Beer on a patient's dinner tray?

Nurses General Nursing

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This isn't a joke. Last night a nurse was talking about her patient getting beer on their dinner tray so she wouldn't leave AMA. The patient had a hx of ETOH abuse.

Other nurses replied that their patients have gotten beer in the hospital.

This totally confused me. Does this really happen??

Specializes in Home Health currently, med/surg prev.

Like the others have already said, it is common. I've even seen it delivered via NGT. Of course, only the minimum amount needed to prevent DT's is given, and it is the pt's usual ETOH (what their body is accustomed to).

With the elderly, you aren't going to change their ways in the sunset of their life so it is better to keep them out of DTs. For the non-elderly acutely ill, many times it is better to prevent DT'ing. Once they have recovered from their illness, the alcoholism can be dealt with. During acute illness just isn't the time to deal with something as dangerous as DT. It will only compound the problems.

I worked with an RN who was 20 (a few months shy of her 21st birthday). Our unit manager told her that she couldn't administer alcohol because state law was that only persons aged 21 and over could sell or serve alcohol. She could IVP narcotics, but she couldn't administer alcohol. I have always thought that was rather funny. LOL.

Many years ago I worked for a geriatric physician who was way ahead of his time. He routinely ordered "spiritus fermenti" for his nursing home patients. He felt that a glass of red wine with dinner improved the appetite, circulation & overall cardiac health. Today we're seeing articles touting this as brand new research!

I wonder how this gets processed through insurance. Do insurance companies usually cover it or does the patient get a bill for $50 beers?

I work for an insurance company and I can tell you there is NO way that its getting paid. It might be submitted with the other medical charges (probably listed under patient convenience items as I've never seen Coors Light 12 pack listed on a UB-92 LOL), but it will be denied. The more probable senerio is that the facility doesn't bill the insurance and instead takes the money for the alcohol from the pts funds (if in LTC or ALF) or bills the family outright, or the family brings it in.

I remember while working LTC for years I would see an order for a glass of wine, beer, harder liquor at HS or PRN and not always for the alcoholic. Many times it was for people who, for the entire adult lives, had a glass of beer/wine with or after dinner, at hs etc. I use to giggle watching the LOL with no teeth in her head, slam back a shot of JD! More power to her, if I tried that, the JD would come right back up :no:

IMHO, no worse than allowing clients to go out to smoke ... (And ETOH kills far fewer people than tobacco.)

Specializes in ICU, PACU, Cath Lab.

Unfortunately there is no alternative to ETOH..that I have seen?? I can give my patients the patch...or the gum...some even get that Chantrix(?) stuff. When I see the DT's commin I have asked for a beer..and have gotten denied every time! (for my patient...lol not for me) I have also never seen anyone go into a deadly withdrawl from smoking...have seen it a number of times with ETOH.

I have also never seen anyone go into a deadly withdrawl from smoking...have seen it a number of times with ETOH.

(Obviously, I was not referring to acute withdrawal, but to the overall, long-term effects. :))

Specializes in ICU, PACU, Cath Lab.
(Obviously, I was not referring to acute withdrawal, but to the overall, long-term effects. :))

Oh I know...sorry..just get going on a topic you know...smoking definately kills more..

Specializes in LTC, med-surg, critial care.

So far I've seen the following orders in acute care:

"Wine with all meals."

"One can of (insert beer brand here) with all meals."

"One can of (insert beer brand here) QHS PRN."

These all came up on meal trays or dietary would stock the fridge with whatever was ordered. It was odd to open the fridge for a apple juice and have two cans of Miller Lite. :p

And my favorite, this was what was written on the MAR:

"Vodka 30mL PO TID with meals. RN to mix with one glass of orange juice" I also had to go to pharmacy and sign out the shot of vodka like I was taking out an Ativan drip or something along those lines. This lady was a heavy drinker who had broken her arm falling at home. I honestly don't think it was enough for her.

In LTC one of our cute, tiny, 98 y/o ladies was allowed to have fried chicken and Bud when her family came in for special occasions (birthdays and whatnot). The family would bring it in and they'd all sit on the patio and have a good time. My favorite thing about it was she always said "Bud only no Bud Lite. Bud Lite is for p****s!" :chuckle Gah, I miss her.

i have see wine ordered with dinner many times because it was what these families drank with their meals from childhood

we once had this guy come in for something and he was a dyed in the wool alcoholic

he had his gardener who would come in carrying a small case i think that this 'gardener' was hired by family to keep an eye on him and keep him out of trouble so he wouldn't drive drunk or get into a bar brawl..anyway this patient was drunk everyday, once the gardener was about an hour late getting there and we had very angery guy on our hands

Specializes in med/surg.

I have have an order for a cup of whiskey tid before. it doesn't happen often but it is not unprecedented. the family has to bring in the liquor but we keep it in the med room and dispense as required.

it doesn't hurt (as long as the meds don't interact) and keeps the patient happy.

A cup of whiskey? Holy crap.

I've given shots of brandy (dispensed by pharmacy in a medicine bottle). I've mixed screwdrivers. I've given beer to pts on their dinner trays. When you've seen a pt have a grand mal seizure from DTs you know why they get their ETOH while hospitalized. There's nothing illegal or unethical about it. Pts can die from DTs.

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