Lesser of two evils...

borrowin any med, let alone narcs labeled for another patient is illegal.

If the pt was in severe pain and was not helped by the Tylenol, I'd be sending the pt to the ER for pain relief.

not his/her med, not given. think of what would happen if said pt had a reaction or died or something, its your butt. no way no way. i work on a ms/ortho floor, i have seen nurses do this, no way dood. not me, and i hate when they attempt to take from my drawer, even for non narcs. nope, nada

And keep something in mind: there will be nurses who tell you "Everybody does it". That does not make it right.

I'm sure there are nurses that do it but it is NOT LEGAL. I have done some prn work in a LTC facfility and we had an emergency narc box, so if a pt ran out before their replacement came (usually at 4a) or they were a new admit we would have something to give them as long as they had an order. We also had one for IV, insulin, and antibiotics. Why should you risk your license because the facility isn't properly equiped.

Tell the truth and shame the devil.

That's an old saying that I think applies here. IOW, give what the MAR allows you to give without borrowing and get the narc refilled ASAP. It's unfortunate the resident may suffer in the meantime. I don't know if I'd send to ER to address the pain.... that would be a judgement call on the spot.

What's important here (besides the resident's pain) is the fact that this scenario is being played out, IMO. Why did the facility run out?!?!? What steps can be taken so it doesn't happen again?

I don't know if I'd send to ER to address the pain.... that would be a judgement call on the spot.

Since intractable pain is considered an urgent/emergent issue, it would be appropriate to send to the ER if it's 4 am, the pt has not slept because of the pain, and the refill order has not been signed by the doc as of yet with no signature in sight.

If the pt was in severe pain and was not helped by the Tylenol, I'd be sending the pt to the ER for pain relief.

Tazz, I agree with you 100%. It also reminds me of my nursing school days. I was called the "Shipping Queen". Before nursing I was a EMT and everytime teacher would say "what would you do" everybody turned to me and said "ship em"!

Since intractable pain is considered an urgent/emergent issue, it would be appropriate to send to the ER if it's 4 am, the pt has not slept because of the pain, and the refill order has not been signed by the doc as of yet with no signature in sight.

I agree... in the scenario you outline. The OP, however, didn't give those details in her/his scenario. Certainly, the resident's pain is a priority and should be addressed. Still, given the circumstances outlined here, I don't know if I'd send the resident to the ED. A pain assessment/other interventions on the nurse's part before transferring to the ED are surely appropiate.

Perhaps I'm missing somethin here.... I work 3rd shift and I've stayed up WAAAAAAY past my bedtime!

i don't think there's any point in saying what should have been done, you're asking about what to do next.

be honest. that way you don't have to remember as much. that's what my youth pastor said, and he has never been wrong.

jess

The truth?!?!

I have never been in such a situation, but I have to admit, I would be tempted to do the same. If the narc is the same drug, same dose and whatever else, I would have been tempted to give it, because it would save time. One of the things I value about this site is hearing the other side of it, and now, I would probably take the situation to the doctor and RN and have them create a solution.

I have friends working in med-surg that had similar things happen with heparin. The pyxis on their unit didn't have any and they went to borrow from another floor where some of the nurses working there created a stash. I guess that was wrong, too.