Need another MD order?

I would look at it this way. The standing order is to get the kit into the house at the start, sort of a "provide the supply" order. The second order is the specific order for the way in which the doctor wants you to administer the "supply" according to your rendition to him/her of the patient's condition at the time.

the second order is to prevent the type of mistake that was made when my mom was dying and a hospice patient. she had breast ca with mets to her liver, pancreas and brain and because of her altered mental state,frequently became hysterical if i came near her or tried to care for her. she was at home and we filled in the gaps with 24 hour nurses and an occasional aide with the hospice nurse visiting regularly. we had the box of hospice meds and instructions to call the doctor before giving certain of the meds.

by then, she wouldn't take anything i gave her so meds administration was up the nurse.

this system worked until the last week when increasing amounts of morphine, and haldol were needed.

also in her regular meds box was halcion. i discovered three days later that the day nurse had been going into the hospice meds box and slipping my mom extra morphine along with haldol because she didn't want to have to deal with a difficult and paranoid patient every shift. to make things worse, she had been giving her halcion instead of haldol three times a day. she no longer has a nursing license.

extreme, but it does happen. orders are necessary. in my mom's case, it would not have kept her alive longer, but she probably would not have been as paranoid, confused or combative had her meds been given with on the spot orders.

kathy

shar pei mom:paw::paw: