Rule Book On Narcotic Pain Medication

[MustangSallie1997]

:uhoh3:Where is the rule book on giving narcotic pain meds ??? Is it, or is it not OK to give pain meds up to 30 min early if the patient is in need and requests it ?? I have been a nurse with the same hospital for almost 10 years, and suddenly I am not sure if I know the answer or not. CAN ANYONE OUT THERE GIVE ANY INPUT ON THIS SUBJECT ???

[cmo421]

In most facilities now when doing an assessment,pain is documented along with interventions and outcomes. JACHO has established a record of the importance of pain assessment,relief,interventions and documentation. There have actually been lawsuits,pt's families against doc's, for pt's being left in pain without relief. As nurses we have no right to with hold meds from pt if ordered. If a pt is having break throu pain, a doc needs to be notified and new orders obtained. It all should be well documented. If pain is a constant issue, most facilities have a "pain team"from the pharmacy that can be consulted, sometimes just by nursing. I have given pain med early when I know a person is having trouble and feel comfortable they can handle it. I then call the doc, let them know that I gave it early,why, and ask for a new order . Most MD's will respect the RN's decision and even cover you with a one time stat. Team rounding and planning can also be an asset in these cases in planning a pt's care. Pain is a really big area being watched these days by accrediation and reimbursement companies. Much feedback by pt's and their families concern the lack of pain control. We always need to cover ourselves and follow facility policies,and most of all be a good pt advocate!

[Kymmi]

I realize it goes by hospital policy however if you follow my therory you will see why I think that giving a PRN med early will result in a extra dose. If a drug is ordered q 4 hours prn then the most the person will receive in a 24 hour period is 6 doses however if it is given q 3.5 hours then they will receive 7 doses. I know it seems like splitting hairs however fact is fact....a extra dose has been given. If you are trying to use the 30 minutes rule on REGULAR scheduled doses that is different because they are ordered at set scheduled times so if it is given 30 minutes early or late it wont matter because the regular schedule will just pick up next dose.

I am not saying withhold the med and make a patient suffer....I am saying I'd give it early ONCE and then let the MD know that something else needs ordered.

[leslymill]

Now I would give it at 1230, splitting the difference between the two percocets from the morning dose.

And I doubt neither one of us are doing something a prudent nurse would consider in error.