BID strictly every 12h or just twice a day? - page 2
by krg8089 | 7,916 Views | 14 Comments
I am a new grad and just started my first nursing job. I was doing med pass and a patient asked me for a prn pain med that was BID. I told them they had just had it about 5 hours before so they could'nt have it till later and... Read More
- 2Nov 4, '12 by ktwlpnAs a new grad you should make a habit of consulting your policy and protocol-frequently.Not only does seeing it black and white help you remember it but you never know if your supervisor is giving you the correct information. It is up to YOU to seek info from the appropriate source and if you do make a mistake (especially one that results in some degree of harm to a patient) " I did what she told me to do" is not a good defense.
- 0Nov 4, '12 by DesireeRN2011, BSN, RNI would clarify with the experienced or supervising nurses how they handle BID/TID meds. Or better, pull up policy, read it and then ask how it's handled (so you know what the policy is but how do you handle the customer service part - what is a good way to explain it to patients...) When I worked on a med-surg floor most of our BIDs were scheduled and pharmacy would assign times based on the drugs themselves (we usually saw BID orders regarding home meds example: a patient might take them twice a day at home say with breakfast and dinner, but pharmacy puts the times in for 0800 and 1700 or something like that). But it does vary between facilities. Very very very good question though!
I think if they wanted it specifically q12 they would have wrote for q12. But it never hurts to explain to a patient that they ONLY get it twice a day whether they get it 6 hours, 8 hours, 10 or 12 hours after the original dose for the day. Being the nurse that I am, I would request parameters from a physician, NP or PA (whoever can modify (presumably) contolled substance pain related orders in your state). I would ask for an amendement to make the order be BID or TID but have them add 'X hours between doses' or 'no closer than X hours'.Last edit by DesireeRN2011 on Nov 4, '12 : Reason: additional information added
- 0Nov 4, '12 by OnlybyHisgraceRNWhen in doubt you should always clarify with the doctor. I know it may seem silly calling the doc for this however, if your supervisor does not know and there is not set policy for BID times, then you would need to clarify.
Let others stated BID means something different to everyone. When I worked LTC, BID was 9a and 5p. Where I work now its 9am and 9pm.
Cover yourself always.
- 0Nov 4, '12 by Daisy_08For me it would depend on the med. If is was Acetaminophen, I`d give it and let them know that`s it for the day, Hydromorph Contin - they are waiting. However in this case I`d do a good pain assessment and call up the doc for better pain control.
Our docs specify if they want BID to be specific, otherwise you use your critical thinking skills. 0800 and 1700 because it needs to be taken with food, or will keep them up at night or 0800 and 2100 because they get the best therapeutic effect by having it in there system at all times.
- 0Nov 4, '12 by PlagueisFor PRN orders, our consult pharmacist discourages orders without a specific time frame. If an order is BID PRN, it should be written every 12 hours, or for TID PRN, every 8 hours. This is to prevent confusion about exactly how much time should pass between PRN doses. (I work in LTC.)