I'm in a detox clinic & this is my first nursing job & first experience in addictions. We have standing PRN orders for 25 mg Vistaril Q6H PRN, Phenergan (must see vomit),75-150mg Trazodone for sleep or 50mg Benadryl for sleep. My clients want the vistaril like it's candy, and are lining up at the nurses station every 6 hrs (or less) to get it. It's ridiculous, but it's that addicted mentality, I know. I'm trying to be as therapeutic as I can & try to tell them that they do not need another vistaril just because the 6 hours is up. Some walk away, but others are VERY adamant. I had 4 argue with me last night because I would not give trazodone & vistaril or benadryl & vistaril at the same time at bedtime. I tried to explain that trazodone also helps with anxiety & they don't need both or that benadryl & vistaril are both antihistamines and I cannot give that much at once. Now, my standing orders do not say anything about giving meds together, but my gut and nursing judgement tell me that's just too much. Also, they beg me for phenergan all the time, and I have two whom I'm sure are making themselves vomit to get it. One (heroin addict) was begging my for phenergan IM. I offered mylanta and that really ****** her off or phenergan suppository, but she said she had diarrhea & couldn't do that.
So, can anyone give me some advice on handling these situations? I'm often the only nurse on & don't have anyone to back me up. I don't feel that handing out meds every time they ask is doing them any good. It gets exhausting when they are constantly knocking on my door and shouting out med orders while I am delivering scheduled meds to others. (I ignore the shouts because that's just rude and I am no one's servant).
These people are here to detox and learn coping skill (well, not everyone has good intentions), but I want to know that I'm doing right by not handing out a med when I don't think it's legitimately needed.
Now, some of these people who are demanding Vistaril from me are already on Buspar or other anti anxiety meds. How do you handle drug seekers?
Sometimes I wish we didn't have Vistaril or Phenergan to offer.
Also, a few weeks ago, we had a client who was soliciting others to get Vistarils for him cuz he wanted to snort them. What wold be the effects of snorting a vistaril? (this client was kicked out)