Ok for whatever reason, my pt has vicoden instead of percocet ordered. Q4h prn pain. So she wanted it round the clock since yesterday. I got her today. I got the first dose about five hours after her last dose, and another nurse gave her the next dose 4h later at my request since I was admitting another patient at the time.
So the nurse coming on after me tells me that there is too much tylenol in Vicoden to give q4 and that it should be q6h.
I am new enough to not have known. And I was told by the previous nurse (who is also an upper level nurse) that she wants it q4 and to give it that way. (Pt kept track and asked for meds, didn't automatically bring them in)
So what the heck...the order was over a day old, and no one said anything about too much tylenol before this. I am GLAD the nurse mentioned this, as I did not know it. I know that vicodin has tylenol, but I never dreamed that it was too much.
I am having trouble knowing what I should know, and not knowing htat I should know something that I don't know! Do I have to look up EVERY medication that is ordered? I always look up the ones I don't know, but the problem is that I thought I knew vicodin.
I didn't think to question the order because I didn't know I should question it.
I *thought* I knew vicoden, I was wrong I guess.
I call the pharmacy at the drop of a hat, with any medicine question, its not like I don't pay attention. I just plain didn't know.
I know I am at fault for not knowing and for not looking it up--but if I don't know, how do I know to look it up?
I am thinking of requesting that there be a protocol that ALL vicoden orders be standard at q6 unless there are special circumstances, or that each vicoden order clearly states the max dose.
anyway, I hate leaving work with that as the last thing done.