My hospital recently hired a JCAHO consultant to "walk" through the hospital and advise the department managers of "potential" problems with the units and how to "beef up" the areas for the next Joint Commission inspection. One of the "requirements" for PACU is for Anesthesia to list the order in which pain medications are to be given (if there is more than 1 option). The consultant stated Joint Commission is watching for this now. So our anesthesia providers have to mark next to the medications what order the meds are to be given and the nurses MAY NOT deviate from the list. The nurse MUST give ALL of med #1 prior to advancing to med#2 and so on. It makes no since to me. Where is the critical care aspect of nursing? Especially in the PACU. Has anyone else come across this issue? Until now, I've never heard of such a thing. Is it a true Joint Commission reg?