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I will give it half an hour early...but only after looking back at the previous 24-48 hours. If it's a pattern, I will have a discussion with the pt about how well the meds work, for how long, and either discuss with the dr...or leave a note for him/her in the morning.
I thought there was no wiggle room with prn's, but as a new nurse, in orientation was told by multiple preceptors that the hafl hour rule still applied as long as I looked back at total use for the day.
Narcs I will not give earlier than 10 minutes before due, if it's q 3hrs and they need something 1/2hr ahead, consistently, dose/drug/interval/addition of adjunt meds ie NSAIDS, etc. need to be addressed- I am a firm believer in the power of pharm aceuticals !! no need NOT to have decent pain control, if it's (clearly) drug seeking,they wait to the minute, I wont be manipulated
We have both computerised systems and paper medication charts, depending on which medical / surgical team the patient is under, as well as the ward they are on - ie the nursing staff may not have been orientated to it yet.
We cannot give prn medications early on the computerised system. It just will not allow it. But there is the option of giving nurse initiated medications, such as paracetamol (acetominaphen I think you call it there? Forgive my spelling), but it can only be done once before review.
On the papercharts, I usually won't do it until at least 15minutes beforehand. Because by the time I write it up in the ward drug register, and then on the patients chart, and then check it with another nurse at the patient's bedside, then it will be relatively close to the allotted time.
If the pain is not controlled before then, then the patient needs review, in fact deserves review. My registration is just as important...
candycane267
30 Posts
i had to post on this because i questioned how early do you give a prn. my assistant nurse manager on nights said 30 minutes prior - is acceptable. because we do computerized meds (we scan them). i gave a prn med 6 minutes early and the hand held was asking why - so i usually put in patients request. but my anm said she always puts in nursing judgement.
:w00t: