Asking all nurses...need a consensus! - page 2

Ok, here we go...just think, this COULD be fun!! :0) As a 15 year-practicing, highly experienced RN, with a background in a multitude of specialty areas, I have come across a nurse manager who has a belief about PRN order... Read More

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    I'm still a fairly new RN, but I don't think I've ever seen a PRN scheduled as BID or TID for exactly this reason--they are always Q8H or Q12H or whatever, so there is no question about the spacing required. If I gave a PRN Ativan and needed more right away, I would need to page the physician and make them aware that there is some kind of special circumstance going on.

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    We get some TID and BID PRN medications on our floor. But the Pyxis flags us if we try to pull a controlled med before the 8-12 hr time that needs to be between them. Other PRNs that's aren't a controlled med that are TID or BID PRN don't have a warning. I agree MDs should specify times because someone can get too much Meds in too little time if it gets into the wrong persons hands.
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    Very good points, QueenJulie and Liveyourlife! We obviously have some excellent "critically thinking" nurses out there...

    I have often wondered these days, when, of the "new grads" coming through my facility; one-third are PHENOMENAL and they absolutely blow me away with their intelligence, attention to detail, and ability to critically think through any problem put before them...

    However, the other two-thirds really have given me pause and I felt, cause for concern, in terms of the depth and breadth of things they absolutely do not understand...

    Clearly, ESPECIALLY regarding those graduated and working nurses on this site (but certainly not ONLY, so please do not misunderstand! I'm absolutely NOT SAYING that students don't have these same's just easier to SEE IN the graduated/working population), there are some AMAZINGLY INTELLIGENT AND BROAD-THINKING minds in nursing today...this thoroughly impressed me when I first began "stalking" around 'AN' prior to joining; reading through the topics and what not...

    These factors are not only evident when nurses are discussing the biggest issues relevant to our carers, but also the smaller points, which people in the field for any length of time obviously grasp exactly in the manner which they should. This gives me great hope for the future of nursing! :0)
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    This is an awesome question!! TID is usually a scripted time made by the pharmacist (all TID meds are 0800, 1400,2100 for instance) and if they are TID prn meds, you can give them up to 3 times a day, but I would probably want a clarification if it were a TID PRN as (via your tums example) that could be 3 times within a half hour if one wanted to give it that way.
    Q 8 hour PRN meds are just that--every 8 hours and gives you a more specific timeline in which you could give the meds if needed.
    Prn meds, in my opinion, need a time (Q 2, 4, 6 hr) or if the MD is insistent on TID for PRN's it could be clarified better (TID after meals PRN nausea) But that is just me.....
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    It would be better if they would say "q1h PRN no more than 6 doses daily" or something like that.
    Ir15hd4nc3r_RN likes this.
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    Yes, I prefer that sort of delineation the nurse some freedom but also lets you know before you've run through your MAX for that patient (in meds that have no outlined "ceiling", such as opiates (& UNLIKE APAP!), while setting exact boundaries regarding the briefest time between MD requires between dosages! :0)

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