I just need some advice on this one, and it's making me NERVOUS. - page 3

by sherabear | 8,846 Views | 52 Comments

I am a new grad LPN. I started my very first nursing job last week, and have been orentating since last Wednesday. On the wing that I will be working on, I have 1 resident in particular that asks for PRN Ativan at least four... Read More


  1. 15
    Quote from Mom To 4
    First, please use correct grammar. You orient to a position not "orientate". It is difficult to read posts when I am not able to see past the usage of the English language.
    I can understand being a grammar nazi when the post is clearly written like this:

    "I cn understnd...... yes, sometims its dificult to understnd this....."

    But come on. ONE word you don't agree with, and suddenly her post is unreadable because she can't use the English language well enough for you?

    Sticks in bums, I say .
    B in the USA, JDZ344, SoldierNurse22, and 12 others like this.
  2. 6
    It is NOT for us nurses to decide what an alert and oriented patient needs, or how often. If there is an order for it and it is time, give the patient their dang med! Never lie to them because you decide they don't "need" it. Shame on the nurse you were orienting with for teaching you bad habits from the get go.
  3. 3
    Plus there should be a check and balance for PRN's for behaviors, or psyche issues. Don't you have to document effective, or not? hmm that opens a whole new can of worms
    SE_BSN_RN, tnmarie, and anotherone like this.
  4. 10
    So she's on the call-light all the time...did you ever think that maybe THAT was a sign of, oh, I don't know, ANXIETY??? She seems pretty ANXIOUS to get her Ativan, doesn't she? As a chronic anxiety sufferer, I take offense that anyone would think that because someone doesn't "look anxious," then she must really not need her medication. Do you know what I'm able to do with my medication? The stuff I need to get done during the day: cleaning, cooking, working, caring for my family and myself. Do you know what I do when I'm not on my medication? Lay on the couch in front of the TV, desperately trying to "relax" and calm myself down. Sounds backwards, I know, but you'd understand if you thought about it a little. You don't know what's going on in my head, and you have no idea what's going on in your resident's head.
    I hope you learned your lesson.
    PrincessO, soxley, dream'n, and 7 others like this.
  5. 1
    I do not understamd why nurses were not giving it when it was ordered. I can not stand that . unless pt seems too unstable for sedating meds than what is the point of this?
    monkeybug likes this.
  6. 2
    Quote from sherabear
    If things go well for me, I am going to talk to the doctor about possibly scheduling it BID or TID depending on what he thinks; she asks for it like clockwork, regardless of whether or not she actually needs it, which in my honest and professional opinion, she does not. She is a higher needs resident and has her call light on at least 6-8 times per hour, which definitely indicates a need for human contact, and I have stayed in her room on more than one occasion, even making her forget that she requested the ativan, which is why I've only administered it once. I think she relies on the idea of the ativan more than the effects of it...that doesn't excuse the whole not administering it thing, I know. And I've had the last two days to have my heart pound and think about the outcome, and really regret being a lemming. I don't agree that she needs it. But like you say...it's not my call. It's the doc's and her's.
    I would suggest no such thing to the dr . frankly this seems offensive to me. You have no idea how she is feeling . mayb e she is a benzo drug seeker or maybe she is very anxious and could bennifit from ativan as the prescribing provider thought. wow. some people can hide their anxiety, depression, delusions and hallucinations (to an extent) very well.
    JDZ344 and NurseDirtyBird like this.
  7. 2
    Quote from catlvr
    OP, I wonder who turned you in or how the pt found out that they were not actually getting the Ativan...you've learned your lesson about honesty and careful documentation, but it sounds as if you have an unsavory character where you work. I absolutely despise this aspect of nursing.
    I immediately thought this too, about who turned you in. Did you tell someone you did this? This sounds like a good learning lesson. I HOPE you learned a few things from this. I'm also wondering, wasn't the controlled drug count off?
    Last edit by SleeepyRN on Mar 8, '13 : Reason: addition
    tnmarie and beeker like this.
  8. 3
    Why would you hold her Ativan? If the doc says she can have it q6 as needed, and he said he needs it, why not give it to her? Why are you withholding meds she is allowed? Because others have? Poor judgement on your part. Perhaps she will use the call light less if she gets her available meds.
    NurseDirtyBird, anotherone, and tnmarie like this.
  9. 5
    Quote from NurseDirtyBird
    So she's on the call-light all the time...did you ever think that maybe THAT was a sign of, oh, I don't know, ANXIETY??? She seems pretty ANXIOUS to get her Ativan, doesn't she? As a chronic anxiety sufferer, I take offense that anyone would think that because someone doesn't "look anxious," then she must really not need her medication. Do you know what I'm able to do with my medication? The stuff I need to get done during the day: cleaning, cooking, working, caring for my family and myself. Do you know what I do when I'm not on my medication? Lay on the couch in front of the TV, desperately trying to "relax" and calm myself down. Sounds backwards, I know, but you'd understand if you thought about it a little. You don't know what's going on in my head, and you have no idea what's going on in your resident's head.
    I hope you learned your lesson.
    This is what I wanted to say. If you saw me, you may not think I'm anxious on the inside. I've dealt with anxiety for so long, that I can appear calm, but you have no clue what's going on inside of my body.

    Also, if she has been on Ativan for awhile, she may experience withdrawal. Being on the call light all of the time could show her outward signs of anxiety.

    Not to mention lying to the patient is wrong. Would it not be easier to just give her her prescribed medication?
  10. 1
    Quote from anotherone
    I would suggest no such thing to the dr . frankly this seems offensive to me. You have no idea how she is feeling . mayb e she is a benzo drug seeker or maybe she is very anxious and could bennifit from ativan as the prescribing provider thought. wow. some people can hide their anxiety, depression, delusions and hallucinations (to an extent) very well.
    I agree. Plus her constantly being on the call light can be one of her symptoms of anxiety. And if she is given her Ativan and still behaving this way at onset and peak. then she may have developed a tolerance and that dosage simply isn't working anymore. Either way, just like pain, anxiety is subjective and is what the patient says it is. I take xanax, and you could not differentiate my behavior from before or after I took it. I sure FEEL a hell of a lot better though.
    NurseDirtyBird likes this.


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