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Yes, I think you would need an order, and don't be surprised if the doctor does not give you one. I assume the patient wants this for heartburn. Baking soda with water is very good at relieving heartburn, but only for about an hour. The doctor would probably want to investigate why the patient is having heartburn or acid indigestion, and use a PPI or something instead.
I had given the patient phenergan twice and she said it didn't help much. She asked for baking soda in water to help with indigestion.
I told her I couldn't give it because I had no order to do so. She got ahold of the RN supervisor on duty and the supervisor gave it to her without a doctor's order. She said it really helped her out.
I question the RN "supervisor" who would do something like this. How can one supervise and assure that care is given per nursing standards when she has breached the standard of care by giving a medical compound without a doctor's order? In my facility, I would be providing a written counselling to the supervisor and having her go through a medication and nursing standards of care re-educationwith the staff educator. I would also not be allowing this person to be a supervisor as she clearly does not understand the role. If it happened again, I would be reporting her to my state board following termination.
Well, I give sodium bicarb mixed in water to several residents for reflux. Of course, our 70 year old physician is infamous for his old-timey orders. We also give spoonfuls of mineral oil for constipation. And one resident can even get aspirin PRN for headaches.
Once he ordered an aspirin dosage in "grains" (I was mystified) and he refers to me as the "duty nurse" or "nurse on duty" (I have no idea what that means)
Blackcat99
2,836 Posts
Aren't we suppose to get a doctor's order for it before giving it?