Narcotics and Safe Practice

Hi Everyone,

I am currently working as a student nurse in a hospital in British Columbia (Canada). Since doing a full time preceptorship this spring and working this summer, I have had some great opportunities to learn more about how they teach things in school and how things are actually done of the wards.

Yesterday I was working, and my patient was prescribed 0.2 mg morphine q4h prn through her a sub-q butterfly. On our unit morphine comes in 1 mg/ml ampules. My understanding with drawing up nacotics is to take as much as you need for that dose, and waste the rest, each and everytime. However, another nurse spoke to me and said that where my patient was asking for it regularly, it was better to draw up the whole ampule in the syringe (i.e the whole 1 mg) and simply give 0.2 mg each time she requested her meds, keeping the labelled syringe in the patient's med drawer in between doses. Her rationale was that it would result in faster administration of the pain medication becuase it would be already drawn up, and means you wouldn't waste as many ampules of morphine. When I asked how she would record it on the narcotic sheet, she said you still reported it as if you had wasted the remaining 0.8 mg.

What do others, as student nurses, think about this practice? It seems like it could get you into a lot of trouble. The nurse said it was up to me, but I decided to play it safe and draw up the amount I needed each time and waste the rest with another RN's signature.

In addition, what other practices have you observed that you have found either questionable OR helpful?