Giving med outside scheduled time.

[notanumber]

I know, it happens a lot in LTC, but . . .

Resident has short acting opioid scheduled five times a day, including one at 2400. Resident frequently over sedated at this time d/t multiple sedating meds (including opioid) given at hs, so it may be held. However, they will frequently wake 2-3 hours later requesting same med.

Do you give it?

[amoLucia]

Simple. Just get a PRN order to permit a later dose if that midnite dose is held. Just ensure that nothing would be given too late in your shift to interfere with the early 7-3 dose.

[notanumber]

That's one thing I suggested to the MRP in the fax I sent, but unless pain is really uncontrolled I wasn't going to phone the on-call in the middle of the night for an order.

[caliotter3]

You can pass on a request for day shift to make the call to get the PRN order. Then it is taken care of.

[notanumber]

I took care of it, I just wanted to know if anyone would have "just given it" at 0300 like the baffled day nurse who I handed off to suggested.

[amoLucia]

Just FYI - personally, and I cautiously say this, I would give the med. But that's just me. There is an order for 5 times a day. That frequency is needed for his pain control mgt. If the pt's VS are OK, responsive LOC approp for pt, uncomfortable, etc, etc, I'd give it. But before I left in the morning, I'd be making a phone call for an order to cover it.

I will say that a lot depends on who's the attending PMP. Maybe because I strove to develop a good rapport with them and they trusted me, I rarely had a problem getting an order. I would make it a point though to explain that that type of order would serve to deter some other nurses from calling at 2am. (A little schmoozing here.) Inasmuch as I knew the PMPs, I knew where to tread cautiously.

[AngelRN27]

This thread should be moved to LTC. This is not the same as LTACH.

[notanumber]

You're right, I posted in the wrong forum.