Narcotics

[mmace]

I work in LTC and had a question about narcotics. I was working on passing pills in the morning and a CNA had informed me that somebody needed a catheter changed and that the client wanted it done right away. I already had all of my medications, including two narcotics, but one or two left to pull. Would it have been legal for me to put them in my cart and give them after the catheter replacement?

Thank you

[merlee]

Give the narcs, then attend to the patient.

[terri1033]

I would have done pills first,cath next. I've been a nurse 25 plus years.....

[tainted1972, ASN, RN]

Unless it is an emergency, I always finish what I am in the middle of before starting a new task.

If I stopped what I was doing every time someone needed something, I would never get my shift finished.

[RNsRWe, ASN, RN]

When I read the OP, I thought "wonder what kind of a situation required her to drop the narcs and immediately run to change the catheter?". Then I thought "unless it's clogged and the bladder is so distended it looks like it's gonna burst, it's gonna wait".

Minus the urgency of a ready-to-rupture bladder....Foley Woman was gonna wait.

[Esme12, ASN, BSN, RN]

Never leave pulled narcs lying around. Give the med......and do the cath or.....do the cath then pull the med.

[Fiona59]

I know that the US system is user pay and people have a sense of entitlement but the fix it NOW attitude is wrong in so many ways.

[Jasel, BSN, RN]

Legal no? I probably would have gone to the patient and explained she was going to have to wait a few minutes (with the narcotics on hand of course). After you pull narcs you want to give them ASAP, and patients have to understand (which they won't anyway but whatever) that a lot of times we're understaffed, overworked, and have multiple people who want their needs met RIGHT NOW and it's not always going to happen. Pulled Narcotics > Leaking catheter.

[michellezlpn]

Sounds like maybe the CNA wanted it done "right now", so she could finish with the patient. Definitely narcs first, then the Cath change. And yes, the charge nurse could have stepped up to help if it was urgent.

[GLORIAmunchkin72]

"unless it is an emergency, i always finish what i am in the middle of before starting a new task. "

unless you're running after alarms...many times i have already poured meds, have several punch cards out and alarms ring (sometimes from 2 or 3 directions). people assume that since i'm the nearest that i should just be able to take off. sometimes i just have to shove everything back in the drawer and hope they don't get mixed up. if i took the time to do it right the patient would already be on the floor.

[withasmilelpn]

The charge nurse definitely should've stepped up to help. I would've said so. It's too easy to make a med error too stopping in the middle of pouring. Leaking caths are not an emergency. Falling patient - yes. Code - definitely. I'd put them in the cart then. But not for a catheter. Let everyone be annoyed. Won't be the last time!

[lamazeteacher]

It's interesting that the original poster (OP) was mainly interested in what is "legal", as if the argument regarding what priority validated the stand taken, depended on legality rather than need.

The point is, was, and always will

be, that patients in pain require immediate action. A catheter replacement for leakage comes

second..... especially since other

nurses could do that, whereas only

the nurse who "picked" the

narcotics could administer them. Both tasks take more than "a

minute" to accomplish.

[Eaglelady]

In my state if you draw it up and do not give it it is considered a firing offense--as a matter of fact a nurse where I worked did this just with one med and got called out on a code blue state walked in and caught the med in the cart and was later terminated for the offense