Pain med admin

[kimdav]

At the hospital I work at there has been some discussion regarding the appropriate admin of pain meds. Doctor ordered pain meds for mild Q8 hours, mod Q8 hours, severe Q6 hours.There was no order for breakthru pain or unrelieved pain. Pt received pain meds for severe pain at 0230, then at 0445 received pain meds for mod pain. Is this proper admin?

My understanding of pain med admin is (in this example) the pt should NOT have received the 0445 dose as it is too early, next dosing of any med in this case should have been 0830. At 0445 when pt still had pain the nurse should have called the doctor for a one-time or breakthru/unrelieved med order.

[Here.I.Stand, BSN, RN]

Interesting, when I had my 2nd child I was Rx ibu and norco because they potentials each other. I often get an order for ibuprofen for my patients with their opioids because I know it's super effective when just the opioid alone isn't working to full effect.

Me too; I was ordered ibuprofen and percocet with all of mine. I'd request one or the other q 2-3 hours, alternating, so that I could get something. I'm a grand multip (if I'm remembering correctly what they call it in OB when you've had a lot o' babies) and those postpartum contractions are hell. Especially when you also feel so hot postpartum that warm packs to the uterus are more annoying than helpful. Actually after my 5th baby--delivered with no pain meds--I joked a day later, "I think I need that epidural now."

I think I would have gone nuclear (and blamed hormones, of course) had a nurse said, "No, I can't implement both med orders. Yes I know the CNM wrote two orders, but I can't do two orders."