Chemical restraint and lazy nurses

Nurses Medications

Published

Ok so I work as an lpn in LTC. We hae a resident who is a bother so to speak. He continually tries to get out of bed at night and has had a few falls. I know he is worrisome BUT

I worked 7-3 this week (I'm PRN so I work all the shifts) an I started to notice that in the mornings, this man was heavily medicated. He has an order for Klonopin 0.5mg QHS which evening shift is happy to give just to help keep him in bed. I've worked the shift. I've given it to him myself. But I wasn't aware of the level of sedation he was under until I worked day shift this week.

Hes so over medicated in the AM that the first day I worked, I thought he was in a coma and had had a stroke. Did neuro checks and watched him closely. He didn't fully wake up until around lunch. Which means he didn't eat breakfast and apparently NEVER does due to the over sedation....not a good thing.

So I approach the NP about my concerns. She D/C the Klonopin to my relief. The next morning he was awake, alert and verbal and ate ALL of his breakfast meal! Wonderful!

Well the 3-11 shift throws an outright fit about the Klonopin DC. They call the NP at home and have her reinstate it. All bc they didn't want to have to run to his room and put him to bed every time he tried to get up.

I know now it's annoying. I've worked that shift and gotten frustrated with him myself BUT I was unaware how sedated he was in the AM also.

Im upset that the Np gave in to the pressure from the nurses and gave this med back! I informed her that they were wrong. That it is illegal to sedate someone just bc they are annoying....apparently she needed reminding!!!!! This is abuse! There are laws protecting this man. But no one cares. My DON, the ADON, the NP. I feel like the nurses threw a fit and she gave them what they wanted bc she favors them. Sorry if I'm not here to discuss manicures with you. I don't kiss ass. I care about my patients and that is all.

what is the deal??? Why am I the only one who cares??? What should I do? Opinions welcome.

What I don't understand is why the OP is posting this on AN instead of reporting it to whomever it is she is supposed to report it to if she feels that this man is being chemically restrained. Asking the opinions of anonymous people on a message board and getting snarky comments accusing you of trying to be a "hero" isn't accomplishing anything.

You're joking right?

People have gave me good suggestions and good solid medical advice on a subject I am unsure of. And I thank every one who has. I have a lot to think about given that this job is my livelihood and I have children to support.

But these opinions of me....not welcome! I am concerned about my patient(s). I suppose I could NOT care at all.

As far as I'm concerned, the subject is closed and I may very well take the advice of some of these people and act on reporting this. I'm NOT looking for hero worship. Case closed.

Back off

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Why? Because it makes your job easier?

Well, yes, having patients medicated for their medical conditions does make my job easier, I must admit.

Residents who have delirium and unsafe behaviors are often given drugs like depakote or klonopin to take the edge off. Demented people who are cared for by family at home recieve these same drugs.

In the case of this particular resident at the OP's facility, most of us agree that its unlikely 0.5 mg of klonopin at HS constitutes "chemical restraint". It's a scheduled medication. The resident is NOT SEDATED when the evening nurse gives it. So why on earth would the evening nurse hold it?

The OP brought her concern to the provider. The med was D/C'd for a day. The other nurses brought their concerns about the med being D/C'd. The provider agreed and re-ordered the med for HS.

This NP gave into "bullying"? A NP is a highly educated professional capable of looking at the facts and making a decision.

So, on top of lazy, incompetent nurses, this facility is also staffed with lazy and incompetent providers?

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This NP gave into "bullying"? A NP is a highly educated professional capable of looking at the facts and making a decision.

So, on top of lazy, incompetent nurses, this facility is also staffed with lazy and incompetent providers?

The providers must be huge pushovers too if they're bullied by the nurses. Thank goodness OP is there to save those poor residents from EVERYONE else in the facility that's lazy and incompetent.

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The providers must be huge pushovers too if they're bullied by the nurses. Thank goodness OP is there to save those poor residents from EVERYONE else in the facility that's lazy and incompetent.

You again? How come everything I post, you reply to in an ugly way?

I thought this site was for help and education.

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You again? How come everything I post, you reply to in an ugly way?

I thought this site was for help and education.

People disagreeing with you are not automatically trolls.

From the beginning, you replied to responses you didn't like with hostility.

Take a look back over this thread. Make note of who has had to have her posts edited by moderators due to TOS violations....

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Specializes in Nephrology, Cardiology, ER, ICU.

When you post on the internet, you will get some answers you feel are helpful and others that might force some introspection.

Has anyone looked to labs? Renal function, liver function.

we wish you we'll.

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When you post on the internet you will get some answers you feel are helpful and others that might force some introspection. Has anyone looked to labs? Renal function, liver function. we wish you we'll.[/quote']

Thank you.

I'm handling it. I've already discussed the situation with my DON.

Thanks for being nice

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Specializes in HH, Peds, Rehab, Clinical.

The facility doesn't prescribe medications, the health care providers of the resident's do. Why you are blaming your facility for all of your perceived mis-dosings has me baffled....

There are many patients in the facility on geodon. Many!!! I was taught in school how dangerous this drug was and wondered the same thing myself.

It has a black box warning but it's given very often....

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And, again, the fact remains that this is a patient with a diagnosis of dementia and a documented history of agitation leading to self-injury.

You make a number of assumptions. That no one else takes the welfare of the residents seriously except you. That the evening nurses only give the scheduled klonopin so they can sit and surf the Internet. That the NP can be coerced by said nurses.

I'm reminded of Occam's razor: among competing hypotheses, the hypothesis with the fewest assumptions should be selected.

In this case, the hypothesis with the fewest assumptions is that the other nurses know what they're doing and are administering a scheduled medication ordered to treat a documented condition.

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People disagreeing with you are not automatically trolls. From the beginning you replied to responses you didn't like with hostility. Take a look back over this thread. Make note of who has had to have her posts edited by moderators due to TOS violations....[/quote']

I'm deleting this app.

Came here for advice and all I get is who probably have no job since they're all over this site....and people like you who aren't there and have no idea what's going on burning me at the stake for trying to take care of my patients.

I've BEEN through with this discussion but yet like you keep replying mean stuff. Let it go Already.

I'm out. I have better things to do than fight on a phone app. Apparently you don't.

Now that I'm gone and not going to reply anymore, I'm sure you will be full of opinions and assumptions about me so have fun! I won't be reading them ✌️

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Specializes in HH, Peds, Rehab, Clinical.

You did receive responses with helpful advice. That you choose to lash out at those who DARE question your thought process or motives is something beyond the control of anyone here. I would like to commend you on what could be a record for most edits by an administrator for TOS violations on one thread however, that's quite an accomplishment! While you may be a fabulous advocate for your patients, I'm willing to bet that your social skills with your peers are lacking, certainly here and I fear for the sake of your coworkers, that it's no different in real life...

Here's one to edit.

I'm deleting this app.

Came here for advice and all I get is who probably have no job since they're all over this site....and people like you who aren't there and have no idea what's going on burning me at the stake for trying to take care of my patients.

I've BEEN through with this discussion but yetlike you keep replying mean stuffLet it go Already.

I'm out. I have better things to do than fight on a phone app. Apparently you don't.

Now that I'm gone and not going to reply anymore, I'm sure you will be full of opinions and assumptions about me so have fun! I won't be reading them ✌️

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Specializes in Nephrology, Cardiology, ER, ICU.

Since OP has bowed out will close this. Thanks for all the comments.

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