Question, patient with multiple wounds, but feeds self, eats well. Owner of care home states vicodin "knocks pt out", so
produces a prescription for fentanyl 75 mcg??? i asked medical director, he said change vicodin 5/500 down to lortab 2.5/500;
also owner of care home states "your marketer said you would pay for her vitamins...." I asked branch manager---no freakn way.... Anywhoo, family member and patient are just so nice to deal with but personal care home owner demands everything! We have NEVER paid for vitamin supplements....we're not talking just normal vitamins-but juven and promod....quite expensive. IMHO, if patient eats well- how about not feeding patient chili dogs and french fries and actually feeding meat and vegetables.......thank you for listening-I do not look forward to this visit today.
I can't even find a converstion from vicodin to fentanyl patch.....from fentanyl iv to vicodin it lists fentanyl as 15000000mg stronger than a vicodin, but i suppose that is divided by 72 hours.......it seems like we are going from a hand file, to a mill lathe LOL
Sounds to me as if someone needs to be reported for patient abuse. I don't care if the patient is on hospice. At any rate, this needs to be ironed out, and I am afraid it will be ironed out in favor of other's opinions and wishes instead of the best interests of the suffering patient.
I have a pretty cool program for my iphone that covert opioid. You just add the 24 hour does of the vicodin and tell it to convert to fentanyl. its called eopiods and I love it!
I smell something baaadd! This "administrator" is not a healthcare professional, obviously knows nothing about Vicodin or Fentanyl, and may be diverting meds. Hold your ground, continue to assess the patient and provide excellent EOL care.
Specializes in Hospice, Education, Critical Care Peds.
How much vicodin is being given in 24 hours? Rather than figuring the 5 mg dose, try to go at it from a full day dose for conversion. If she is gorked out on a short term narcotic, she may do better on a longer acting med because of fewer ups & downs, but a 25 mcg patch would be more appropriate. As always, start low and go slow. The administrator may just be marking her territory, but if the patient is comfortable, I'd question disease process vs. narcotic sedation. Perhaps the admin. doesn't know (or consider) the differences.
caliotter3
38,333 Posts
Sounds to me as if someone needs to be reported for patient abuse. I don't care if the patient is on hospice. At any rate, this needs to be ironed out, and I am afraid it will be ironed out in favor of other's opinions and wishes instead of the best interests of the suffering patient.