIKBasic principles of compounding and dispensing (Prescription) MANIK
Basic principles of compounding and dispensing (Prescription) MANIK
Imran Nur Manik
 
6 rules of drug administration
6 rules of drug administration6 rules of drug administration
6 rules of drug administration
akusoleha
 
prescription.pptx
prescription.pptxprescription.pptx
prescription.pptx
vaishnavigomase1
 
Clinical pharmacy management
Clinical pharmacy management Clinical pharmacy management
Clinical pharmacy management
sandeep chandakavate
 
6rulesofdrugadministration 120322135333-phpapp01
6rulesofdrugadministration 120322135333-phpapp016rulesofdrugadministration 120322135333-phpapp01
6rulesofdrugadministration 120322135333-phpapp01Mesfin Mulugeta
 
Induction Training Nursing.pptx
Induction Training Nursing.pptxInduction Training Nursing.pptx
Induction Training Nursing.pptx
Sushil Mahato(Pharm-D)
 
SBAR report to physician about a critical situation S .docx
SBAR report to physician about a critical situation S .docxSBAR report to physician about a critical situation S .docx
SBAR report to physician about a critical situation S .docx
anhlodge
 

Similar to Transcribing doctors order (20)

The prescription, An important topic of pharmacy, Pharmaceutics 2nd, Prescrip...
The prescription, An important topic of pharmacy, Pharmaceutics 2nd, Prescrip...The prescription, An important topic of pharmacy, Pharmaceutics 2nd, Prescrip...
The prescription, An important topic of pharmacy, Pharmaceutics 2nd, Prescrip...
 
Practical Prescribing Guide
Practical Prescribing GuidePractical Prescribing Guide
Practical Prescribing Guide
 
Criticise rewrite 1
Criticise   rewrite 1Criticise   rewrite 1
Criticise rewrite 1
 
Prescription raman
Prescription ramanPrescription raman
Prescription raman
 
MEDICATION Rajendra keer
MEDICATION Rajendra keerMEDICATION Rajendra keer
MEDICATION Rajendra keer
 
Prescription
PrescriptionPrescription
Prescription
 
Prescription - Day-2.pptx
Prescription - Day-2.pptxPrescription - Day-2.pptx
Prescription - Day-2.pptx
 
pharmacology ospe
pharmacology ospe pharmacology ospe
pharmacology ospe
 
Prescription.pdf
Prescription.pdfPrescription.pdf
Prescription.pdf
 
Chapter 5 prescriptions
Chapter 5 prescriptionsChapter 5 prescriptions
Chapter 5 prescriptions
 
Prescription
PrescriptionPrescription
Prescription
 
Chapter 5 prescriptions
Chapter 5 prescriptionsChapter 5 prescriptions
Chapter 5 prescriptions
 
The prescription
The prescriptionThe prescription
The prescription
 
Basic principles of compounding and dispensing (Prescription) MANIK
Basic principles of compounding and dispensing (Prescription) MANIKBasic principles of compounding and dispensing (Prescription) MANIK
Basic principles of compounding and dispensing (Prescription) MANIK
 
6 rules of drug administration
6 rules of drug administration6 rules of drug administration
6 rules of drug administration
 
prescription.pptx
prescription.pptxprescription.pptx
prescription.pptx
 
Clinical pharmacy management
Clinical pharmacy management Clinical pharmacy management
Clinical pharmacy management
 
6rulesofdrugadministration 120322135333-phpapp01
6rulesofdrugadministration 120322135333-phpapp016rulesofdrugadministration 120322135333-phpapp01
6rulesofdrugadministration 120322135333-phpapp01
 
Induction Training Nursing.pptx
Induction Training Nursing.pptxInduction Training Nursing.pptx
Induction Training Nursing.pptx
 
SBAR report to physician about a critical situation S .docx
SBAR report to physician about a critical situation S .docxSBAR report to physician about a critical situation S .docx
SBAR report to physician about a critical situation S .docx
 

Recently uploaded

labb123456789123456789123456789123456789
labb123456789123456789123456789123456789labb123456789123456789123456789123456789
labb123456789123456789123456789123456789
Ghh
 
How Mentoring Elevates Your PM Career | PMI Silver Spring Chapter
How Mentoring Elevates Your PM Career | PMI Silver Spring ChapterHow Mentoring Elevates Your PM Career | PMI Silver Spring Chapter
How Mentoring Elevates Your PM Career | PMI Silver Spring Chapter
Hector Del Castillo, CPM, CPMM
 
太阳城娱乐-太阳城娱乐推荐-太阳城娱乐官方网站| 立即访问【ac123.net】
太阳城娱乐-太阳城娱乐推荐-太阳城娱乐官方网站| 立即访问【ac123.net】太阳城娱乐-太阳城娱乐推荐-太阳城娱乐官方网站| 立即访问【ac123.net】
太阳城娱乐-太阳城娱乐推荐-太阳城娱乐官方网站| 立即访问【ac123.net】
foismail170
 
Midterm Contract Law and Adminstration.pptx
Midterm Contract Law and Adminstration.pptxMidterm Contract Law and Adminstration.pptx
Midterm Contract Law and Adminstration.pptx
Sheldon Byron
 
How to Master LinkedIn for Career and Business
How to Master LinkedIn for Career and BusinessHow to Master LinkedIn for Career and Business
How to Master LinkedIn for Career and Business
ideatoipo
 
lab.123456789123456789123456789123456789
lab.123456789123456789123456789123456789lab.123456789123456789123456789123456789
lab.123456789123456789123456789123456789
Ghh
 
Interactive Dictionary AIDS-B.pptx aaaaaaaaaaaaaaaaaaaaaaaaaa
Interactive Dictionary AIDS-B.pptx aaaaaaaaaaaaaaaaaaaaaaaaaaInteractive Dictionary AIDS-B.pptx aaaaaaaaaaaaaaaaaaaaaaaaaa
Interactive Dictionary AIDS-B.pptx aaaaaaaaaaaaaaaaaaaaaaaaaa
23211a7274
 
一比一原版(TMU毕业证)多伦多都会大学毕业证如何办理
一比一原版(TMU毕业证)多伦多都会大学毕业证如何办理一比一原版(TMU毕业证)多伦多都会大学毕业证如何办理
一比一原版(TMU毕业证)多伦多都会大学毕业证如何办理
yuhofha
 
欧洲杯投注网站-欧洲杯投注网站推荐-欧洲杯投注网站| 立即访问【ac123.net】
欧洲杯投注网站-欧洲杯投注网站推荐-欧洲杯投注网站| 立即访问【ac123.net】欧洲杯投注网站-欧洲杯投注网站推荐-欧洲杯投注网站| 立即访问【ac123.net】
欧洲杯投注网站-欧洲杯投注网站推荐-欧洲杯投注网站| 立即访问【ac123.net】
foismail170
 
DOC-20240602-WA0001..pdf DOC-20240602-WA0001..pdf
DOC-20240602-WA0001..pdf DOC-20240602-WA0001..pdfDOC-20240602-WA0001..pdf DOC-20240602-WA0001..pdf
DOC-20240602-WA0001..pdf DOC-20240602-WA0001..pdf
Pushpendra Kumar
 
一比一原版(UVic毕业证)维多利亚大学毕业证如何办理
一比一原版(UVic毕业证)维多利亚大学毕业证如何办理一比一原版(UVic毕业证)维多利亚大学毕业证如何办理
一比一原版(UVic毕业证)维多利亚大学毕业证如何办理
pxyhy
 
Luke Royak's Personal Brand Exploration!
Luke Royak's Personal Brand Exploration!Luke Royak's Personal Brand Exploration!
Luke Royak's Personal Brand Exploration!
LukeRoyak
 
Brand Identity For A Sportscaster Project and Portfolio I
Brand Identity For A Sportscaster Project and Portfolio IBrand Identity For A Sportscaster Project and Portfolio I
Brand Identity For A Sportscaster Project and Portfolio I
thomasaolson2000
 
DIGITAL MARKETING COURSE IN CHENNAI.pptx
DIGITAL MARKETING COURSE IN CHENNAI.pptxDIGITAL MARKETING COURSE IN CHENNAI.pptx
DIGITAL MARKETING COURSE IN CHENNAI.pptx
FarzanaRbcomcs
 
Personal Brand Exploration Comedy Jxnelle.
Personal Brand Exploration Comedy Jxnelle.Personal Brand Exploration Comedy Jxnelle.
Personal Brand Exploration Comedy Jxnelle.
alexthomas971
 
原版制作(RMIT毕业证书)墨尔本皇家理工大学毕业证在读证明一模一样
原版制作(RMIT毕业证书)墨尔本皇家理工大学毕业证在读证明一模一样原版制作(RMIT毕业证书)墨尔本皇家理工大学毕业证在读证明一模一样
原版制作(RMIT毕业证书)墨尔本皇家理工大学毕业证在读证明一模一样
atwvhyhm
 
Exploring Career Paths in Cybersecurity for Technical Communicators
Exploring Career Paths in Cybersecurity for Technical CommunicatorsExploring Career Paths in Cybersecurity for Technical Communicators
Exploring Career Paths in Cybersecurity for Technical Communicators
Ben Woelk, CISSP, CPTC
 
'Guidance and counselling- role of Psychologist in Guidance and Counselling.
'Guidance and counselling- role of Psychologist in Guidance and Counselling.'Guidance and counselling- role of Psychologist in Guidance and Counselling.
'Guidance and counselling- role of Psychologist in Guidance and Counselling.
PaviBangera
 
Resumes, Cover Letters, and Applying Online
Resumes, Cover Letters, and Applying OnlineResumes, Cover Letters, and Applying Online
Resumes, Cover Letters, and Applying Online
Bruce Bennett
 
Digital Marketing Training In Bangalore
Digital  Marketing Training In BangaloreDigital  Marketing Training In Bangalore
Digital Marketing Training In Bangalore
nidm599
 

Recently uploaded (20)

labb123456789123456789123456789123456789
labb123456789123456789123456789123456789labb123456789123456789123456789123456789
labb123456789123456789123456789123456789
 
How Mentoring Elevates Your PM Career | PMI Silver Spring Chapter
How Mentoring Elevates Your PM Career | PMI Silver Spring ChapterHow Mentoring Elevates Your PM Career | PMI Silver Spring Chapter
How Mentoring Elevates Your PM Career | PMI Silver Spring Chapter
 
太阳城娱乐-太阳城娱乐推荐-太阳城娱乐官方网站| 立即访问【ac123.net】
太阳城娱乐-太阳城娱乐推荐-太阳城娱乐官方网站| 立即访问【ac123.net】太阳城娱乐-太阳城娱乐推荐-太阳城娱乐官方网站| 立即访问【ac123.net】
太阳城娱乐-太阳城娱乐推荐-太阳城娱乐官方网站| 立即访问【ac123.net】
 
Midterm Contract Law and Adminstration.pptx
Midterm Contract Law and Adminstration.pptxMidterm Contract Law and Adminstration.pptx
Midterm Contract Law and Adminstration.pptx
 
How to Master LinkedIn for Career and Business
How to Master LinkedIn for Career and BusinessHow to Master LinkedIn for Career and Business
How to Master LinkedIn for Career and Business
 
lab.123456789123456789123456789123456789
lab.123456789123456789123456789123456789lab.123456789123456789123456789123456789
lab.123456789123456789123456789123456789
 
Interactive Dictionary AIDS-B.pptx aaaaaaaaaaaaaaaaaaaaaaaaaa
Interactive Dictionary AIDS-B.pptx aaaaaaaaaaaaaaaaaaaaaaaaaaInteractive Dictionary AIDS-B.pptx aaaaaaaaaaaaaaaaaaaaaaaaaa
Interactive Dictionary AIDS-B.pptx aaaaaaaaaaaaaaaaaaaaaaaaaa
 
一比一原版(TMU毕业证)多伦多都会大学毕业证如何办理
一比一原版(TMU毕业证)多伦多都会大学毕业证如何办理一比一原版(TMU毕业证)多伦多都会大学毕业证如何办理
一比一原版(TMU毕业证)多伦多都会大学毕业证如何办理
 
欧洲杯投注网站-欧洲杯投注网站推荐-欧洲杯投注网站| 立即访问【ac123.net】
欧洲杯投注网站-欧洲杯投注网站推荐-欧洲杯投注网站| 立即访问【ac123.net】欧洲杯投注网站-欧洲杯投注网站推荐-欧洲杯投注网站| 立即访问【ac123.net】
欧洲杯投注网站-欧洲杯投注网站推荐-欧洲杯投注网站| 立即访问【ac123.net】
 
DOC-20240602-WA0001..pdf DOC-20240602-WA0001..pdf
DOC-20240602-WA0001..pdf DOC-20240602-WA0001..pdfDOC-20240602-WA0001..pdf DOC-20240602-WA0001..pdf
DOC-20240602-WA0001..pdf DOC-20240602-WA0001..pdf
 
一比一原版(UVic毕业证)维多利亚大学毕业证如何办理
一比一原版(UVic毕业证)维多利亚大学毕业证如何办理一比一原版(UVic毕业证)维多利亚大学毕业证如何办理
一比一原版(UVic毕业证)维多利亚大学毕业证如何办理
 
Luke Royak's Personal Brand Exploration!
Luke Royak's Personal Brand Exploration!Luke Royak's Personal Brand Exploration!
Luke Royak's Personal Brand Exploration!
 
Brand Identity For A Sportscaster Project and Portfolio I
Brand Identity For A Sportscaster Project and Portfolio IBrand Identity For A Sportscaster Project and Portfolio I
Brand Identity For A Sportscaster Project and Portfolio I
 
DIGITAL MARKETING COURSE IN CHENNAI.pptx
DIGITAL MARKETING COURSE IN CHENNAI.pptxDIGITAL MARKETING COURSE IN CHENNAI.pptx
DIGITAL MARKETING COURSE IN CHENNAI.pptx
 
Personal Brand Exploration Comedy Jxnelle.
Personal Brand Exploration Comedy Jxnelle.Personal Brand Exploration Comedy Jxnelle.
Personal Brand Exploration Comedy Jxnelle.
 
原版制作(RMIT毕业证书)墨尔本皇家理工大学毕业证在读证明一模一样
原版制作(RMIT毕业证书)墨尔本皇家理工大学毕业证在读证明一模一样原版制作(RMIT毕业证书)墨尔本皇家理工大学毕业证在读证明一模一样
原版制作(RMIT毕业证书)墨尔本皇家理工大学毕业证在读证明一模一样
 
Exploring Career Paths in Cybersecurity for Technical Communicators
Exploring Career Paths in Cybersecurity for Technical CommunicatorsExploring Career Paths in Cybersecurity for Technical Communicators
Exploring Career Paths in Cybersecurity for Technical Communicators
 
'Guidance and counselling- role of Psychologist in Guidance and Counselling.
'Guidance and counselling- role of Psychologist in Guidance and Counselling.'Guidance and counselling- role of Psychologist in Guidance and Counselling.
'Guidance and counselling- role of Psychologist in Guidance and Counselling.
 
Resumes, Cover Letters, and Applying Online
Resumes, Cover Letters, and Applying OnlineResumes, Cover Letters, and Applying Online
Resumes, Cover Letters, and Applying Online
 
Digital Marketing Training In Bangalore
Digital  Marketing Training In BangaloreDigital  Marketing Training In Bangalore
Digital Marketing Training In Bangalore
 

Transcribing doctors order

  • 2. CARRYING OUT OF MEDICAL ORDER: Objective: To be able to interpret intelligently doctor’s order Scope: This work instruction is to be done by a nurse Medical Order – an order (written or verbal) made by the physician pertaining care or management. Work Instructions Detail: 1. Transcribes medical order to nursing Kardex. 2. Fills up instruction sheet, medication cards or ticket and appropriate forms for laboratory and diagnostic requests.
  • 3. CARRYING OUT OF MEDICAL ORDER: 1. If the nurse have any doubt regarding the medical order, she will clarify it with the attending physician who made the order. 2. Affix initials including date and time below it has been carried out already.
  • 4. How to interpret drug orders? Make sure that the 5 rights are there in the doctor’s order. - right name of the drug - right name of patient - right dosage - right time, frequency - right route by w/c the drug administered
  • 5. Example 1:Procan SR 500 mg p.o. q. 6 h 1. Procan SR is the brand name of the drug 2. 500 mg is the dosage 3. p.o. is the route 4. q. 6h is the frequency This order means; Give 200 milligrams of Procan SR orally every 6 hours.
  • 6. How to interpret drug orders? Example 2:Dilantin 100 mg p.o. t.i.d. Read:___________________________________ _____ Example 3: procaine penicillin G 400,000 U IM q.6h Read:___________________________________ _____
  • 7. Example 4: Demerol 75 mg IM q.4h, pain; Read:__________________________________ Example 5: Pen-vee K 1 g p.o. 1h pre-op dental surgery Read:__________________________________ Other Doctor’s order for treatment: 1. 2/3 strength solution Ensure. Give 90 ml qh for 5 hours via NG tube. Read:___________________________________ ____________________________________
  • 8. 2. 5/8 strength solution Isomil 36 ml via NG tube hourly for 8 feedings. Read:___________________________________ ____________________________________ 3. Acetaminophen 240 mg. p.o. q4-6h p.r.n., pain or T>38⁰C. Read:___________________________________ ____________________________________
  • 9. 3 Common Errors in Transcribing Medication 1. Incorrect interpretation of order due to misunderstanding of traditional time. • SITUATION: • A physician ordered a mild sedative for an anxious Patient who is scheduled for a colonoscopy in the morning. The order read “Valium 5 mg orally at 6:00 x 1 dose.” • The evening nurse interpreted that single dose order to be scheduled for 6 o’clock PM along with the enema to be given to the patient. • The doctor meant for the Valium to be given at 6 o’clock AM to help the patient relax prior to the actual test.
  • 10. • 2. Failing to clarify incomplete orders. • SITUATION: • Suppose a physician ordered Pepcid tablet p.o. h.s. for a patient with an active duodenal ulcer. You will note there Is no dosage listed. • The nurse thought the dosage came in only one strength, added 20 mg to the order, and sent it to the pharmacy. The pharmacist prepared the dosage written on the physician’s order sheet. • Two days later, during rounds, the physician noted that the patient had not responded well to the Pepcid. When ask about the Pepcid, the nurse explained that the patient had received 20 mg at bedtime. The physician informed the nurse that the patient should have received the 40 mg. tablet.
  • 11. • 3. Not checking the correct dosage. • SITUATION: • A nurse flushed a triple central venous catheter (an IV with three ports). According to hospital policy, the nurse was to flush each port with 10 ml of normal saline followed by 2 ml of heparin flush solution in the concentration of 100 units/ml. • The nurse mistakenly picked up a vial of heparin containing 10,000 units/ml. Without checking the label she prepared the label with all three ports. The patient received 60,000 units of heparin instead of 600 units.
  • 12. Critical Thinking Analysis Reading the labels of medications is critical, Make sure that the drug you want is what you have or hand before you prepare it.
  • 13. COLOR CODING OF MEDICINE TICKETS COLOR FREQUENCY TIME WHITE O.D. / STAT PINK BID YELLOW TID BLUE QID/EVERY 4 HOURS GREEN EVERY 6 HOURS RED EVERY 8 HOURS ORANGE PRN HS 6-6/12-12 6-12-6 6-10-2-6 6-10-2-6-10-2 6-12-6-12 6-2-10 9 PM
  • 14. MEDICINE TICKET Objective: To be able to guide the nurse to follow the doctor’s written order indication the drug to be given the frequency of doses the amount of each dose and the method of administration. Scope:1. name of patient 5. name of drugs 2. age 6. route 3. room no. 7. time frequency 4. date 8. doses (doctors’ name, NOD signature)
  • 15. SAMPLE OF MEDICINE TICKET MEDICINE TICKET Date:_________________ Rm no.______ Bed no.______ Name:______________________________________ Drugs Ordered:______________________________________________ ____________________________________________________ . Dosage:___________________________________________ Frequency:________________________________________ Route:___________________________ Dr:________________ NOD Sig.:_______________
  • 16. Give me the color code…. Example: 1. Lasix 40 mg. IM stat -------------------- 2. Motrin 600 mg. p.o. b.i.d. ------------ 3. Tranxene 7.5 mg p.o. q.i.d. ----------- 4. Tylenol w/ codeine gr. I p.o. q. 4h p.r.n. for pain --------------------- 5. Inderal 50 mg. p.o. t.i.d. -------------- 6. Amoxicillin susp. 100mg p.o. q. 6 hrs. ------------------------------------ 7. Oxacillin sodium 0.25 g p.o. q. 8 hrs-
  • 17. Sample of Medication Sheet – MMGH MEDICATION SHEET NAME: ___________________ Room:_________ Bed No:_______ Chart No.:______ NURSE’ FULL NAME/SPECIMEN SIGNATURE Date Medication & Treatment Freq PRN STA T
  • 18. SAMPLE DOCTORS’ SHEET _____________________________________________________________________ First Name Given Name M.I. WARD:_________ROOM NO._______BED NO._______PHYSICIAN_________________ ______________________________________________________________________ Date and Time: Time Remarks: Ordered: Signature: ______ PROGRESS NOTES DOCTOR’S ORDER
  • 19. SAMPLE DOCTORS’ SHEET _Panduco Pedro__________________________P.____________ Last Name Given Name M.I. WARD:_Wing A_ROOM NO. 212 BED NO._2__PHYSICIAN__Dr. Roberto de la Cruz_ ______________________________________________________________________ Date and Time: Time Remarks: Ordered: Signature: _____ PROGRESS NOTES DOCTOR’S ORDER 7-04-2008 - Give Lasix 40 mg. I.M. stat (+) edema lower - Start Motrin 600 mg. p.o. b.i.d. extremities ¥æ€ (+) rales on boths Dr. de la Cruz Lungs; RR-26/min; BP 110/80 2:45 p.m. 7-05-08 - Tylenol w/ codeine gr. I p.o. q. 4h p.r.n. for pain Complaint of headache ¥æ€ 5:30 p.m. Dr. de la Cruz
  • 20. Example: Transcribing Doctors’ Order in Medication Sheet MEDICATION SHEET NAME: _Penduco, Pedro__ Room:_212_ Bed No:_2_ Chart No.:_000123_ NURSE’ FULL NAME/SPECIMEN SIGNATURE Date Medication & Treatment Freq 4 5 6 7-4-08 Motrin 600 mg. p.o. b.i.d. 6 ffl 6 ffl 7-5-08 Tylenol w/ codeine gr. I p.o. PRN q. 4h p.r.n. for pain 6pm ffl STAT 7-4-08 Lasix 40 mg. I.M. stat 3 pm ffl ffl - Florence Nightale RN
  • 21. SAMPLE OF DOCTORS’ SHEET Panduco Pedro__________________________P.____________ Last Name Given Name M.I. WARD:_Wing A_ROOM NO. 212 BED NO._2__PHYSICIAN__Dr. Roberto de la Cruz_ ______________________________________________________________________ Date and Time: Time Remarks: Ordered: Signature: _____ PROGRESS NOTES DOCTOR’S ORDER 7-06-08 - Tranxene 7.5 mg p.o. q.i.d. Leukocytes –CBC result - Oxacillin sodium 0.5 g p.o. q. 8 hrs- - D/C Motrin ¥æ€ 9:30 a.m. Dr. de la Cruz
  • 22. Example: Transcribing Doctors’ Order in Medication Sheet MEDICATION SHEET NAME: ___________________ Room:_________ Bed No:_______ Chart No.:______ NURSE’ FULL NAME/SPECIMEN SIGNATURE Date Medication & Treatment Freq 4 5 6 7-4-08 Motrin 600 mg. p.o. b.i.d. 6 ffl D C 7-6 6 ffl 7-5-08 Tylenol w/ codeine gr. I p.o. PRN q. 4h p.r.n. for pain 6pm ffl STA T 7-4-08 Lasix 40 mg. I.M. stat 3 pm ffl ffl - Florence Nightale RN
  • 23. Example: Transcribing Doctors’ Order in Medication Sheet MEDICATION SHEET NAME: ___________________ Room:_________ Bed No:_______ Chart No.:______ NURSE’ FULL NAME/SPECIMEN SIGNATURE Date Medication & Treatment Freq 6 7 8 7-06 Tranxene 7.5 mg p.o. q.i.d. 6 10 ffl 2 ffl 6 Oxacillin sodium 0.5 g p.o. q. 8 hrs 6 2 ffl 10 ffl - Florence Nightale RN
  • 24. SAMPLE OF DOCTORS’ SHEET Panduco Pedro__________________________P.____________ Last Name Given Name M.I. WARD:_Wing A_ROOM NO. 212 BED NO._2__PHYSICIAN__Dr. Roberto de la Cruz_ ______________________________________________________________________ Date and Time: Time Remarks: Ordered: Signature: _____ PROGRESS NOTES DOCTOR’S ORDER 7-06-08 - Tranxene 7.5 mg p.o. q.i.d. Leukocytes –CBC result - Oxacillin sodium 0.5 g p.o. q. 8 hrs- - D/C Motrin ¥æ€ 9:30 a.m. Dr. de la Cruz 7-07-08 - Continue Oxacillin 0.5 g p.o. q8h for 4 doses and D/C ¥æ€ 12:30 a.m. Dr. de la Cruz
  • 25. Example: Transcribing Doctors’ Order in Medication Sheet MEDICATION SHEET NAME: ___________________ Room:_________ Bed No:_______ Chart No.:______ NURSE’ FULL NAME/SPECIMEN SIGNATURE Date Medication & Treatment Freq 6 7 8 7-06 Tranxene 7.5 mg p.o. q.i.d. 6 ffl 10 ffl ffl 2 ffl 6 ffl Oxacillin sodium 0.5 g p.o. q. 8 hrs 6 ffl 1 – 2 – 3 - 4 2 ffl ffl 10 ffl ffl - Florence Nightale RN
  • 26. SAMPLE FORMAT OF MEDICINE TICKET-MMGH Room No. ________________ Date:_______________ Name:_____________________________ Age:______________ Order:_________________________________________________________ Route: ________________________________________ Frequency:____________________________________________ Dr.___________________________ Sig.__________________________
  • 27. SAMPLE FORMAT OF MEDICINE TICKET Room No. ________________ Name:_________________________________________________________ Room No.______________________ Bed No._______________________ Drug:__________________________________________________________ Dosage/Freq:____________________________________________________ Route:________________________ NOD:_________________________
  • 28. SAMPLE FORMAT OF MEDICINE TICKET-MMGH Room No. _212-2__ Date:___7-06-08______ Name:___Penduco, Pedro__________ Age:__22_________ Order: __Tranxene 7.5 mg p.o. q.i.d. ____ Route: __per orem_____ Frequency:_______6 – 10 – 2 - 6______________________ Dr._Dr. de la Cruz_______ Sig.___ffl______
  • 29. SAMPLE FORMAT OF MEDICINE TICKET Date __7-06-08_____ Name:___Penduco, Pedro__________________________ Room No.__ 212____ Bed No.__2____ Drug:_Amoxicillin susp.100mg p.o. q. 6 hrs._ Dosage/Freq:__6 – 12 -6 - 12________________________ Route:___oral______ NOD:____ffl_________
  • 30. Irregularities in Transcribing MT • If the order is PRN with varied time frequencies • If the order is stat and then with regular time frequency • To indicate dosage; you can write – name of drugs, strength (dosage), time frequency • Stat order to be administered less than 1 hr. on a • Medicine ordered with a series of doses should also write no. of dosage done on the ticket
  • 31. Example situation Date __7-06-08_____ Name:___Penduco, Pedro__________________________ Room No.__ 212____ Bed No.__2____ Drug:_Amoxicillin 500mg IVTT q. 6 hrs. x 6 doses_then shift to p.o. Dosage/Freq:__6 – 12 -6 - 12__________________ Route:___IVTT______ 1-2-3-4-5-6 NOD:____ffl_________
  • 32. Keys to Remember: 1. Never transcribe doctors’ order in a medicine ticket with erasures or tampered. 2. Always write legibly, neatly, and correctly. 3. Do not recycle the used medicine ticket. (as much as possible) 4. A new doctors’ order is a new medicine ticket. 5. Endorsed to your charged nurse the old ticket that has changed order in; (increase/decrease dosage; route) 6. Do not revise/rephrase what have written in the doctors’ order. Rewrite completely what have written in the order. 7. If in doubt; check your ticket from the doctors’ order sheet first before in the medication sheet.
  • 33. 8. Arrange your drugs according to their color coding if for 1 patient with lots of drugs in different frequencies/timing. 9. Make an indication/marks on the medicine ticket for stat orders; to prevent from administering twice. 10. Signing the medication sheet as prompt as possible after administering/given a due medicines. 11. Do not sign the medication sheet in advance; without administering the drugs yet. Especially IVTT meds. 12. Always coordinate with the charge nurse with regards to new orders; new drugs ordered; etc. 13. Be mindful always……
  • 34. Drugs just like a sword that has two sharp edges; Whether it heals you, or kill you for just a minute from miscalculation.