okay, this could be a stupid question/story, but my degree is not in nursing - i start this summer
so, when i was in the hospital after a c-section (with my 2nd child) and my son was in NICU - i was prescribed to lortabs (2 every four hours). since i was staying in the hospital, i didn't have to go out and get a prescription - the nurse brought it to me...while i was there.
when i had my first child, i was released from the hospital the next day after my c-section - went to the pharmacy, and took MAYBE 5 or 6 pills once i was home. the rest stayed in my med. cabinet.
but with my 2nd child being in NICU and me being stuck at the hospital without being able to breastfeed, hold him, and do all the things new mothers usually do - i was a nervous wreck and stir crazy - wanting to walk to see him, wanting to walk to the ice machine, wanting to put on make up, wanting to go develop pictures - wanting to do ANYTHING besides sit in the hospital bed without my baby!
point being - since i was doing so much running around, i actually needed the pain meds this time. so, after about 6-7 hours without, i asked the nurse if i could have some and she was nice and brought them to me. i suspected that she'd bring me some 4-5 hours later. when she didn't, i asked again. she brought them to me. i asked if they could just bring them to me when they had the chance (around the time i was prescribed) because i would be needing them and i didn't want to bother them - and she said no, and that i had to ask for them. i felt like a drug addict begging for meds every 4-5 hours! i hated it. and after a few times of asking, i felt like THEY were treating me like one!
why do you have to ASK for pain meds in the hospital when they're prescribed after surgery? i'm sure there's a reason - it just made no sense at the time.
percocet 5-325 mg 1 tab po every 4 hrs x 48 hours. (of course i will tell md per patient request)
yea that works but i dont know why you would call a dr. about this when you had a prn order that leaves the administration to the discretion of the nurse...
yea that works but i dont know why you would call a dr. about this when you had a prn order that leaves the administration to the discretion of the nurse...
because the patient requested it to be given every 4 hours so i need a new order. if the pain med was ordered prn, then my patient will have to ask me every 4 hours each time. that's what prn means.
because the patient requested it to be given every 4 hours so i need a new order. if the pain med was ordered prn, then my patient will have to ask me every 4 hours each time. that's what prn means.
nope, that is not what prn means, it means as needed....that means the nurse gets their butt into the patients room on or about the time it could be given and assesses the patients pain and decides if it is needed.
yea that works but i dont know why you would call a dr. about this when you had a PRN order that leaves the administration to the discretion of the nurse...
I agree with you on this one. If my patient is taking prn pain meds every 4 hours, I will keep track of their next dose and bring it to their room so they don't have to call and ask for it. It's prn, as needed, they need it every four hours.
thanks for the responses. who knows why it happened - maybe she saw me up and about (putting on makeup out of boredom) and thought i didn't need them. had i been lying in bed like most women who actually have their child, i probably wouldn't have. it was because i didn't have him that i was up and moving. i'm sure i could've gotten in bed and done without, but i didn't want to! i'm not sure if it hurt more than the first c-section because of my mobility or because i was cut on an old incision. either way - i think anyone who has had their stomach cut open with no reward (the baby) needs a little pep in their step! oh well - these are the things we keep in mind when we're on the other side!
I agree with you on this one. If my patient is taking prn pain meds every 4 hours, I will keep track of their next dose and bring it to their room so they don't have to call and ask for it. It's prn, as needed, they need it every four hours.
I'm with you on this one. I would keep it prn and give it as requested -when they can get it next. I would not in this case change it to an ATC order since as time goes by it is anticipated that the a new mother's pain will get better. For LTC I might consider an ATC order since that pain will probably continue and/or get worse.
nope, that is NOT what prn means, it means as needed....that means the nurse gets their butt into the patients room on or about the time it could be given and ASSESSES the patients pain and decides if it is needed.
I'm with you on this one. I would keep it prn and give it as requested -when they can get it next. I would not in this case change it to an ATC order since as time goes by it is anticipated that the a new mother's pain will get better. For LTC I might consider an ATC order since that pain will probably continue and/or get worse.
so, does saying, "can you bring it to me when i'm due next so i don't have to bother you" not count as requesting it? it actually has to be requested each and every time?
i think that's a little silly for a c-section patient on day 2-3 who has been walking all over the place. it was actually a request because A) i knew i would need it bc when it started wearing off, i started slowing down...and B) i was trying to be nice to the nurse by not bugging her every 4-6 hours and instead saying "bring it when it's due and you have the chance."
so, does saying, "can you bring it to me when i'm due next so i don't have to bother you" not count as requesting it? it actually has to be requested each and every time?
i think that's a little silly for a c-section patient on day 2-3 who has been walking all over the place. it was actually a request because A) i knew i would need it bc when it started wearing off, i started slowing down...and B) i was trying to be nice to the nurse by not bugging her every 4-6 hours and instead saying "bring it when it's due and you have the chance."
If you had asked me to bring it back again when it was due, I would. I see no issue with a patient asking that - especially one that is alert and oriented. Also it is good to stay on top of pain.
You will find that nurses have differing opinions on pain meds and the administration of those pain meds. Some take PRN meaning as needed and that you need to ask for them every time. Some nurses will give them or at least assess at the intervals prescribed. They are both right. But I think as you noted from your experience, we do need to let the patient know what is available and what PRN means.
I consistently assess a pt's need for medication and often bring the PRN just as it is due, because I know they are going to ask for it and need it. Nothing wrong there, thats just good assessment skills. Assess the pt. needs the pain relief and needs it pretty much as frequently as its ordered and bring it to them. Thats simple. You'll find going this route will make your patients happy and make things easier better for both of you.
I've seen the Nurse Ratchet's who insist the call bell be put on and the whole sherade of "asking" for it be performed before they will get the med. And if the pt. calls....just 5min. early....they say no and the whole song and dance has to be repeated again in 5 min. This is not nursing at all. Where are the assessment skills/autonomy/pt focus in that? Thats passive aggressivness, plain and simple.
Now, the line I won't cross that I've had a lot of people ask me to do is........I won't wake people up in the middle of the night to give them a pill. If they ask me to, I'll stick my head in the door to see if they are awake. If they are sleeping, I leave them alone.
Specializes in Medical and general practice now LTC.
We have to remember that everyone's pain thresh hold is different and each situation is different. As nurses we should be treating everyone holistically and individually. I personally think if meds are prescribed PRN and patient requires them 4 hours then give it 4 hourly and get the order reviewed by the doctor and changed if necessary. I too will not wake someone up to give them pain relief but if they are awake and request it then I will give it. If the med is a narc I will not obtain it without knowing the patient is awake so not to waste it.
CVmursenary
240 Posts
yea that works but i dont know why you would call a dr. about this when you had a prn order that leaves the administration to the discretion of the nurse...