BID strictly every 12h or just twice a day?

  1. 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?
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    About krg8089

    Joined: Nov '12; Posts: 7; Likes: 1


  3. by   kristinemagtoles
    Hi, BID means two-times-a-day. the timing depends on the hospital guidelines in giving medication.. some hospital timed BID as every 6am-6pm, or 8am-6pm, or 8am-8pm...IT ALL DEPENDS ON THE HOSPITAL'S GUIDELINES.. To play safe, ask your senior or supervising nurse.. It is very important to memorize the 12 Rights in giving medication, such as the timing and color coding the medications since nurses are prone to medication errors. Hope this helps.
  4. by   kristinemagtoles
    In addition to the PRN, when the doctor's order is BID PRN ... same rule can be applied... that the medication should be given 2x a day as needed.. when the patient complaint of ex.pain, u should check the previous time the PRN was given, if it is not relieved, then its time to refer it because the patient may be suffering too much that the dose of BID PRN cannot give any relief. ALWAYS, ALWAYS KEEP IN MIND THAT "ASK" YOUR SUPERIOR WHEN IN DOUBT.
  5. by   turnforthenurse
    BID is twice a day, or every 12 hours...but as PPs have mentioned, it depends on your hospital's policy. If a patient only has a PRN med ordered BID and they are still complaining of a lot of pain, perhaps it is time to speak with the patient's physician about increasing the dose or increasing the frequency if possible.
  6. by   TheCommuter
    At my workplace, BID PRN means twice a day, but at least 6 hours apart.

    Therefore, a patient could have their medicine at 8am and again at 2pm.
  7. by   Meriwhen
    BID PRN is roughly 8-12 hours apart, depending on your facility's specific policies and the medication involved. If they want to have it given strictly every 12 hours, q12h would be the better choice. If they are more concerned with limiting the number of doses than the timing of them, then they could say "NTE 2 doses in 24 hours".

    If BID PRN isn't working for the pain, you need to let the prescriber know so they can increase to dose amount and/or frequency.
  8. by   merlee
    BID of 'regular' meds is usually 9A & 5P. So there should be at least 8 hrs between those doses. Ask for clarification.
  9. by   krg8089
    Oh ok, so it varies from facility to facility? I will be sure to ask my supervisor tomorrow then! Thanks so much for the input everyone!
  10. by   TheCommuter
    Just like TID is not necessarily Q8h. It could be 0800, 1400 and 2000, or 0700, 1400 and 2100 depending on facility policy.

    It could also be TID with meals (0700, 1200, 1700).
  11. by   morte
    The order isn't truly complete, there should be a "not closer than" part. And, unless your P+P states it, BID isn't nec. Q12. good luck
  12. by   ktwlpn
    As 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.
  13. by   FurBabyMom
    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
  14. by   OnlybyHisgraceRN
    When 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.