What to do when the pt asks you for the favor?

ChristineN, BSN, RN · Dec 12, 2008

My guess is the pt may use the eye drops in the morning, or at least more than once a day at home. I would have asked if such is the case, and then either changed the time to a once a day AM med, or called the doc if pt takes more than once a day at home.

As far as abusing nasal spray, I really can't think of any harm that could be done.

There are some meds (Zenaderm's a good example) that will show up in the MAR for once a day, but in all practicality pt's often use it more frequently. For something like nasal spray I probably wouldn't make an issue out of it.

lpnflorida · Dec 12, 2008

There are some nurses who do leave meds such as aqueous nasal spray in a room. There was a time when it was not unusual to leave a patients prn inhaler in the room along with eyes drops.

Those days are over, I think some nurse in your case simply forget the eye drop bottle the night before. She may have had every intension of taking them out of the room and putting back where they belong. No, if they are ordered to be given at night, you would not be able to give them when you or the patient feels like it. You could contact the doctor and ask if times could be changed if that was what a patient requested and it was not contraindicated for any reason.

lovehospital · Dec 12, 2008

My guess is the pt may use the eye drops in the morning, or at least more than once a day at home. I would have asked if such is the case, and then either changed the time to a once a day AM med, or called the doc if pt takes more than once a day at home.
As far as abusing nasal spray, I really can't think of any harm that could be done.
There are some meds (Zenaderm's a good example) that will show up in the MAR for once a day, but in all practicality pt's often use it more frequently. For something like nasal spray I probably wouldn't make an issue out of it.

Thanks for the answer.I always thought that the eye drops could be basically PRN,and as far as the nasal spray itit was sodium chloride so I dont think it would cause hypertension or rebound congestion.

truern · Dec 12, 2008

I would give her the eye drops and document that the patient requested them at whatever time it was that she administered them.

Those times on the MAR most often are ARBITRARY. If her eyes were dry at the time she requested you can bet she probably uses them at that time at home.

ChristineN, BSN, RN · Dec 12, 2008

Thanks for the answer.I always thought that the eye drops could be basically PRN,and as far as the nasal spray itit was sodium chloride so I dont think it would cause hypertension or rebound congestion.

That's what I was wondering. If it's just sodium chloride, and not like an allergy med or something, then it defiitely won't hurt.

Thornbird · Dec 13, 2008

It does't matter whether the patient uses it differently at home or that it does no harm. The orders should be changed and if it's OK to leave at bedside, that can be part of the order.

Especially while you are a student, you must do things by the book. Don't change times or leave any meds at bedside unless you have an order. When you're not a student, you may use your own discretion as to how much to rigidly "go by the book".

nurselsteele · Dec 13, 2008

here we are permitted to give the medication 1 hr before & 1 hr after the "time" that is listed, our times are set by our company, medication times are 0900-1600-2100 & 0400, if its prn than its listed as that in the order, if its "may be administered by inmate" its states on the medex & in the original doctors orders. only "admin by inmates" are inhalers, & saline eye drops , but thats how its done in our prison....

but one thing to remember

the times are set up by the order or by the facility, (am= 0900 pm= 2100)

but if its in a doctors order to administer at 0700 or 1100, then you best give it at that time...

atleast in pa its that way, not optional...

lovehospital · Dec 13, 2008

It does't matter whether the patient uses it differently at home or that it does no harm. The orders should be changed and if it's OK to leave at bedside, that can be part of the order.
Especially while you are a student, you must do things by the book. Don't change times or leave any meds at bedside unless you have an order. When you're not a student, you may use your own discretion as to how much to rigidly "go by the book".

Well the situation was that when I went to get my meds from the cart the nasal spray (which I was to administer in the morning) wasnt there.So I went to look for it in the patient's room and I found it by the bedside...

lovehospital · Dec 13, 2008

It does't matter whether the patient uses it differently at home or that it does no harm. The orders should be changed and if it's OK to leave at bedside, that can be part of the order.
Especially while you are a student, you must do things by the book. Don't change times or leave any meds at bedside unless you have an order. When you're not a student, you may use your own discretion as to how much to rigidly "go by the book".

The order seems to lack sense,I mean dont eyes hurt and are dry the most in the morning? :confused: