We have a particular md who orders prn pain meds every 15 min. One of our nurses ended up giving 12 mg Dilaudid over 1.5 hr period to 20 yr old girl for flank and abdominal pain. Pt was not hooked up to any monitoring device such as bp or pulse ox, even though both are readily available at bedside on all of our beds. The pt's mom happened to be in room, came out and said she thought her daughter was breathing funny. Turns out, pt resp arrested, had to be bagged and narcaned. Pt was admitted to critical care unit for observation. Wouldn't you question giving that much pain med? Seems unreal to me to give that much pain med and not talk to the md about it. Even worse, pain meds were verbal order, nurse taking verbal order did not write it as verbal order (just wrote pain med order, not v.o. dr so and so/jennifer, rn.) and the md did not sign chart. So, no md documented on order sheet. I always thought I was overly anal about charting, monitoring and documenting, now, I am grateful for being overly cautious.
