Benadryl without an order

[ncrachuj]

Hi, I am an LPN and I was told that I just need to use common sence when a person needs benadryl and give it even though the person has no order for this. Some of the Nurses where I work have done this, I have refused because I have been taught that no meds are given without an order over the counter or not. I was told by a 3rd party that this is what the house doctor said.

Thanks,

NO COMMON SENSE

[shoegalRN, RN]

I'm not a nurse yet, not even a nursing student (starting 01/17/07), but when I had an allergic reaction to shrimp, I went to the ER. The nurse came in and assessed me and then the dr came in. The dr said she was going to order Benadryl to be given. The nurse came back in and started an IV with Benadryl based on the dr's order. From this experience, I can say that the nurse followed the dr's order. If I were you, I would NOT give any meds without a dr order.

[Jolie, BSN]

Why is Benadryl being given? Is this for an acute allergic reaction? What type of facility do you work in? Are there standing orders from the medical director to cover medication administration in the event of an acute allergic reaction?

If not, I certainly would not be administering anything without contacting the physician.

[Elvish, BSN, DNP, RN, NP]

I wouldn't give it either. If you're covered by standing orders or something, that's different. But just to give it without an order is practicing medicine w/out a license. Believe it or not, I have seen people be allergic to Benadryl (geez, guess you're out of luck if you react to something else....). So you'd really be hung out to dry if that pt were one of the rare few c a Benadryl allergy. Then what do you tell the doc?

In any case, I think you're right. Good luck.

[adrienurse, LPN]

I would advise against giving any periatric person benadryl because or it's sedating effect. That's good enough reason to require an MDs order to give it. I imagine it could be misused quite a bit to control behaviours.

[puggymae]

I wouldn't give it either. If it was the charge nurse who suggested that you use "common sense" I would go to them and have them give it if s/he thinks it is okay to do.

[bethin]

Not a nurse yet, but I am under the impression that you cannot administer any medication (OTC or not) without a MD order. I've had people ask me if the nurse can get them some Maalox. I have to tell them it'll be awhile because we have to get an order.

[babynurselsa, RN]

CHeck and see if your facility has a standing order for benedryl for itching, etc.

Giving ANY medication in your capacity as a nurse without a valid physician order is practising outside of your scope of practice and can land you in a heap of trouble.

[S.T.A.C.E.Y, LPN]

CHeck and see if your facility has a standing order for benedryl

Check the policy/protocols at your facility. If there is one, maybe the nurses just know the circumstances that it is ok for them to give the benedryl according to policy. If there is a policy regarding this then all's well, if there isn't then I'd keep out of it. No sense losing your license by something someone told you someone else said.

[TheCommuter, BSN, RN]

If a patient appears to be having a severe allergic reaction, place a quick phone call to the MD so you can obtain a telephone order for Benadryl.

If a patient appears to be going into anaphylaxis, call 911 ASAP!

However, I would avoid giving medications without a physician's order.

[RNinSoCal]

Nurses who give meds without an order are playing Russian roulette with their licenses. I won't give anything without an order. What if the person had an unknown allergy to Benadryl? What if it was given IV and the pt became sedated. I have had elderly patients sleep for 12 hours after benadryl was given IV. I hope you don't follow their bad examples.

Our smarter doctors sign standing order sheets that have MOM, Tylenol, zofran, benadryl and other prns on them so they don't get 2 am phone calls for minor problems. Maybe your house MD should use one of these.

Just a suggestion.

[classicdame, MSN, EdD]

Never give anything without an order.Period. An exception would be a nursing protocol for specific situations that has been approved by Admin and the Medical Staff (like pre-op meds for certain surgeries). Benadryl is NOT a harmless drug. No drug is. Benadry can cause kidney failure which can lead to a heart attack. Then what would be your position if you treated a patient without an order?That is the same as deciding what the diagnosis is then deciding how to treat - and that is what MD´s arefor. If your facility does not support this then move on- your license is more valuable than their excuse of "we have always done it this way".