serving alcohol to patients

[mqurse37]

I just started my first job as a nurse at a nursing home dementia unit. The other nurses who have oriented me to the unit give 3 shots of whiskey to a patient after dinner. He also gets HTN meds, namenda, airesept and tylenol before dinner. The family supplies the alcohol for him and he is addement about having it after he eats or he gets very agitated. My question is I start on my own on monday and Im not sure this is a legal practice. Im concerned about my license.

Another quick question, they give all meds 4-8 meds at the same time, around 5-6. Is this normal practice? I was taught in nursing school to only give if its an hour before or after, the other nurses say theres not enough time to do 2 med passes. Which is true, however the supervisors think they are doing 2 med passes.

Any advice?? thanks!!

[SkylerW]

The hospital pharmacy that I volunteer as a tech at keeps all kinds of liquor to send to the patients if a doc orders it.

[merlee]

Many, many years ago I worked in 'mixed-use' facility and we had a pt who had "leave" priveleges. He could leave unaccompanied to go wherever he wanted. It was usually to a local bar. He would call a cab, wheel himself to the front door, the cabbie (a particular cabbie) would transfer him into the cab, stow the wheelchair, and take him away. A few hours later, he would return, totally drunk. He was an ugly drunk, in every sense of the word. He happened to be a V.A. patient, and we would call the social worker the next day to complain about his abusive behaviour.

She had a hard time believing us because he was so sweet during the day when she would call or visit. Eventually, he was transferred to another facility.

But we had others who would get a glass of wine or beer in the evenings, and I think it was helpful to some.

Many ALFs have happy hour around here, and please do not cut in line!!!!

[kenyacka]

In Missouri, the residents have basically the same rights as you and I. We cannot keep them from smoking or drinking, but we can keep it locked up so that they aren't smoking in their rooms which is unsafe. I know it's hard, but no one busts into your home and tells you "hey stupid, don't drink that with all those meds!" you know? They're called residents for a reason... it's their home, not a hospital.

[Lynx25, LPN]

We have "Happy Hour" every week on Friday with beer and wine, A refridgerator with Budweiser in it for a certain resident, and another is allowed two shots of Jack Daniels a day.

I don't care if it's not medically needed... they want to drink, let them have a few glasses of wine.. let the family take them out for cocktails, have fun!

As far as the med pass thing... If I work nights, I have 60 patients. Don't wanna hear the FIRST whimper about med pass times. Seriously.

[Not_A_Hat_Person, RN]

When I worked in assisted living, we had residents who had orders for booze. One had a scheduled drink and a PRN drink.

[xtxrn, ASN, RN]

One of the standard orders on admission to all LTCs I've worked in was the ok to have alcohol. The nursing home is their home. It's not prison, or some sort of punishment. These folks were drinking booze at home with their meds. To NOT give it could be a bigger risk, depending on how long the guy has been drinking. Granted 3 shots isn't much in terms of alcoholism- and the guy may not have an addiction; but physical tolerance is not the same thing. If you'd rather deal with the death of someone following seizures w/DTs- I guess that's up to you (along with withholding a MD order). It's booze- not cyanide. :)

[MomRN0913]

If the LTC is their home, they are entitled ot it, and a Dr's order needs to be in place.

As far as the meds go, think about it. How many people who live at home take their meds at 6pm, then 8pm, then 10pm?

A patient being managed at home usually has morning meds and night meds. That's it. And usually when it is convenient for them. It's different in an acute care setting, if there is scheduled abx, or you are strictly trying to control a BP.