Tylenol ordered for pain.

enuf_already · Apr 30, 2015

You are correct. The order for Tylenol you had was for pain. Of course you know Tylenol can be effective for a fever, but the doctor did not order it that way.

If I recall, The Joint Commission is the governing body that cracked down on giving medication such as Tylenol and Motrin, only within the guidelines written. You had no orders for fever so you correctly called the doctor.

caliotter3 · Apr 30, 2015

In the old days, some nurses would give the tylenol in those circumstances and get the order from the doctor after the fact. But those doctors cooperated. Nowadays, not a likely scenario. You are right. You need a viable order.

loveofrn, BSN, RN · Apr 30, 2015

Well, I think you can use tylenol for mild pain and fever. I think the doctor was right about the order

allnurses Guide · Apr 30, 2015

with the exception of one doctor, all the doctor's at our LTC facility use a standing order of Tylenol 650mg for mild to moderate pain 1-5/10 or temp greater than 100 degrees. This order covers the bases for us and the doctors. That one doct will write 2 different orders.

akulahawkRN, ADN, RN, EMT-P · Apr 30, 2015

The order wasn't for fever, it was for 1-2/10 pain. While the med can be used for fever, without an order for it (protocol or otherwise), you technically could get in trouble for administering the med. That doc was probably angry/irritated and you just happened to be a convenient outlet. It wasn't you. He probably would have exploded and taken out half the floor had you replied something along the lines of "...then you should have written the med order to cover that because I'm not going to practice medicine without a license."

suanna · Apr 30, 2015

Would you rather get chewed out for giving Tylenol for temp and "masking" the patients fever. Why some docs want to see how high a temp will get before they treat it is a mystery to me- but I've been chewed out for both giving Tylenol and for following the order as written (for pain) and calling the temp. The correct answer is whatever you did- you are wrong-don't ever let it happen again. You can get snarky and instruct the doctor on proper parameters in the orders, or you can just do the best you can for your patient and try not to kill too many attendings- there is a doctor shortage in primary care and it gets worse when nurses kill too many of them.

Seaofclouds, BSN, RN · Apr 30, 2015

Well, I think you can use tylenol for mild pain and fever. I think the doctor was right about the order

While Tylenol can be used for pain and fever, it must be ordered for both. If the order was strictly Tylenol for pain, the OP did not have an order to give the Tylenol for fever. If she gave it without the order specifically stating to give for fever, she would have been practicing medicine without a license and could get in big trouble. There is a huge push for proper indications on PRN medications and for these PRN medications to only be given with the specified indications.

OP, you did the right thing based on the orders you had at the time. Don't let this doctor get to you. Perhaps you can bring the issue up to your manager as a need for management to remind the doctor's of the need of proper indications for PRN medications.

morte, LPN, LVN · Apr 30, 2015

but suanna, the quality is better.....lol

morte, LPN, LVN · Apr 30, 2015

I think part of the problem is the admitting nurse accepted this order.

ClaraRedheart, BSN, RN · Apr 30, 2015

Pyelonephritis hurts, at least a little bit... enough to give Tylenol. I'd have reassessed pain. Surely they were hurting a LITTLE bit, enough to give the Tylenol. You can notify the doctor after you've treated the "pain"/fever.

SwansonRN · Apr 30, 2015

Guy sounds like a pompous *not nice word*. I would have said something like 'hey this patient's febrile but their order for Tylenol needs to be adjusted because it's only written for pain." If he was rude in response he'd be asking for trouble :). There's no excuse for behavior like that.