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.
General Nursing Discussion /

Pushing Dilaudid?



Did You Know?
allnurses is the largest community for nurses on the web. We now have over 388,238 members! Join today to network with other nurses, laugh, share, and much more.
Page 3 of 5 < 12 3 45 >

No. 20
from morte
Old Nov 03, 2009, 04:36 AM

Default Re: Pushing Dilaudid?
Originally Posted by JulieSandlin View Post
One of our doctors literally created an addict where I work, by just changing med orders because the patient 'requested' her 75mg Demerol push q4prn... we all wrote nurses notes on her behavior of NOT having pain, just seeking her fix and he still won't change a thing. She's 'weaned' off her med some to 50mg q 6 scheduled. I've never in my life heard of anyone receiving that amount of Demerol and all of the nurses are having a very difficult time with this. I feel like my license is on the line at times.
unless you are dealing with a small adult, this is not a large dose of demerol....50 mg is darn near pediatric dose!
Top

1 Reader Gave Kudos
 
Advertisement
Sponsored Links
 
No. 21
from swirlygirl
Old Nov 03, 2009, 05:23 AM

Default Re: Pushing Dilaudid?
Originally Posted by chacmool View Post
Yes of course I leave the room. I don't see how it would be an issue as it is in a bag so the patient isn't going to take it. It's not like a PCA where there's a huge syringe full of narcotic so we have to lock it. Even if they were to take the bag down what would they do with 50cc of fluids mixed with dilaudid? Drink it?
Yes - they will drink it! I've had detox patients that have had to have the Purell hand sanitizer dispenser removed from their room because they will drink it for the alcohol.
Top

1 Reader Gave Kudos
 
No. 22
from mom4josh
Old Nov 03, 2009, 05:38 AM

Default Re: Pushing Dilaudid?
Originally Posted by chacmool View Post
Okay, I'm not going to lose my license if a patient takes a med down from an IV and drinks it. Get a couple years more of experience and you'll learn this.

Okay... trying not to get too ticked off here.

You asked for advice, now you want to argue with everyone who has taken the time to post? Excuse me? It seems that you didn't want advice after all, just someone to back up your idea of what is right.

If I were you, I'd re-think about your policy of mixing with saline and hanging it. Think about this: if your patient IS an addict, perhaps they have syringes with them. They know how to get meds out of an IV bag after you leave the room and push the med themselves. Then you could be in serious trouble because you weren't in the room to observe their reaction.

I would listen to all the experience out here, check with your facility policy, your drug book... whatever.
Top

9 Readers Gave Kudos
 
No. 23
from RNperdiem
Old Nov 03, 2009, 06:07 AM

Default Re: Pushing Dilaudid?
This is where a PCA is a good idea. However, if I have to push Dilaudid, I slowly work in 1mg at a time through a running IV. There is a computer in the room, so I keep up on my charting while taking the time to give the meds.
I do work in a SICU, so addict or not, getting hit by a truck or having big abdominal surgery is going to need pain control.
Top

1 Reader Gave Kudos
 
No. 24
from Reno1978
Old Nov 03, 2009, 07:01 AM

Default Re: Pushing Dilaudid?
I push my PRN narcs. If they're on a fentanyl drip, I can bolus them from the pump if they need extra pain control. I've never seen narcs mixed in a 50mL bag and hung as a secondary over a long period of time. Waste of resources, IMO.
Top
 
No. 25
from Key_
Old Nov 03, 2009, 07:18 AM

Default Re: Pushing Dilaudid?
I've never seen it mixed either. I push slowly over a couple of minutes, but I have also never given more that 1.5mg at a time.
Top
 
No. 26
from JoPACURN
Old Nov 03, 2009, 08:25 AM

Default Re: Pushing Dilaudid?
I work in Recovery. We IVP all meds. Don't have time to hang anything but PCA stuff.

And we med with no airway so it's a skill learned in that environment that takes practice, you can push someone into apnea if you're not careful.
Top

1 Reader Gave Kudos
 
No. 27
Old Nov 03, 2009, 08:39 AM

Default Re: Pushing Dilaudid?
Does the physician write for it to be given as a drip in the 50ml of saline? If not in my facility they would consider that a med error since I did not follow the order of slow IVP. We push our Dilaudid but we don't usually give that large of a dose.
Top

2 Readers Gave Kudos
 
No. 28
Old Nov 03, 2009, 09:25 AM

Default Re: Pushing Dilaudid?
Push it! If you are so worried about respiratory status, age, or snowing them....just do it slow or maybe question what you are giving. You know the drill VS before....15 minutes with reeval after. Although with very old people I have diluted...but usually I will take the 1ml of dilaudid or whatever else and dilute into 10mls normal saline and push slow. Then slow flush.

While there are drugs I throw in a bag like Rocephin on an elderly person or someone with a tiny iv or pepcid....most meds we push if we can....it's more time and money efficient.

Maisy
Top
 
No. 29
from Magsulfate
Old Nov 07, 2009, 04:58 AM

Default Re: Pushing Dilaudid?
Originally Posted by chacmool View Post
Yes of course I leave the room. I don't see how it would be an issue as it is in a bag so the patient isn't going to take it. It's not like a PCA where there's a huge syringe full of narcotic so we have to lock it. Even if they were to take the bag down what would they do with 50cc of fluids mixed with dilaudid? Drink it?
Yes. Drink it. I guess you haven't been around many addicts.
Top
 
Page 3 of 5 < 12 3 45 >
Reply




Thread Tools


Who's Online
282 members
2,456 guests
2,738

28

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

3

Really interesting article on Indian open hearts

4

High-Tech Pump Does What Her Heart Can't

0

Air Force RN Force RN Found Not Guilty

9

Hospital Falters as Refuge for Illegal Immigrants

6

California Imposes Stricter Rules Regarding Drug Abuse In...

36

Are older nurses being forced out of the profession?

3

An outlook in California?

8

Australian surgeons successfully separate conjoined twins

44

Disruptive behavior by doctors, nurses persists a year...



1

Society Needs Care Too

12

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

14

A Sister Never Forgets

16

Ruby's Marbles

37

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

10

It's Just a Shower





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: