[Ms.RN]

Hello

What do you guys think is a good nursing intervention of patient who pretends to take medication but when someone is not watching, take it out and put it some place for later use? Do you think there is really nothing nurses can do about it since we cannot change addictive behavior? This patient is not confused, but like you and me, who knows what they are doing. Any thoughts? Any suggestions?

[deeDawntee]

Have them open their mouth and pick-up their tongue to show it is swallowed. If they refuse to swallow it, take it away from them....

Perhaps, have a contract drawn up with patient and with Doctor's involvement so that there is definite boundaries around acceptable behavior.

[Dolce]

Patients have varying reasons for pocketing meds like this. When I am suspicious that a patient is not swallowing their meds I just kindly ask if they will open their mouth and let me check. More often than not I get a "gulp" and then check an empty mouth. You cannot force a patient to take any medication, however, you can prevent them from "stocking up" in their room.

[Suesquatch]

Crush them and put them in applesauce.

[kizzykatlove]

Originally Posted by Ms.RN

Hello

What do you guys think is a good nursing intervention of patient who pretends to take medication but when someone is not watching, take it out and put it some place for later use? Do you think there is really nothing nurses can do about it since we cannot change addictive behavior? This patient is not confused, but like you and me, who knows what they are doing. Any thoughts? Any suggestions?

wow the same hting happened to me a few weeks ago.. i told the doc and he wrote an order for mouth checks and we had to watch her take every pill.. every pill you give you are responsible for and have to account for..i make sure every one goes in their mouth and then tell them to open wide...

[bagladyrn]

I've had this happen with patients who weren't "saving" the pills, but trying to avoid the effects in a passive-agressive way - wouldn't admit they didn't want to take the meds, but cheeking them and spitting them out. In fact, her mother informed us that she was disconnecting her medication tubing from the IV and letting it run in the trash can when we were out of the room.
Rather than making an issue, after one round of discussing patient's rights and options r.e. treatment, I'd simply give them the med, a drink, and THEN stand in the room talking to or assessing them for 5-10 min. Drugs that are not enteric coated, and some that are, start to taste pretty bad by this point, and generally the patient will go ahead and swallow and drink more liquids.

[earle58]

when my dtr was hospitalized in a psyche unit, she and sev'l other girls, were pocketing their meds, putting them together and randomly divying them up.
when i went to visit her one day, i noticed she was very lethargic.
i asked the nurse what she was taking for meds, including any prns.

my dtr ended up telling me what had been going on.
a big investigation ensued, and policy changed on how they did mouth checks.
i share this, to caution those who work in environments where this may happen.
it was very scary, to know the different meds they were blindly taking.

leslie