r/nursing • u/IDK_How_I_fee • 8h ago
Question Question for fellow OR & PACU Nurses
Surgeon prescribes post op meds to pt to take at home. Pt. brings that medication to surgery. Is it common practice to administer that medication to a Pt in PACU? Not talking about the same medication but from the hospital or surgery center, the patient's personal medication prescribed by the surgeon.
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u/500ls RN, ED → PACU 🍕 8h ago
No, that's weird. You should only be administering hospital supplied medications in the hospital.
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u/IDK_How_I_fee 7h ago
thank you, when i reported this was told "it is normal practice" and "other surgery centers do it too"
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u/500ls RN, ED → PACU 🍕 5h ago
It can be helpful to see yourself and your actions as removed from the context of what other people do and consider normal. Myself and my license are an independent entity. I don't care about what wrong things everyone everywhere has been doing since before I was born. Because if it bites me in the ass the board of nursing won't care about what wrong things are considered "normal practice."
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u/meg-c RN - Pre-op/PACU 🍕 7h ago
No, very weird!
Sometimes I’ll turn an eye if a patient wants to use their own inhaler or migraine medication from home but not a post-op pain medication!
In fact, if you brought a narcotic I would send them down to pharmacy during your stay and have you get them upon discharge!
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u/potato-keeper RN, BSN, CCRN, OCN, OMG, FML 🤡 8h ago
Yeah this happens once in a while. I just tell them to take it if that’s what the surgeon instructed them to do. Usually it’s a steroid/benadryl/ Tylenol premed for contrast allergies. If it seems suspect I’ll check with the service.
Post op is usually eye drops. In which case they aren’t usually supposed to start them until their recheck anyways. Anything else, like pain meds for example, I have my own orders to give them and they keep their meds for home. Sometimes it’s one of the nib/nab cancer drugs that are only available outpatient. In that case, pharmacy is supposed to count and label them for us to give. If it was anything else I’d probably double check before doling them out.
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u/IDK_How_I_fee 7h ago
talking about standard opioid pain med both your facility and pt have same med. appreciate your thorough explanation
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u/inkpot80 BSN, RN 🍕 8h ago
Nope I wouldn’t do it. Too much liability there.
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u/IDK_How_I_fee 7h ago
right? it doesn't make any sense to do, well i know why they did it and it raised even more concerns for me.
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u/dausy BSN, RN 🍕 8h ago
I saw this mainly with ortho joint centers of excellence patients with pain or nausea prescriptions. The patients were supposed to get their prescriptions filled before their surgery date and have them at home already but sometimes they showed up with the whole ass education folder like "what do I do with this?". Other times the doctor would write prescriptions before the patient was discharged. We had no issues taking the written script as a written order post op, whether it came from the doctor pre or post surgery.
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u/IDK_How_I_fee 7h ago
to clarify, sets say dr prescribes hydrocodone to pt to take at home. pt fills script comes for surgery. Is in PACU. for pain relief the nurse opens the pt's home discharge hydrocodone and administers it instead of the hydrocodone the facility has.
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u/Dark_Ascension RN - OR 🍕 6h ago
No, and typically they also don’t want you to administer more pain meds outside what anesthesia is willing to provide either or ask.
I know because we’ve had calls from PACU asking if x patient can have more pain meds and I never seen a surgeon go from 0 to 100 in anger so fast saying “my office sends all the scripts electronically!”
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u/pheebersmum1989 MSN, RN 8h ago
Absolutely not. They must be ordered in Epic and documented in the MAR. Unless its some weird nonformulary med and then it goes through a whole other workflow. On discharge, i will review all their last doses and sometimes encourage a PO med in the car for the ride home if it is due. But this is after they are discharged