SOCK Method - Pharmacology Note Template Updated for MSN770 - Fall 2021 PDF

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How to study pharmacology using the SOCK method note taking template...

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The S.O.C.K. Note-Taking Method for Mastering Nursing Pharmacology Adapted & condensed from a Nursing.com post by Jon Haws, BS, BSN, RN, Alumnus CCRN Check out his accompanying audio: https://nursing.com/blog/sock-method-nursing-pharmacology/ Note: Nursing.com has a wide range of videos & sample study guides for paid subscribers. I absolutely recommend that you do not purchase any cheat sheets or notes AS A SUBSTITUTE for writing or typing them out yourself – especially pharmacology. (That said, if you have accessibility issues that impede handwriting or typing & are not already working with Colleen Barnett, Alverno’s Student Accessibility Coordinator, I strongly encourage you to contact her: [email protected] | 414-382-6026.) Using a note-taking template like the SOCK method (or similarly defined methods) to actively write & study your own pharmacology notes is key to learning the material. I added a few margin comments to this document with tips for customizing this template for your own course & exam requirements. _____________________________________________________________________________________________

Think about this: When you are a brand-new nurse with limited knowledge of medications, how helpful can you be to your patients?     

Limited medication knowledge is less helpful and more dangerous than anything else. Medication administration is one of the paramount tasks of the nurse. In an ICU or MedSurg setting, your patient might be taking 50+ medications. It’s vitally important that you understand those medications, how they interact, why they are being given, and how they should be given. Without that knowledge, you are like someone who doesn’t know the language of the country they’re visiting – just smiling and nodding while people talk to you.

So, instead of saying there’s a “fix” (there’s not) for learning every medication, and instead of telling someone not to worry because it is a hard task (it is) – let’s focus on a 4 (actually 6) step process for learning Pharmacology that I like to call the SOCK Method for Mastering Nursing Pharmacology. 

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For aesthetic reasons, I’ve called it the SOCK Method, but in reality it should be called the O.K.C.S. Method as that is the proper order of the steps. The order doesn’t matter as much as knowing the framework as it will guide all future learning. o In other words, this isn’t as much a checklist of steps for learning as it is a framework for learning Pharmacology as a whole.

So here is what each letter means . . . we’ll dive in deeper below.

S: Side Effects O: Organs C: Classes/Considerations/Cards K: Know (Must Know) Let’s dive in a bit more and uncover what each letter actually means & how you can apply this method to master nursing pharmacology.

S: Side Effects I am a HUGE stickler for medication side effects (ask anyone I’ve precepted!). In my mind, if you don’t know the side effects of a medication you are giving, how do you know if the medication is working or if the patient is experiencing a severe side effect? One key to learning side effects is to understand very well what the intention of the medication is in the first place. For example, some of your side effects are going to be the opposite effect you were trying to achieve (a patient hypothyroidism might experience a “thyroid storm” while receiving thyroid replacement therapy). As you are learning medications you should:   

Focus on side effects that are life threatening Focus on side effects of major organs Focus on side effects that are the opposite of intended therapy

It is possible to get stuck trying to remember 4,348 side effects of Tylenol . . . however, that is not a realistic goal. Instead focus on the handful of KEY side effects. **On the clinical floor, I will not let new nurses pass medications if they are not aware of the top/most concerning side effects they should be watching out for.**

The best way to think about this is to once again go back to the ABCs. Those pesky ABCs will come back to haunt you often in your nursing career . . . you must always think of them first.

O: Organs When learning pharmacology, it’s important to have a macro understanding of the body, the organs, and how they interact with each other. This knowledge should come from A&P and MedSurg. As you study medications, you should also focus on the major organs when it comes to side effects and considerations. This all goes back to the ABCs that we learn from day one of nursing school. For example, giving a CNS depressant for pain is fine, but you MUST understand how that will impact the heart and respiratory drive . . . cause we kinda need those to live. Other side effects, while important, take a back seat to the ABCs. In general, I recommend learning medications, side effects, and considerations following this order of organs:       

Cardiac Respiratory Neuro Renal GI/GU Integumentary Musculoskeletal

This keeps you focused on the ABCs. If you forget that steroids cause “soggy bones” (osteoporosis), that is far less detrimental to your patient than forgetting it will raise blood sugars or depress the immune system. You should also have a deep basic understanding of what each system will do and why meds would be given to that system.

C: Classes/Considerations/Cards CLASSES: In Pharmacology we classify HOW a medication works – either how it WORKS or how it HELPS. These are the pharmacologic and therapeutic classes respectively. 

Pharmacologic Class: how the medication WORKS

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Therapeutic Class: how the medication HELPS

For example: 

Cimetidine (Tagamet) o Pharmacological Class: Histamine H2 Antagonist o Therapeutic Class: Antiulcer

I recommend learning Pharmacological Classes when learning pharm for a few reasons. 

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This goes hand in hand with learning A&P and focusing on the organs. If you understand the A&P and then focus on the Pharmacological Class, everything starts coming together. As you understand how the body works and how the medications work within the body to alter physiology things start to click much faster. Most importantly, generic medication names are based on Pharmacological Classes. o If you know that H2 antagoists end in -idine, as soon as you see an -idine medication on a test, MAR, or elsewhere, you know exactly what it does.  On the other hand, not all antiulcer (therapeutic class) meds end in -idine.

CONSIDERATIONS: When learning a new medication, it is important to look at and remember the nursing considerations . . . these include:

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Administration concerns Patient education

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Vital information

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Some things that might be included in here are: how slow to administer Zofran, how fast to administer Adenosine, pregnancy categories, telling a patient not to eat grapefruit . . . you get it.

Again, you are looking for considerations that could be detrimental to the patient, will allow them to self administer, or interfere with intended results. As the nurse, you are the one RIGHT there with the patient administering or teaching the patient how to administer the medication. A prescription or order does not mean you MUST give the medication. Be a clinician!! By this I mean you MUST use nursing judgement. You are the eyes and ears of the medical team . . . you are the one at the bedside! The physician and pharmacist are NOT AT THE BEDSIDE. You must know your considerations and know the current state of the patient’s condition and make a sound clinical decision. BE A CLINICIAN!!!! #beaclinician Don’t just blindly carry out orders. Knowing the considerations and assessing are paramount to this. CARDS: Repetition is king when it comes to learning new information. Learning nursing pharmacology is no exception. If you were to ask me, “what is the one thing I can do to learn nursing pharmacology?” . . . my two-word answer would be “DRUG CARDS” . . . make them, throw them away, and make them again . . . REPEAT. Working through the SOCK Method, you’ve identified:  

The drugs you need to know The things you need to know about those drugs

Now it’s time to start reviewing those medications over and over and over (you get the point). Many students ask me to create drug cards for them – I’m not gonna do that! Creating your own drug cards is the best way to learn this stuff. But here is what I HAVE done for you . . . I’ve created a drug card template that is developed with the S.O.C.K Method in mind:

How do I know the patient needs this drug class or individual drug? Labs, diagnostics, etc.

How do I know this drug is working for this patient? Labs, diagnostics, etc.

Here’s what you need to do . . .     

Armed with your list of Must Know Drugs, start working through this template for EACH and EVERY drug on your list. Print out as many copies as you need. Create a binder with as many templates as you have drugs on your list. Organize them by generic name. Once you’ve created a drug card for each drug, start redoing cards for the ones you are using most often.

I know what you’re thinking. “Jon, you’re insane! I already don’t have enough time to study let alone create 6,435,689 drug cards!” Spending time studying what REALLY matters saves you time in the end. Your knowledge of the important information grows, and you become a more focused nurse.

K: Know (Must Know) Early on in my career as a nursing student, I began to notice some patterns. Some meds are given and tested on far more than others. Why is that? Is it that we just don’t give a damn about patients who take abaloparatide injections? Of course not! When it comes down to it, some medications are far more common, taken by more patients, in more situations, and therefore more “important” to know and be aware of. Here’s an example of a priority list relevant to nursing practice:  

Outlined the most commonly tested medications. Cross-referenced that with the most commonly prescribed medications.

If you get a job in a specialty area, you should add this to the list: 

Add the most common/unique medications prescribed on your unit.

The Correct Order: Okay, now that we are clear on what each letter in our SOCK acronym means, I want to cover the correct order for actually working through this method so that you can become a master of nursing pharm.    

O: Organs K: Know (Must Know) C: Classes/Considerations/Cards S: Side Effects

To get the most from this system you should actually start with ORGANS and a solid top-level understanding of A&P and ABCs. This will help to keep you focused as you move through the system. You should then use that base knowledge to help you uncover the MUST KNOW meds [and their prescribing practices!] using the method outlined above. From there, you should move onto CLASSES . . . it is so important that you become comfortable with Pharmacological Classes, how they are named, and how they work in the body. If you take the time at this stage to do this . . . you will be light years ahead of your peers.

CONSIDERATIONS comes next. Become a master of nursing considerations for the drugs you give most often. You are ready to make DRUG CARDS. Use the template offered above and take a focused study session to create a nice pharm binder that includes a drug card for each of you must know medications. Phew . . . you’re finally ready to dive deep into the SIDE EFFECTS. This is the last step in the SOCK Method for learning Nursing Pharmacology and must not be ignored. When you are learning side effects it is important to focus on the method outlined above. If you do this, you will be a safe nurse who has a deep knowledge of pharm. It’s too dangerous not to do and know.

Conclusion In order to function as a true member of the health care team, nurses must be equipped to make clinical decision. Much of our time as nurses is spent providing medications. We must understand what it is that we are actually doing. OK – now dive in!...