Giving Narcotic After Scheduled

  1. 1
    If a patient gets a narcotic, ex: Morphine Sulfate, scheduled q 12 hrs but they refuse it when it is due then want it a few hours later. Is it OK to give them that narcotic when they asked or do we tell them that it was counted as a refusal and not in the time frame anymore?

    I'm just confused - would I get in trouble for not giving it because they didn't get it when scheduled (and state they're in pain) or would I be in trouble for not giving it at the correct time (ex: 4 hrs late)? Most patients have alternate PRN's scheduled but what do you do if a patient is heart set on getting the medication they refused a few hours ago?

    I also work night shift and so sometimes questionable at calling MDs for stuff like this when they are asleep.
    MMaeLPN likes this.
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  3. 9 Comments so far...

  4. 1
    You should get a order so that it looks on the up and up. I would also suggest with educating the patient about taking his pain medication and that will keep him/her from having peaks and valleys in their pain control.
    katherine100 likes this.
  5. 1
    On our unit we can give it late, but then must reschedule the subsequent doses. So if its due at 0900 and 2100 but you don't give until 1200 you must reschedule the second dose for 2400. But every place is different so maybe ask your charge nurse
    katherine100 likes this.
  6. 0
    It would be okay to give it on my unit. You should check your policy though.

    ~ No One Can Make You Feel Inferior Without Your Consent -Eleanor Roosevelt ~
  7. 0
    I'd say go ahead and reschedule. Maybe they didn't need at 9pm, but by MN they do. Would you want the pain to continue until 9am when it was next due?
  8. 0
    Check your med policy. If this patient is a repeat offender- ask for an order 'patient can have his q12hr morphine given to him 4 hrs early or 4hrs late, per his choice', that way you won't have to keep calling.
  9. 0
    I work on a med-surg floor at night and I see this quite a bit when patients are woken up or refuse their pain medication at certain times. Usually what I do if it is scheduled it go in an hour before (I don't know if you can do this at your facility) and ask if they are ready for it, then go again at the scheduled time and see if they want it then. If they still refuse to take it, I educate them on the importance as mentioned in one of the comments above about their pain getting out of hand and then you end up chasing it until you're on top of it. So my answer would be if they want it later on after the scheduled time I would definitely call and get it rescheduled and give it to stay on top of their pain but that's just me! Hope this helped!
  10. 0
    Quote from slauren
    If a patient gets a narcotic, ex: Morphine Sulfate, scheduled q 12 hrs but they refuse it when it is due then want it a few hours later. Is it OK to give them that narcotic when they asked or do we tell them that it was counted as a refusal and not in the time frame anymore?

    I'm just confused - would I get in trouble for not giving it because they didn't get it when scheduled (and state they're in pain) or would I be in trouble for not giving it at the correct time (ex: 4 hrs late)? Most patients have alternate PRN's scheduled but what do you do if a patient is heart set on getting the medication they refused a few hours ago?

    I also work night shift and so sometimes questionable at calling MDs for stuff like this when they are asleep.
    I would have given it and rescheduled all subsequent administrations to start 12 hours after the time I gave it.
  11. 0
    I would give it, and if it is a "scheduled routine med" then just change the times due. What would you do if an antibiotic was due, but the IV was infiltrated, or the patient was in another department having a test done? You would give it either when you got another IV access, or when the patient was back in his room. Why would a pain med be treated any different? The patient has a right to refuse the med, and also has a right to request it later. I would not call the doctor about something like that. Just give the med and change the times.
  12. 3
    Make certain that you are educating your patient about that Q12 Morphine...it is the long acting med that helps him to be comfortable most of the time so that he has to use little short acting. These are meds that the patient should NOT skip, refuse, or delay without significant reason.

    IT IS NOT A GOOD IDEA to hold or not give the long acting opiates...the patient will experience pain as the med wears off that may not be easy to get back under control.
    EMYrn2011, Sadala, and sallyrnrrt like this.


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