DEMEROL ... does Your unit use it?

[jodyangel]

Ok so I am in a new facility. My old facility used demerol 12.5-25mg post csection IF needed for shivering. Not sure why, but demeral cuts the shivering.

The other day my pt was shivering so bad her teeth were chattering. I called Anesthesia and asked if she could have some. He gave me a verbal order and I wrote it down and pulled it. When I told my preceptor that I was going to give it to her she looked at me like I had two heads!!

WHY?? She said. She had never heard of using it..and thought it would "snow" the mother.

She said maybe we could put the bear hugger on her if she was cold. I wanted to say, Noo shes not cold she has that post anesthesia shivering...but kept quiet. Both she and the charge nurse said Ohh we dont take any verbal orders, you'll get in trouble for that.

Hmmmm..ok.

So I put it back. Let the pt. shiver. I know its ideal to have the doc write the orders..but sometimes you need something right NOW..and well..ok so no verbal orders..shesh.

They give their CSection pts. Duramorph IN the epidural so they also get NO post surgery pain meds.

[PinkNBlue, BSN, RN]

That is bizarre about no verbal orders. We input verbal/telephone/written orders all of the time at our hospital via computer charting.

Anyway, we do use Demerol for shivering. We also use Duramorph and have standing orders for these patients including Nubain for unrelieved itching that Benadryl doesn't take care of as well as pain relief if Toradol isn't cutting it. Then obviously anti-nausea meds as well as Narcan to reverse the Duramorph.

I would see you asking the doctor for something for your patient as being an advocate. It may not be emergent but your patient is uncomfortable and you're trying to help make her comfortable....