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 their argument was that they just have an allotment of twice a day, but not necessarily 12 hours apart and that no other nurse waits 12 hours in between doses. What is the correct way to go about that?
I 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 FurBabyMom on Nov 4, '12
: Reason: additional information added