Maybe different facilities have different rules but at my facility insurance will only pay for so many patches a month. If we replace a fentanyl patch early there would be a few days that pharmacy wouldn't send another one because it is 'reorder too soon'. I would have just taped it back on.What if one falls off and you can't find it? It doesnt work like that, i was on it for 2 years. When you put it on, it takes a full 24 hours to release 100mcg/hour. Hence why it is used chonicly because it builds up in your system and body fat where you put it. I'd suggest trading it for 4 25/mug or someting else. You cant put it on and take it off. About Fentanyl patches. When the patch is put on your child's skin, a small amount of the fentanyl is absorbed continuously through the skin. Then take the fentanyl patch off your child's skin. 'Do you know.' Is an educational series for patients and their families. ![]() What if it falls off and you find it stuck on the bed sheets or rolled up in a ball or folded over stuck to itself? All these things have happened at my facility. I personally would not feel comfortable reapplying a patch that could be damaged or one that had been found stuck on something else. Do we really know if it still contains the correct amt. Of medication and will still work properly to deliver the amt. Of medication it's supposed to? I wouldn't put it back on either - I would have wasted it and put a new one on and changed the schedule to reflect this. I would be worried about how well it was being absorbed once it had been removed or fallen off. We would just replace it - but if you need a new Dr's order then that is what should have happened. It is also our policy -from the manufacturer I believe - that we do not put tegaderm over the patches as they warm up from the body heat and it increases the absorbtion rate. We can use tape around the edges to secure it but we are not to completely cover it - even with clear tape. We do use tegaderm underneath it if we are making a 12.5 patch out of a 25mcg patch for example. Well sounds like the facility is supercalafragilistic uptight when it comes to the narcs. Like others, secure with clear drsg or change it. The changes are reflected in the narc count therefore pharmacy sends what's needed; well at least where I've worked. A few years ago I was with another nurse and we were attending this hospice patient who was wearing a 100mcg patch. Well, the nurse had a replacement patch (she was changing the patch and had called me to the room) I saw her unwrap it, then she starts talking about how she doesn't' know how to put on the patches. During this time she took off the patch that was on the patient. So I'm like 'OK; let me show you how you.' The patch is gone; no where to be seen. We looked everywhere and finally went and got another; documented as wasted and carried on. Long story short the next day I was getting ready for work and yep you guessed it; the patch was on the bottom of my shoe. I have absolutely no idea how the patch got on my shoe but it was hilarious. I am sorry that you and others (from what I've read) must call a doc for another order before actually putting on another patch. Nurses shouldn't have to do that at night or any other time. The med is a continuous release med and it stands that if a mistake is made or a patch falls off for whatever it needs to be replaced quickly. It saddens me that facilities are not trusting and empowering licensed staff as they should and seem to be growing more suspicious and making more rules to monitor nurses. Not to make our jobs easier; but suspicion, as if there's no trust anymore. How about respect and honor; some good old fashion beliefs that we as nurses know what we're dong and can be trusted. .I have to state, I have an issue with this. A patient's pain was not managed properly because nobody had time to attend to it and nobody wanted to wake the physician to get a new order? Seriously, THAT is why physicians get paid the salaries that they do.if I need to wake them up for a legitimate reason, I wake them up.if they get mad, that falls under the category of too bad.But why wake a physician for some basic critical thinking? I'm ALL FOR waking physicians when they need to get involved, but you don't need a new order for some tape. As a previous poster said, these patches are pretty fickle. Sometimes it's best to save the trouble and add tegaderm on top of every brand new patch. I think it depends upon the situation as well. If its been on the floor, and you don't know how long its been there then clearly it should not go back on. You don't know how long its been off, if its even the correct one, if ts been stepped on, spilled water on etc. But if you found it hanging on the skin, and you knew it was on 15 minutes ago when you did your assessment, then yea i would just tape around the edges. I guess it would be up to the nurse to use their best judgement. I'm not saying the nurse in this situation was wrong, maybe she was correct. I dont think there is a clear cut answer since its so dependent upon the situation with this. Do i think she did something wrong??? Traffic update rt 22 nj restaurants. ![]() .you can use basic critical thinking unless your facility policy states you cannot for certain medications.Such as a fentanyl patch which is a controlled substance and is in the narcotic count. Our order goes like this, it must be followed to a T. Fentanyl Duragesic Patch 12.5 mcg/hr Apply to skin. Change every 72 hours or as per MD order. If another patch is needed before the 72 hour change. An MD order is required. Again, this is my facility. Another facility might let a nurse just waste the old one and slap a new one one. But we would have to first get a doctors order to put a new one on. Well sounds like the facility is supercalafragilistic uptight when it comes to the narcs. Like others, secure with clear drsg or change it. The changes are reflected in the narc count therefore pharmacy sends what's needed; well at least where I've worked. A few years ago I was with another nurse and we were attending this hospice patient who was wearing a 100mcg patch. Well, the nurse had a replacement patch (she was changing the patch and had called me to the room) I saw her unwrap it, then she starts talking about how she doesn't' know how to put on the patches. During this time she took off the patch that was on the patient. So I'm like 'OK; let me show you how you.' The patch is gone; no where to be seen. We looked everywhere and finally went and got another; documented as wasted and carried on. Long story short the next day I was getting ready for work and yep you guessed it; the patch was on the bottom of my shoe. I have absolutely no idea how the patch got on my shoe but it was hilarious. I am sorry that you and others (from what I've read) must call a doc for another order before actually putting on another patch. Nurses shouldn't have to do that at night or any other time. The med is a continuous release med and it stands that if a mistake is made or a patch falls off for whatever it needs to be replaced quickly. It saddens me that facilities are not trusting and empowering licensed staff as they should and seem to be growing more suspicious and making more rules to monitor nurses. Not to make our jobs easier; but suspicion, as if there's no trust anymore. How about respect and honor; some good old fashion beliefs that we as nurses know what we're dong and can be trusted. Such as a fentanyl patch which is a controlled substance and is in the narcotic count. Our order goes like this, it must be followed to a T. Fentanyl Duragesic Patch 12.5 mcg/hr Apply to skin. Change every 72 hours or as per MD order. If another patch is needed before the 72 hour change. An MD order is required. Again, this is my facility. Another facility might let a nurse just waste the old one and slap a new one one. But we would have to first get a doctors order to put a new one on. It seems a bit like fiddling while Rome burns to be still talking about this, it's not really a big deal in the whole scheme of things but it's just one more example of how our jobs are being made harder all the time.
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