How soon to give a prn??

[candycane267]

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:

[jnrsmommy]

I factor in what is going on w/ the pt. Did they recently have any kind of painful procedure done? Is this a habit w/ them? Is their doc the one that absolutely refuses to change the pain med (be it time or med itself)? What have they been receiving?

I came on shift one night, and had a pt that had surgery that AM, who only received 1 Darvocet two separate times, even though she had other PO and IVP meds ordered. When I went into her room, she was in such pain, I couldn't bear it. Yes, I did immediately give her the IVP Morphine/Phenergan, 1hr later gave the PO Lortab, and 30 min prior to the IVP being available again (it was q 4 hrs), I gave it. I told her before hand what she had available, what we were going to do to get the pain under control, then to back off on the meds, and that's just what happened. Got her pain under control, and she was able to rest.

[NurseyBaby'05, BSN, RN]

I have given them up to 30 min early if they are at least q4h apart. If they are ordered for closer intervals, I don't. The doses would wind up running into each other. If there's still a lot of time between doses, I call the doc for a one-time dose. If I have to call the doc more than twice, then I get the order changed. With our onc patients, pain control is very high priority. It's hell trying to catch-up after their pain was allowed to be uncoltrolled. Our residents rotate through for a month. By the time we get the current ones trained well for pain control, the new ones start. Then it's back to square one for us nurses. :grn: