How much time do you take to push opioids?

  1. 1
    I'm a new nurse and I always take the time recommended in the drug guides to push medications, HOWEVER this is turning into a major time-stealer for me, especially when I've got multiple patients with morphine q2h who all want it on the dot and I'm running around having to spend 7-10 minutes per patient to give one med (pushing the morphine over 5 minutes and then pushing however much saline you need to clear the line at the same rate.) I'm trying to hold on to doing things "by the book" but this is just not feasible when you're having a hectic night. So my point is, how long you you more experienced nurses take to push morphine and dilaudid? Those are my two major time-consuming drugs.
    Joe V likes this.
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  3. 9 Comments so far...

  4. 8
    Generally I would say less than five minutes. It depends on the clinical picture of course. Nana who is 85 lbs and hasn't had morphine in 40 years would be different than Bubba who weights 300 lbs and eats vicadin like candy. It depends on the drug and how much you are giving. I would never counsel anyone to take shortcuts or not follow safe clinical practice, but you are finding how hard it can be. You will develop clinical judgement through experience. Keeping your patients safe is the highest priority.
    brownbook, JRP1120, RN, KelRN215, and 5 others like this.
  5. 4
    The recommendations are based on delivery into the circulatory system. but are you pushing directly - in a lock - or into a running IV? If it's the latter, you need to take into account the infusion rate... it may be slow enough to 'deliver' your dosage without all the manual fol-de-rol. You may OK with injecting into a higher y-port and just let the infusion "deliver" it. I would recommend consulting your pharmacist to get specific information about this.
    redhead_NURSE98!, sphinx, Meep,RN, and 1 other like this.
  6. 1
    I think up to about a minute is usually the longest I take to push & like stated above, it can depend on the pt. And when the pt instructs me on how fast they want me to push it, I dilute it even more with NS. They're usually satisfied that it seems I'm pushing it faster, while I know it's not.
    cclear2020 likes this.
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  8. 1
    I never take under atleast 3-5 minutes for pushing both the med and flush. As someone else said, fluids running are great! Put it in the highest port and it can infuse itself (when appropriate). I'm a pretty new nurse myself and I'm trying not to pick up any shortcuts that could harm my patient. I know it will take a lot longer than 7 minutes to retrieve and administer Narcan and monitor extremely closely afterwards than to just appropriately give the med initially.
    MgMRN1 likes this.
  9. 0
    Love the idea of injecting it into a higher port. I had this same issue last night but it was with one patient who had Dilaudid and Morphine IVP and I felt like I lived in that room. She did have IVF running so next time, I'm going to do the higher port idea. Thanks for the idea! Seems simple enough huh? :-)
  10. 0
    Anything that takes longer than 2 minutes goes on a medfusion pump where I'm from. If you need to give morphine over 7 min to more than one pt, go to pt one pop it on the medfusion pump, go to pt 2 and start theirs, then go back to pt one and flush, return to pt 2 and flush and voila! you've given both patients their meds in under 10 minutes. The default infusion time for both of these meds on said infusion pumps was 5 minutes in my old hospital though. If the child had IV fluid running, I would push it into the y port and allow the fluids to carry it through.
  11. 1
    I usually gave narcotics, such as morphine, dilaudid and demerol to adults over about a minute with no problems. I actually had a nurse give me an IV injection of dilaudid in the ER once and she gave it very quickly over about 5 seconds or so and I when it hit me, I thought I was going to explode right through the roof of the place. I guess some people like that feeling, but I did not, it was scary to me. 7 minutes seems like a long time. I don't remember PCA pumps taking that long to administer a dose.
    dudette10 likes this.
  12. 0
    I push over 2-4 minutes for 1-4 mg and the. Flush over a minute because once you have the .5ml through the saline lock time doesn't matter much. 5-10 mg of mso4 goes at about 5m. The rest of the nurses get ticked off when I take that long or longer. I like to be careful, they say if we break it we can fix it because we are in a PCU. I don't want to fix what was not broken.


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