Jump to content

BID strictly every 12h or just twice a day?

First Year   (41,643 Views | 15 Replies)
by krg8089 krg8089 (New) New

1,553 Profile Views; 7 Posts

I am a new grad and just started my first nursing job. I was doing med pass and a patient asked me for a prn pain med that was BID. I told them they had just had it about 5 hours before so they could'nt have it till later and their argument was that they just have an allotment of twice a day, but not necessarily 12 hours apart and that no other nurse waits 12 hours in between doses. What is the correct way to go about that?

Share this post


Link to post
Share on other sites

4 Posts; 2,012 Profile Views

Hi, BID means two-times-a-day. :) the timing depends on the hospital guidelines in giving medication.. some hospital timed BID as every 6am-6pm, or 8am-6pm, or 8am-8pm...IT ALL DEPENDS ON THE HOSPITAL'S GUIDELINES.. To play safe, ask your senior or supervising nurse.. :) It is very important to memorize the 12 Rights in giving medication, such as the timing and color coding the medications since nurses are prone to medication errors. :) Hope this helps. :D

Share this post


Link to post
Share on other sites

4 Posts; 2,012 Profile Views

In addition to the PRN, when the doctor's order is BID PRN ... same rule can be applied... that the medication should be given 2x a day as needed.. when the patient complaint of ex.pain, u should check the previous time the PRN was given, if it is not relieved, then its time to refer it because the patient may be suffering too much that the dose of BID PRN cannot give any relief. ALWAYS, ALWAYS KEEP IN MIND THAT "ASK" YOUR SUPERIOR WHEN IN DOUBT. :D

Share this post


Link to post
Share on other sites

turnforthenurse has 7 years experience as a MSN, NP and specializes in ER, progressive care.

3,364 Posts; 36,772 Profile Views

BID is twice a day, or every 12 hours...but as PPs have mentioned, it depends on your hospital's policy. If a patient only has a PRN med ordered BID and they are still complaining of a lot of pain, perhaps it is time to speak with the patient's physician about increasing the dose or increasing the frequency if possible.

Share this post


Link to post
Share on other sites

TheCommuter has 10 years experience as a BSN, RN and specializes in Case mgmt., rehab, (CRRN), LTC & psych.

2 Followers; 228 Articles; 27,607 Posts; 318,932 Profile Views

At my workplace, BID PRN means twice a day, but at least 6 hours apart.

Therefore, a patient could have their medicine at 8am and again at 2pm.

Share this post


Link to post
Share on other sites

Meriwhen is a ASN, BSN, RN and specializes in Psych ICU, addictions.

2 Followers; 4 Articles; 7,907 Posts; 60,003 Profile Views

BID PRN is roughly 8-12 hours apart, depending on your facility's specific policies and the medication involved. If they want to have it given strictly every 12 hours, q12h would be the better choice. If they are more concerned with limiting the number of doses than the timing of them, then they could say "NTE 2 doses in 24 hours".

If BID PRN isn't working for the pain, you need to let the prescriber know so they can increase to dose amount and/or frequency.

Share this post


Link to post
Share on other sites

merlee has 36 years experience.

1,246 Posts; 13,543 Profile Views

BID of 'regular' meds is usually 9A & 5P. So there should be at least 8 hrs between those doses. Ask for clarification.

Share this post


Link to post
Share on other sites

7 Posts; 1,553 Profile Views

Oh ok, so it varies from facility to facility? I will be sure to ask my supervisor tomorrow then! Thanks so much for the input everyone! :)

Share this post


Link to post
Share on other sites

TheCommuter has 10 years experience as a BSN, RN and specializes in Case mgmt., rehab, (CRRN), LTC & psych.

2 Followers; 228 Articles; 27,607 Posts; 318,932 Profile Views

Just like TID is not necessarily Q8h. It could be 0800, 1400 and 2000, or 0700, 1400 and 2100 depending on facility policy.

It could also be TID with meals (0700, 1200, 1700).

Share this post


Link to post
Share on other sites

1 Follower; 6,983 Posts; 32,764 Profile Views

The order isn't truly complete, there should be a "not closer than" part. And, unless your P+P states it, BID isn't nec. Q12. good luck

Share this post


Link to post
Share on other sites

ktwlpn is a LPN, RN and specializes in Med Surg, Homecare, Hospice.

3,844 Posts; 30,987 Profile Views

As a new grad you should make a habit of consulting your policy and protocol-frequently.Not only does seeing it black and white help you remember it but you never know if your supervisor is giving you the correct information. It is up to YOU to seek info from the appropriate source and if you do make a mistake (especially one that results in some degree of harm to a patient) " I did what she told me to do" is not a good defense.

Share this post


Link to post
Share on other sites

FurBabyMom has 8 years experience as a MSN, RN.

1 Follower; 1 Article; 794 Posts; 25,154 Profile Views

I would clarify with the experienced or supervising nurses how they handle BID/TID meds. Or better, pull up policy, read it and then ask how it's handled (so you know what the policy is but how do you handle the customer service part - what is a good way to explain it to patients...) When I worked on a med-surg floor most of our BIDs were scheduled and pharmacy would assign times based on the drugs themselves (we usually saw BID orders regarding home meds example: a patient might take them twice a day at home say with breakfast and dinner, but pharmacy puts the times in for 0800 and 1700 or something like that). But it does vary between facilities. Very very very good question though!

I think if they wanted it specifically q12 they would have wrote for q12. But it never hurts to explain to a patient that they ONLY get it twice a day whether they get it 6 hours, 8 hours, 10 or 12 hours after the original dose for the day. Being the nurse that I am, I would request parameters from a physician, NP or PA (whoever can modify (presumably) contolled substance pain related orders in your state). I would ask for an amendement to make the order be BID or TID but have them add 'X hours between doses' or 'no closer than X hours'.

Edited by FurBabyMom
additional information added

Share this post


Link to post
Share on other sites
×

This site uses cookies. By using this site, you consent to the placement of these cookies. Read our Privacy, Cookies, and Terms of Service Policies to learn more.