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Behaviorist role in nursing? Protocols not by a physician questions...


Good Afternoon everyone.

I currently just started work in a day program with adults for developmental disabilites. Their current practice is that their behaviorist on site (Not an MD/PA/NP) makes protocols and addendums to doctors orders. For example, I have an order for Ativan PRN for Agitation and the behaviorist will come up with the criteria for administration. His protocol would then say Agitation is defined as 2 assualts and Ativan is to be given after this and if de-esclating plans did not work.

Can I just give it when I feel the client is agitated by my nursing judgement? Do i keep the addendum and just do what I want? Do I follow the behaviorist's plan? Is the the behavior protocol even legal against doctor's orders?


Esme12, ASN, BSN, RN

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma. Has 41 years experience.

I know little of non acute facilities. I would think that the ba=ehaviorist would have t have the MD's permission. Is there an official policy laying out the behaviorists role?

These kind of settings typically have clearly defined behavioral plans for each client, and everyone on the team is expected to follow the identified behavior plan. I suggest you talk with your direct supervisor about the expectations of your role at that facility. The behavior plan you describe is not "against" the physician's orders; it's just clarifying what counts as "agitation." Are you new to working in psych/developmental disabilities? I would expect that, if you start just giving people Ativan when you feel they are agitated, and not following the established behavior plan, you're not going to be working there v. long.