Nurses Helping Nurses
allnurses Network: Central | Jobs | Books | Newsletter
allnurses: A Nursing Community for Nurses
Home General News Blogs Articles Students Region Specialty Degrees F.A.Q.
Log In | Register | Last 24 Hours
General Nursing Discussion /

Did he get too much morphine?



Did You Know?
allnurses is the largest community for nurses on the web. We now have over 388,597 members! Join today to network with other nurses, laugh, share, and much more.
Page 4 of 7 < 123 4 567 >

No. 30
from BlueRidgeHomeRN
Old Apr 17, 2008, 06:36 AM

Default Re: Did he get too much morphine?
Originally Posted by Blee O'Myacin View Post
I have more of an issue with a student nurse giving an IV push drug without supervision than I do with the dosage.

Blee

Yup--and I don't care if she's #1 in her class and 5 days away from graduation!!
Top
2 Readers Gave Kudos
 
Advertisement
Sponsored Links
 
No. 31
from BlueRidgeHomeRN
Old Apr 17, 2008, 06:41 AM

Default Re: Did he get too much morphine?
Originally Posted by SMK1 View Post
It is illegal for that to happen in my state and I'm guessing others as well so that is probably why some of us are shocked. Clearly all RN students have probably given their fair share of IV push meds, it is just surprising that things are not as strict in other places on this issue. (then again this is nursing so why am I shocked! lol)
Maybe this varies by Nurse Practice Act per state..but SN + IVP Narcotics=BIG PROBLEM POTENTIAL
Top
5 Readers Gave Kudos
 
No. 32
from Blee O'Myacin
Old Apr 17, 2008, 09:31 AM

Default Re: Did he get too much morphine?
OP - I have a question about one of your additional posts - in every facility I've worked at, IV potassium is a two-nurse drug. We need two RN's to be present when the drug is given in order to sign off on it. We manage to do this in a busy ER, so please no "real world/ideal world comparisons" please. Was this student alone in the room when hanging the rider? Did your brother see a nurse that day other than the student? Was the instructor present at all? Just curious because as a previous poster mentioned, we can't assume that the student came in alone, but another person was never mentioned.

Thanks!

Blee
Top
 
No. 33
from Altra
Old Apr 17, 2008, 10:41 AM

Default Re: Did he get too much morphine?
8mg IV is on the high side for a patient who is opioid-naive, but not out of the ordinary. I have often given 10mg pre- and post-op.

Some degree of sedation is an expected side effect, not necessarily an adverse effect.
Top
 
No. 34
from Altra
Old Apr 17, 2008, 12:24 PM

Default Re: Did he get too much morphine?
Originally Posted by Blee O'Myacin View Post
in every facility I've worked at, IV potassium is a two-nurse drug. We need two RN's to be present when the drug is given in order to sign off on it.
This has not been the case at the 6 hospitals in which I've worked or had clinical experience as a student. Clearly, there are significantly different policies everywhere.
Top
1 Reader Gave Kudos
 
No. 35
from jessiern
Old Apr 17, 2008, 01:59 PM

Default Re: Did he get too much morphine?
If a patient is alert and oriented, I explain to them how to notify me that they need pain medicine. I advise them not to wait until pain is too severe. Then, I leave it up to them. I may ask periodically through the day if they are in pain, but if they don't complian of severe/mod pain I don't take it upon myself to offer meds. I certainly don't walk around with a morphine push "just in case". Sounds like a student nurse that needed a check off on IV pushes, and a CI that was not around enough.
Top
 
No. 36
from SDS_RN
Old Apr 17, 2008, 02:19 PM

Default Re: Did he get too much morphine?
I have not given that much MS at one time even for my heaviest of pts. Some times pre-op we would have orders like 2mg q 10-15min which would equal out to about 8-12mg an hour but they were usually to OR before the hour was up. For IVP I've never seen an order exceed 4mg @ one time in my facility.
If they were needing that high of a dose then they would be on a PCA pump along w/ scheduled toradol q 6hrs.
Top
 
No. 37
from SMK1
Old Apr 17, 2008, 02:36 PM

Default Re: Did he get too much morphine?
Originally Posted by BlueRidgeHomeRN View Post
Maybe this varies by Nurse Practice Act per state..but SN + IVP Narcotics=BIG PROBLEM POTENTIAL
I completely agree.
Top
 
No. 38
from RazorbackRN
Old Apr 17, 2008, 02:45 PM

Default Re: Did he get too much morphine?
As others have said, the dose really is really not an issue. I have given doses larger than that on several occassions, and would feel comfortable with it.

My question is this: If you were concerned about it, why didn't you speak up PRIOR to her giving the med? From the way it sounds, you were right beside of him, you even knew his exact VS from the moment this occurred.

I firmly believe that an A & O pt or family member should question what is happening whenever someone comes to your bedside with syringe in hand. This should be done PRIOR to the intervention.

If your brother is not a medical person, this would have been the perfect opportunity to educate him on the importance of being knowledgable about what is going on with his care, but first and foremost, you should've questioned it for him.
Top
 
No. 39
from scarymary
Old Apr 17, 2008, 02:55 PM

Default Re: Did he get too much morphine?
Originally Posted by ER_baby12 View Post
I have not given that much MS at one time even for my heaviest of pts. Some times pre-op we would have orders like 2mg q 10-15min which would equal out to about 8-12mg an hour but they were usually to OR before the hour was up. For IVP I've never seen an order exceed 4mg @ one time in my facility.
If they were needing that high of a dose then they would be on a PCA pump along w/ scheduled toradol q 6hrs.
I have nursed patients that were prescribed morphine 2-10mg iv, and usually make it up with normal saline so that it is 1mg per ml.

Give very slowly 1mg at a time until the patient is settled. Very rarely have to give the whole 10mg.

When the pain is that bad they definitely need to be on PCA plus regular iv paracetamol.

In the UK student nurses don't give iv drugs at all, never mind without supervision.

Morphine is a controlled drug anyway, so what was a student nurse doing with CDs on her own?
Top
 
Page 4 of 7 < 123 4 567 >
Reply




Thread Tools


Who's Online
385 members
3,514 guests
3,899

Nursing News

17

lawsuit - But don't most RN's work through breaks/lunch...
0

Patient Evaluation of Retail Clinic Care
2

The hard to reach on-call doctor, and its effects on...
7

Woman charged with passing off prescription drug as...
13

Man in "Vegetative State" was conscious for 23...
2

Interesting article on ThedaCare's Collaborative Care Model
12

Possible breakthrough regarding MS
63

16th Philly area hospital to stop delivering babies: Mercy...
12

Really interesting article on Indian open hearts
10

High-Tech Pump Does What Her Heart Can't


Nursing Articles

39

Dear preceptor
1

Society Needs Care Too
13

Why am I doing this, anyway?
2

Nurse Heal Thyself
9

My Papa, why I am the nurse I am today.
17

I made it through
11

An angel's gaze
16

A Sister Never Forgets
16

Ruby's Marbles
38

What Do Operating Room Nurses Do?
14

My Little Old Jedi
20

I love this job......
23

"I hear voices"
19

Preventing FRUTI (Foley Related Urinary Tract Infection) in...
24

Error and Attitude


Does allnurses.com make you a better nurse?


Sponsored Links

Currently Reading This Page: 1 (0 members & 1 guests)

Interested in the hottest topics of the week? Subscribe to the Nurse-zine Newsletter.
Enter email address:

Available Topics (tags)


Search By Tag:

New To Site
Need Help
Quick Links

Copyright © 1996-2009, allnurses.com. All rights reserved.  allnurses.com, Inc.
All times are GMT -6. The time now is 12:22 PM.