Do you wait long enough

You should give the meds as directed. For some meds, especially cardiac meds, there can be pretty profound hemodynamic changes if given all at once.

Unfortunately it really depends on the medication and if or how the patient is being monitered.

With many narcotics the drug information pamphlet will specify slow, over (it varies) 2 - 5 minutes for most narcotics.

Working PACU we give morphine, Demerol, fentanyl, and just push it in. These patients are on O2 sat and BP monitors. It also of course depends on your patient, and the amount you are giving. A healthy wide awake patient complaining of a lot of pain, I would push it fast. A older, not quite awake but complaining of pain patient I would go just a little slower, but also be giving a smaller amount.

Working on the floor without continuous monitoring I would go slowly.

I'll never forget first time I studied to be a moderate sedation nurse. Studying doses per patient weight giving drugs over several minutes!!!! Ha Ha, in a gastroenterology lab for an EGD the doctor would be done with the procedure before you had completely given the first dose!

I don't know about 5 minutes, but I never give anything fast. It's just a safer practice to give IV meds over at least a couple of minutes. Cardiac meds and opiates are the ones that first come to mind that could get your patient into big trouble if they are pushed too fast. The cardiac meds, obviously, could lead to dysrhytmias if pushed too fast. Opiates give a "rush" if given too quickly, which can affect the heart and/or respirations. It can also make patients who are opiate-naive really nervous/upset, and make them not want to have it anymore, even if they really need it. I know it's hard on a busy shift to take the time to do while you're in the moment, but if you add it up over a whole shift, it's probably only an extra 10 minutes or so that you would spend giving all of your patients their IVP meds more safely than pushing them fast.