adverse reactions to medication handouts

[inthesky]

My unit has found yet a new way to hinder nursing practice. It is procedure to give patients handouts when they receive new medications. Being med nurse, it is extremely important to me (and my job) that patients know what medications they are taking and why they are taking them. Out of everyone, I would say that I am the most prolific printer of med handouts. I do use judgment and will not initiate a handout to a very paranoid delusional patient (if the patient asks me, it is his right). On Sunday, I printed out a handout to a mostly Spanish- speaking woman in spanish. Apparently after I left, she read it over and panicked that the med was going to kill her and refused the med. This patient does not have any psychotic disorder, but is definitely one of those patients who always finds something to ruminate about. It makes me wonder whether it is the first spanish med handout she has ever received >_<. that would say horrible things about the system if were true. an irrelevant point but perhaps patient is right to worry taking thorazine for sleep>

So the wise minds of the unit decided that med handouts should be a doctor's order. what??! As much as I desire more MD-patient medication education, it seems like a waste of their time to write out every med sheet they want each patient to receive and endless irritation for nurses having to ask the docs. The night charge told me tonight that I will need to tell the patients to ask the docs for permission for the handouts. If I answer every question with 'ask the doctor', I am useless.

In my opinion, this is a huge undermining of my job as med nurse. There is no intervention that will benefit every patient. Perhaps, rather than banning her from handouts, this just means that she needs more education. What if she were just watching TV one day at a commercial of her med and stopped taking it because of the side effect warnings at the end of the ad. There is also a legal standpoint of the ethicality of giving a spanish-speaking patient a med when the language barrier makes the administering nurse unable to adequately describe the med verbally.

Is this truly as ridiculous as it appears to me? Am I over-reacting? I will need to drag myself to the next nursing "leadership" meeting to fight this one with the half an ounce of credibility I still have here. I think it would make more sense for the docs to tell us whom {not} to make handouts for and assume that we make handouts for everyone else for all new meds and any requested med information.

Thanks for listening to another of my job rants =).

:trout:

*counting the days until my NP program begins*

[Whispera, MSN, RN]

It's in scope of practice to educate patients, and patients have the right (and it's mandated too) to information about their medications. You don't kill a practice when it goes wrong with one patient!

Thorazine for sleep in a non-psychotic patient???? How inappropriate! I don't blame her for being upset!

[inthesky]

hmmm mandated.. i should dig out a patient's bill of rights or something. I have my next shift tomorrow and will probably just verbally ask the doc for general med handout permission rights. If that fails, I'll just get back to the printer anyway and play ignorant. I don't bend to stupid and unethical =P

I thought that Thorazine was weird as well. She said she would kill herself if she couldn't sleep so I think desperation set in. Ambien, seroquel, temazepam, and remeron have failed. I say bring on the trazodone and possibly a sleep study.

thanks =)

[EarthChild1130]

In my state, when I got my license here, they sent me a little book called 'Nursing Practice in Oregon: What You Should Know' and it was a summary of the nursing scope of practice for this state...it did make clear that not only could I educate my patients, it was expected of me as a nurse...I'd check out your responsibilities as a nurse in your state, and have a chat with whoever decided that you couldn't carry out your duties as a nurse.

I've never seen anyone get Thorazine for sleep either...Trazodone is good...we use Rozerem some too but it's hard as heck to get covered on insurance!

[morte, LPN, LVN]

hmmm mandated.. i should dig out a patient's bill of rights or something. I have my next shift tomorrow and will probably just verbally ask the doc for general med handout permission rights. If that fails, I'll just get back to the printer anyway and play ignorant. I don't bend to stupid and unethical =P

I thought that Thorazine was weird as well. She said she would kill herself if she couldn't sleep so I think desperation set in. Ambien, seroquel, temazepam, and remeron have failed. I say bring on the trazodone and possibly a sleep study.

thanks =)

OT, but maybe it was supposed to be trazodone?

[inthesky]

Nope, it was definitely thorazine. After the patient panicked, they THEN tried trazodone. The patient still didn't really have good results; she probably needs a sleep study.

As an update, the unit manager decided that this was indeed a legal issue and handouts had to be provided. The catch is that the only thing we can print out for patients is what our hospital provides (bare bones information ie side effects only). One nurse even went on a rant about how horrible my medline gov handouts were >_<. at least now i can resume my printing. too bad the hospital info sucks.>

[morte, LPN, LVN]

Nope, it was definitely thorazine. After the patient panicked, they THEN tried trazodone. The patient still didn't really have good results; she probably needs a sleep study.

As an update, the unit manager decided that this was indeed a legal issue and handouts had to be provided. The catch is that the only thing we can print out for patients is what our hospital provides (bare bones information ie side effects only). One nurse even went on a rant about how horrible my medline gov handouts were >_<. at least now i can resume my printing. too bad the hospital info sucks.>

i wasnt questioning YOUR reading, but the original order/intent of physician.....take care