Pain Meds

[marjoriemac, LPN]

I have a concern regarding analgesia, particularly co-codamol and paracetemol. Our drug times are 10,2,6,10 however the nurse is not able to start the drugs until 9.30 in the morning due to staffing and being counted as one of the 'hands on deck'. I have 30 residents to give meds to and often do not finish meds until 11ish (note all the C/A's are quite happy to disappear for their breaks at 10.30!). My concern is that the nurse is expected to do the afternoon meds from 1pm onwards and for certain residents this is not 4 hours between analgesia. It is difficult because I have tried to hold back the pain killers until their due time (involving noting the time the morning dose was given) but these residents see others getting thier meds and want thier own. Other nurses in the home do not seem to bother and give out the analgesia regardless, bit these nurses also forget about meds that are not in the popper packs as well! What do I do???

[nightmare, RN]

Keep on doing what you are doing!Document time given if it is out with specified drug time and chart next time that it is "not four/six hours" explain to the resident that it is too soon.After all if you give it routinely too soon ane they develop complications who do you think will get the blame? Keep yourself right by documentation so that you can prove your self right.If management hum and haw about it point them to the BNF or get the drug times changed.Yes I know its a hassle having odd drug times but it is the residents health at stake here.

[SuesquatchRN, BSN, RN]

Simply say, "You can't have them yet. It's too soon." Repeat it like a mantra.

Amazing how an entire ocean doesn't change things, huh?

[Daytonite, BSN, RN]

i don't know if you are able to change the medication times at your facility over there in ireland as we are able to do here in the states. however, medication times are not written in stone here. we do have the ability to change the medication administration times on the medication sheets to accommodate the patient and the nursing staff. i would discuss this first with your supervisors/managers before doing it so everyone knows what's going on before making any actual changes.

if you can't do that, i'd find a small timer to carry either on me or on my medicine cart and set it to go off at the time when these medications need to be given. when the alarm goes off, finish up what you are currently working on, give the particular medication, then go back to what you were doing. there are some really nice digital timers you can purchase that are really cheap. i've seen some that can be programmed for up to three different times. these timers are how i used to keep track of my iv piggyback meds when i worked in the acute hospital in the days before all the ivs were put on iv pumps. you should be able to find them in stores where the cooking gadgets or alarm clocks are.

[achot chavi]

i don't know if you are able to change the medication times at your facility over there in ireland as we are able to do here in the states. however, medication times are not written in stone here. ]

if you can't do that, i'd find a small timer to carry either on me or on my medicine cart and set it to go off at the time when these medications need to be given.

here in israel- we have flexible med adm times as well- pain meds as well as antiparkinson meds can be given as early as 5:30am so they are working when the patient gets his day started and we all set our cellphone timers to remind us all sorts of things. i once supervised a night nurse caught sleeping between 12 and 5 and her defense was that i was not to worry as she set her timer to wake her!!!

anyway we have to broaden our med adm and remember to give certain meds half hour before meals etc. not all meds can be given at once, calcium supplements should not be given with dairy meals etc.

giving meds is serious business and we could do more damage than good by being so boxed in by facility imposed limits- approach ur dns and ask for her support on this- lots of luck