Can I give half a dose?

[limabean]

can you give less than the physicians order? for example, i had a patient the other day who wanted only half of his xanax. i said that i could only give him what was ordered (which i thought was right). he said, well that is what the nurses always do b/c i dont like taking that big of a dose. so i went out and asked my charge nurse and several other nurses who said that it was okay to give him half. well i did it, even though i really think i remember that you can not do this. am i right? and if i shouldnt have given him half do you think i should write up a med error and tell my supervisor? thanks...i just want to do the right thing with this.

[KK92RN]

i was taught in school that for any change you have to talk to the md. but if i know the doctor or it was a pt home med then you should be covered. I the doctor wrote specifically for that then i would call. some mds you can never tell what they will do.

[not now, RN]

There is a woman in my facility that has an order for two Vicodin PRN. Normally she'll take the two but one night she only wanted one. I pulled two pills, gave her one, wasted the other. In the MAR I wrote "One tab given. Resident refused second tab. Second tab wasted." Did the same in the narc record.

Later I asked my DON what I should have done and she said what I did was right but "If she continues to ask for one then we'll have the order changed." She's never asked me for one since.

[rosemadder]

I am pretty sure you can give the 1/2 legally without a new order...but having to waste the 1/2 would be the hassle so I would give the 1/2, waste the other 1/2 at that time, then leave a note on the chart for the doc stating I would like an additional order for 1/2 (if these were prn's) in case I later needed the larger amount...I probably wouldn't call the doc for this (just leave the note) especially if it was the middle of the night.