Are PRN's Abused?

[Meerkat]

It seems that whenever someone is having anxiety, or trouble controlling themselves, we dole out PRN's. In my opinion that teaches the patient nothing. In fact, it seems like PRN's are more for Staff's convenience. (Quieting a pt down so we can get on with our work and attend to others).

Am I missing something here?

[MadRedneckRN]

Many patients ask for PRN's for things they should be able to control. I agree it is easier for the staff to just give them a pill. I'll usually try to figure out what is causing the anxiety, but if the patient says they need it, I'll give it rather than make it a big issue. If I say "no, you aren't anxious" You can bet in 10 minutes they will be:uhoh3:

Some Docs are better than others about not prescribing too many PRN's. The doc for my unit is good. We don't need many PRN's. Across the hall... it's like a candy store. Same type of patients, but they are PRN hounds:chuckle The way the Doc handles the drug orders is the main thing.

I will usually suggest some quiet time in their room if the guys seem to be getting upset before I run for the Ativan. I'll talk to the patient and reassure them they are in a safe place and I am there to help. If that doesn't work, I'll call for a one time order. Usually it doesn't come to that, but on other units.... I feel like a dealer

Lori

[PRNMEDS]

I hear this argument at work a lot. Staff will say what are they learning? or what will they do when they are home. My answer is usually - they are NOT at home they are in an ACUTE psychiatric setting. Its hard to gage when someone is "really" feeling anxious, why do they need to become visibly anxious and disruptive to get a PRN? That they are in the hospital indicates that something is wrong. That they are choosing to ask for meds to get through a hard time seems reasonable to me. If they are getting to many - then the doctor should be notified, and it should be discussed in Treatment Planning. Perhaps the doctor does not have them on enough standing meds.

[TitaniaSidhe]

I hear this argument at work a lot. Staff will say what are they learning? or what will they do when they are home. My answer is usually - they are NOT at home they are in an ACUTE psychiatric setting. Its hard to gage when someone is "really" feeling anxious, why do they need to become visibly anxious and disruptive to get a PRN? That they are in the hospital indicates that something is wrong. That they are choosing to ask for meds to get through a hard time seems reasonable to me. If they are getting to many - then the doctor should be notified, and it should be discussed in Treatment Planning. Perhaps the doctor does not have them on enough standing meds.

Couldn't have said it better. Adjust their meds to a correct dose & the need for PRN meds should deminish. Meanwhile, as the adjustments are being made & unless you are dealing with a substance abuser, listen to your patient & give them what they need.