If I know you have done everything they could to redirect or soothe a pt then I will certainly get a PRN.
If you just come up to me and have make no
effort at all to connect or engage the pt, then I will suggest some nonpharm interventions.
Hell, I'll even show you what I mean if you're skeptical (and don't doubt my gero whispering skills again
... honestly, I want to teach everyone the Art of Gero Whispering, but you'll never learn it if you keep running to the nurse for a PRN!!)
When a pt is on a 1:1, the sitter's job isn't just to watch the pt and call for help, but to find ways to prevent having to call for help in the first place: engage them in a conversation-- even in it's not nonsensical, play some music, fuss over them: smoothe the bedding or... *gasp* give them a back rub... the list is endless and full of things that would make you go, "Yeah, right, Hygiene!", but you'll see how you need to allow yourself to be creative and slightly courageous.
Somebody else on AN pointed out that sitting is "exhausting if you're doing it right" (sorry, I don't remember who said it) but they were spot on! If someone thinks they're just going to read a book all shift because the nurse is going to give a PRN... well, no, that's wrong.
I expect staff to do their jobs before the PRN's come out... and that includes myself!
The techs may not always realize what medical issues-- on top of some serious meds-- the pt may have. I will try to explain that, sometimes, adding more meds (PRN's) on top of that can actually be rather scary.
And what does anyone do when the doctor refuses to order an PRN? Well, it's back to developing, utilizing and honing those soothing and redirecting skills... and I'll be right there with you until we can find something that works... and hopefully, no one gets a punch in the nose in the process.
But don't just tell me to give Bubba a PRN because he tried the door or poured his coffee on the floor... let's see if we can figure this guy out first.