Giving med outside scheduled time.

  1. I know, it happens a lot in LTC, but . . .

    Resident has short acting opioid scheduled five times a day, including one at 2400. Resident frequently over sedated at this time d/t multiple sedating meds (including opioid) given at hs, so it may be held. However, they will frequently wake 2-3 hours later requesting same med.

    Do you give it?
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  2. 7 Comments

  3. by   amoLucia
    Simple. Just get a PRN order to permit a later dose if that midnite dose is held. Just ensure that nothing would be given too late in your shift to interfere with the early 7-3 dose.
  4. by   notanumber
    That's one thing I suggested to the MRP in the fax I sent, but unless pain is really uncontrolled I wasn't going to phone the on-call in the middle of the night for an order.
  5. by   caliotter3
    You can pass on a request for day shift to make the call to get the PRN order. Then it is taken care of.
  6. by   notanumber
    I took care of it, I just wanted to know if anyone would have "just given it" at 0300 like the baffled day nurse who I handed off to suggested.
  7. by   amoLucia
    Just FYI - personally, and I cautiously say this, I would give the med. But that's just me. There is an order for 5 times a day. That frequency is needed for his pain control mgt. If the pt's VS are OK, responsive LOC approp for pt, uncomfortable, etc, etc, I'd give it. But before I left in the morning, I'd be making a phone call for an order to cover it.

    I will say that a lot depends on who's the attending PMP. Maybe because I strove to develop a good rapport with them and they trusted me, I rarely had a problem getting an order. I would make it a point though to explain that that type of order would serve to deter some other nurses from calling at 2am. (A little schmoozing here.) Inasmuch as I knew the PMPs, I knew where to tread cautiously.
  8. by   AngelRN27
    This thread should be moved to LTC. This is not the same as LTACH.
  9. by   notanumber
    You're right, I posted in the wrong forum.

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