administering meds during emergencies without a standing PRN order

[patrickrlim]

During emergencies, can RNs administer meds even without a standing PRN order? I had a situation when a patient had a blood sugar of 21, symptomatic. I knew that D50 is needed but I didnt want to administer it without an MD order (since we dont have a standing PRN order for it) so I let the pt drink orange juice while waiting for the MD to return my call. Now, my fellow RNs are saying that I should have just given the D50 then just notify the MD after. If that is the case, what are the meds that RNs can give during emergencies without a standing prn order? im confused

[Horseshoe, BSN, RN]

So........ to the OP.....In this situation you did fine. The patient was conscious and able to take fluids so the "prudent" thing to do was to give OJ and sugar until the MD could be reached and orders recieved. If however, the patient was obtunded and unable to respond and take po fliuids without asparation........Waiting for the MD would NOT be the "prudent" thing to do and failing to give the D50 would be negligent and you would be held liable and responsible for your actions. It is confusing and ambigious but...... First....do no harm. Second...always act in the best interest of the patient. Third....when in doubt call for help and fourth..... carry malpractice insurance.

I completely agree.

[jujuseah, RN]

In these situations, our roles and responsibilities are very very debatable. In Singapore, our drs have handphones instead of pagers. When the pt is in hypoglycemic state, we will call and inform them and ask to give verbal order if he/she cannot be here in 1 minute and usually they get nervous and give verbal order and we will push the D50 40mls and get the dr to sign for it once they are there to review the pt and we usually leave the ampoules around so that they know we have given the right drug (of cos before that it is counter checked with another RN)

We must think critically and act accordingly even if it puts our license at risk but there are certain tapes that we try not to cross. I believe as long as our conscience is clear for the things that we do for the pt and that the pt is alive and kicking, i believe my job for the day is done (and girls they wanna have funnn!).

We must be assertive, protocol knowlegdable and a teamplayer. We must be more than a nurse!

[dthfytr, ADN, LPN, RN, EMT-B, EMT-I]

My daughter is an Army combat medic (just a little proud!) who has a saying: "A boat in the harbor is safe, but that's not what boats are for."

[Jenni811, RN]

my instructor told me in nursing school.

"Don't be afraid to give whatever life saving drugs you need to give during a code. You cannot make it worse, they are already dead. so the only thing you can do is to do something"