serving alcohol to patients

  1. 0
    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!!

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  3. 42 Comments...

  4. 11
    We used to do this all the time before the self-righteous stepped in and felt that to allow a patient thier own private habits from home to be intrusive to medicine. I would much rather give a couple of shots of whiskey than another med to make them more confused and at a higher risk of becomming confused from the med and getting hurt.
    sharpeimom, MomRN0913, xtxrn, and 8 others like this.
  5. 0
    I have heard of residents getting alcohol because this is suppose to be treated as if they were home but I do not know how legal or how it will effect license
  6. 14
    In my experience, there needed to be an MD order in place.
    sharpeimom, xtxrn, Not_A_Hat_Person, and 11 others like this.
  7. 7
    And we needed to sign for it each time it was given (mar/tar)
    xtxrn, Not_A_Hat_Person, merlee, and 4 others like this.
  8. 1
    I don't know the laws about alcohol in a nursing home or even in acute care hospitals. I have heard of alcohol being offered on the menu of fancier hospitals per doctor orders. I agree with Esme, it does't bother me.

    As to the med pass. There is a private non-profit organization called The Insitutue for Safe Medical Practice. It did an in depth study of nurses giving meds. It found it was unsafe for nurses to strictly follow any time frame i.e., it has to be 1 hour before to 1 hour after. If you look up ISMP on the Internet you will find more information.

    As to what the supervisors think is being done, maybe find the study on ISMP and ask the supervisors what they think about it?
    fromtheseaRN likes this.
  9. 1
    You could get a doctor's order for the alcohol if you're worried about giving it, given medication interactions and all. Or you could have the family members give it. I tend to agree with Esme. Treating withdrawal symptoms is much more upsetting to a patient who never intended to quit drinking that just to keep drinking.

    3 shots is more than just a nitecap though. Does your facility have a policy on this? Check with your manager.
    Esme12 likes this.
  10. 5
    Beer is given to a number of pts in a hospital setting as well. In the acute setting, we are not "gonna fix" them.. MD orders beer and yep pharm brings it up with a pt label on it. I think this is safer than having a pt go through DT's.. Is it legal in a LTC setting, IDK.. Check with your DON.

    As for the med pass, well, I have no experience in LTC.
  11. 4
    In long term care they should be able to drink alcohol if they want. It is their home. As far as meds go, it would be impossible to pass the meds at hour intervals when you are taking care of 20 residents. Also something to think about, do you think that when the residents were home self medicating that they took all of their meds at several different times of the day instead of just morning lunch and dinner?
    MomRN0913, Debilpn23, loriangel14, and 1 other like this.
  12. 4
    Yes, you can give alcohol to a nursing home resident with a Dr order.

    I was only 19 when I became an LPN. I had a LOL with an order for one ounce of wine at bedtime. I was a little worried at the time that it was illegal for ME to serve it to her since I was technically underage.

    As far as giving the meds all together: If they can really all be given together then just get an order to change the times of the meds and legally give them all together. As a supervisor it always worries me that some fool is giving an Ambien at 6pm along with all their other meds - or something similar (and trust me - I have seen it. Some just don't get it).

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