Giving narcotics to patients with no ride

[alimill]

I was helping a fellow co-worker yesterday in the ER with her abd pain patient. I had started the line, drew blood, gave zofran and started NS. I walked out and gave her the Dilaudid that was ordered and said "he doesn't have a ride and I don't give pain medications to patients with no ride" She replies "pancreatitis is one of the worse things that you can have and when the patient says he has pain you have to believe him" Did I feel bad? Kind of. Is my nursing license worth losing on a patient who "promises to call a cab if you give him pain medication?" NO! Another nurse I work with stated she gave over 10mg Morphine to a mother with 2 kids with no other adult with her that ended up literally running out of the door to her car! How do you other ER nurses feel about this subject?

[LaughingRN]

It depends on where you work. It depends on hospital policy. It depends on the local police. Multiple stab wounds usually are admitted OBS and suspected aortas go to al least tele.

I have worked at places that waited an hour or 2 and let them go, I have worked at places that waited 4. I have worked a places that called for a cab and used vouchers. I have worked for places that refuse to voucher anyone and call the police to PC. Personally it depends on the situation and presentation in my decision making process.

This has been discussed at length here.....

Google Search Results for giving narcs no ride home Try here. :)

Thanks Esme12

you are right...it does depend on all these factors.

Each situation/hospital is unique.

In the large Urban inner city where I work...GSW's, stab wounds and basically everything "initially life-threatening" are sent home from ER if the test results clear them.

The census level and acuity level are very heavy....these events occur daily. We simply do not admit unless prudently necessary...or else we would run out of space

Someone else mentioned earlier in this thread that the majority of their patients walk in. I echo that. The vast majority in our neighborhood walk in and thus don't drive. ( nor have the ability to own a vehicle)

Thanks for referring me to another post, but this was someone else's inquiry, not mine, and I was simply trying to diversify the responses with my point of view.

[Hagabel]

We give a lot of Codeine to our pts in the w room and I will not give it to them if they have are driving. Most of our pts have rides and their whanau are normally with them. Same with pts in the back unless you know they will have to have a ride home, ie pain meds for the nasty looking fracture that is going to have conscious sedation.

[Esme12, ASN, BSN, RN]

Thanks Esme12

you are right...it does depend on all these factors.

Each situation/hospital is unique.

In the large Urban inner city where I work...GSW's, stab wounds and basically everything "initially life-threatening" are sent home from ER if the test results clear them.

The census level and acuity level are very heavy....these events occur daily. We simply do not admit unless prudently necessary...or else we would run out of space

Someone else mentioned earlier in this thread that the majority of their patients walk in. I echo that. The vast majority in our neighborhood walk in and thus don't drive. ( nor have the ability to own a vehicle)

Thanks for referring me to another post, but this was someone else's inquiry, not mine, and I was simply trying to diversify the responses with my point of view.

Oh no I get....:hug: Many don't know tha inner workings of the inner city. I worked the South Side Chicago and downtown Gary , IN....... I have discharged stab wouds and GSW, but those places aren't the norm. Cook Country on a good Friday night, you counted the points of entry and if they had an O2 sat and no sucking chest wounds....they waited.

The Link was posted for others to see other discussions and not specifically meant for you. Inner city policies and experiences are vastly different from everyone else....stay safe!