'Poisons Act' for RN drug administration

[Susan to Vanc]

Hi,

im an international nurse studing for my CRNE (BC) and wondering where I can find documentation specific to rules or regulations RN's have to stick to for all drug administration.

ie and what rules are different for giving out paracetamol as opposed to Oxycodone?

and can nurses give out 'nurse initiated medication' ie coloxyl & senna or suppositries for bowel management without a physicians order?

Thanks muchly

Susan

[suzanne4, RN]

Paracetamol is an over the counter pain reliever that can be purchased without a prescription.

Oxycodone is a narcotic and requires a prescription to obtain from a phamacy.

Normally, any medication given to a patient in a hospital setting requires a physician's order for it, even for an aspirin or something else that can just be bought over the counter.

Depends on what the nurse's scope of practice is as to what they can give without a physician's order. Many facilities may have standing orders for things like bowel preps, etc., but there is still a written order in the facility concerning this.

[Fiona59]

Let's start off at the beginning. When the patient is admitted to the unit, there will be a set of orders outlining which meds can be given and when.

Some narcotics are given at scheduled times and others are prn which basically works at your discretion and the patients reporting of pain.

Bowel meds are usually written at the same time. We ask the patient at every assessment how their bowels are. If alot of narcotics are ordered there will more than likely be an order for Colace or sennakot. Some patients will ask outright for them. If you see a lot of narcs in use and no BM for a couple of days then we just offer the meds.

If there are no bowel meds or if the pain meds seem ineffective we just contact the doctor for the orders.

Every hospital has it's own routine and they will tell you at orientation how it works.

[Susan to Vanc]

thankyou muchly, that helps with the PRN & bowel medications.

What is the protocol for administering oxycodone PO or morphine SC. does another RN need to check the order and witness the drug being given?

[suzanne4, RN]

It is not normally witnessed by another nurse that you are giving something. Only when you are wasting part of a dose, or all of it does it need to have a witness.