Deciding what to give to the patient who gets everything

[Birdy2]

So I've been wondering how to decide what to give my patients who are prescribed a million things for pain. I had one that got dilaudid and morphine q2 prn, Percocet q4 pen, Ativan q8, and morphine po scheduled. There were times when they technically could have gotten them all and were asking for them, but BP was low plus they were having trouble breathing. How do I decide what to give??? I hate it when they order that many. It makes it hard for me to decide and takes me forever to sit there and calculate when they got each thing last.

[wheeliesurfer]

GrnTea and Heather basically took the words right out of my mouth! Thanks for the great posts :)

[CamillusRN, BSN]

Not really a suggestion - more a humorous observation: one of the Army docs I was talking to one time said he would tape a fentanyl lollipop to the patient's finger and have them stick it in their mouth. When drowsiness set in, the finger would fall out and thus an overdose would be prevented. Of course, this was for combat casualties so it's probably not relevant to your situation.