What does TID PRN really mean?

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What Members Are Saying (AI-Generated Summary)

Members are discussing the interpretation and implications of TID PRN orders, with some advocating for clearer guidelines and others expressing confusion or frustration with the potential for inconsistent interpretation. There is debate over the appropriate dosing intervals, the role of nursing judgment, and the need for more specific orders to ensure patient safety and prevent misunderstandings. Some members emphasize the importance of clear communication and the potential consequences of misinterpreting orders.

Hey friends, I recently had a pt with a medication ordered TID PRN and gave a dose of this antianxiety medication early in my shift and the pt became anxious again several hours later. As TID means three times daily, I always translated that to mean every 8 hours. So I called the MD and requested an additional dose for the pt and the MD went off on me. I'm used to this guy flying off the handle but he basically told me I was stupid and that TID means I can give the medication every five minutes if I want to as long as I don't exceed three doses a day. This...doesn't sound right to me but I'm putting it out here to see what you guys have to say. Can you give a TID PRN medication as frequently as you need to?

This is closest to my interpretation.

Like what RX are we talking about?? A valium 0.5mg or valium 10mg needing repeat 2 hours later or 8 hours?

It was 1mg of Ativan IVP and the pt was anxious again after about 4 hours. The pt was NPO and had a history of anxiety and, if I recall correctly, took something like Xanax at home. She was a new admit from the ER and I don't remember her specific diagnosis but I work on a medsurg floor with a heavy focus on GI issues and abd surgeries so it was probably something like a SBO or gallbladder and I guess she was worried about possibly having surgery.

Like I mentioned before, TID PRN for meds is not something we encounter at my facility often so I asked my experienced coworkers and they all agreed it meant no sooner than every eight hours as needed.

Honestly, I feel like clarifying with the MD what it was he meant was a great use of my nursing judgement. He's a jerk and I'm used to him yelling. I once had to beg and plead for him to come up to see one of my pts - it wasn't something I could put my finger on, but something was off and she said she felt "different" but vitals were fine and he was so pissed I had bothered him about it. He said "I'm going to be in there for two mins and I'm not going to write any orders." Then he finally comes up, goes to see the pt and spends like 20 mins with her, walks by the nurse's station not saying a word to me and leaves the floor. Two minutes later, the computer is printing up a bunch of new orders for her, including a stat Chest CT. Turns out, she had bil pulmonary embolisms.

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Specializes in LTC and Pediatrics.

I understand that this type of order is unusual in the hospital setting. I work in LTC and we have several residents with anxiety who have the Ativan TID PRN order. Anxiety can be a tricky thing. For us, TID PRN is 3 doses in a 24 hour period, midnight to midnight. Sometimes, a second dose in 4 hours is needed to reduce the anxiety. Other times, they may go 8 hours or longer. We have other residents who have it scheduled so those orders are written differently. For three times a day, it will read TID q 8 hours.

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I'm very glad I stumbled upon this. I used to think TID PRN meant you had to wait 8 hours. So from now on when obtaining orders I will ask for clarification with the MD/NP if they want it spaced out or not.

Great post and answers!

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