Narcotic Adminstration in Pacu

[SaraDavisEdick]

Hi All,

I work in a PACU where another nurse can get you a narcotic medication for you if your busy ie: medicating another pt, just getting report on pt, etc. that nurse will either give a dose of that medication themselves or hand it to the nurse taking care of that specific pt. We also will document electronically that we either gave the med or if the other nurse gave the med. Sometimes we waste with a whole different nurse after the patient has reached their comfort level. When it comes to breaks/lunch relief and we have a patient still reguiring medications we leave the rest of the med for the relief nurse to continue providing. I am curious what other PACU'S do and if any have any policies regarding this issue.

[Rose_Queen, BSN, MSN, RN]

Well, first of all, real world nursing is different from "textbook" or "ideal" nursing. Ideally, one would not give a med removed from the medication dispensing system except in the case of dire emergency. And if you leave an opened vial with another nurse, what ensures that the med goes to the patient and isn't diverted? I don't work PACU (I'm OR) but I'd protect my own butt by not leaving open vials of medications around. Helping out by pulling AND administering is one thing- what you are talking about is another. I've actually in the past had a medication reconciliation come back to me- I had removed Versed from the Pyxis in the preop area for the anesthesiologist to give prior to transporting the patient to the OR. It was documented on the anesthesia record. However, because I had taken it out, the expectation was that I would administer it and document it (nursing was using computerized administration records, anesthesia was still using paper). Fortunately, the anesthesiologist backed me up and pointed it out on his record, but that was the last time I ever pulled a med for someone else to give.

[SaraDavisEdick]

I agree also cover your own butt, but like you said real life nursing isnt always text book nursing. I'm trying to see if there are any PACU's that do this or don't do this and if they have a system in place as we are trying to change our system. Thank you for your response.