Being Ordered to Give Whiskey

[purplegal]

So, the another night, we got a new admit. Along with this new person, amongst all the busyness that accompanies new people, was a strange order that made, and still makes, me nervous. Apparently, we are to give him whiskey along with his evening medications. This worries me since alcohol interacts with so many medications. Not to mention that, if we were to need to manage any pain, we would have to give dilaudid, which shouldn't be given with alcohol. It is an order, and he said he legally is able to do so, but it still makes me uncomfortable. It doesn't seem right as part of my nursing duties to be giving patients alcohol.

Has anyone ever heard of this? Am I right to be leery about this order?

[Here.I.Stand, BSN, RN]

These posts are actually scaring me.. to think that a good portion of the nurses that are posting here agree with giving a patient in the hospital alcohol, just so they don't go thru dt's?? or so they don't annoy you all night???or because they will just go back out and drink again???

Of course it's not about us being annoyed. It's about being proactive vs. reactive (as with a prn Valium protocol based on CIWA scores); and it's stating fact that sometimess the EtOH is part of the patient's medical plan of care. Just like any other med. We can't refuse to give meds because of a philosophical opposition to them. I was the one who responded upthread about giving a can of beer down the pt's feeding tube TID post major face/neck surgery. The ENT team chose to address the DTs issue with the beer instead of treating DTs after they are already happening, so I was explaining that in my experience, this is the reason for an alcohol order.

[guest2210]

Family usually provides the alcohol of choice. If there is no family, the money can be taken from the patient's account and the admininstrator or other office admin goes to the liquor store and picks it up. At least, that is how I have seen it done over the past 34 years.

[Ruby Vee, BSN]

These posts are actually scaring me.. to think that a good portion of the nurses that are posting here agree with giving a patient in the hospital alcohol, just so they don't go thru dt's?? or so they don't annoy you all night???or because they will just go back out and drink again???

I get alot of detoxers on my unit, we do give ativan/librium/valium to detox them, they are not going cold turkey. Yes, CIWA's might be annoying but neccessary. To say that these patients are going to go back out and drink again away is crazy! Ive seen people come to the hospital many times and then finally stop because we didnt give up on them. It only takes one drink for an alcoholic to get started again and sometimes just one person can make a difference. Just think if this were your mother,son,daughter..you would want someone who is actually educated about alcoholism to talk to them and care for them.

They did give alcohol a long time ago in hospitals, with education better options became available and the medical community unanimously agreed that alcoholism is a disease.

Alcohol given in an LTC setting is totally different. They are residents in a community, that is there home and they are not detoxing.

I'm sorry you're unable to process the posts that disagree with your opinion without being frightened.

I'm not sure any of the nurses posting here think that giving a patient alcohol in the hospital is the BEST idea; but it IS a way to prevent DTs, and for years it was the standard order for doing so. There are still some older physicians out there who order this as a matter or course.

DTs are no laughing matter, and i'd rather give alcohol to prevent them than not prevent them and end up with a patient in full blown DTs. In addition to the very real possibility that they weill seize and stroke, I've seen many a patient have to go back to surgery because with their thrashing about in DTs, they had a wound dehiscence.

Alcoholics are going to annoy us all night no matter what -- the alcoholic personality exists even if the person has not been drinking for years. So it's not to avoid being annoyed. As far as them going out and drinking again -- it's very possible. And they're not in my ICU with that enormous incision for a course of alcohol detox.

If this were my mother, son, daughter or husband, I would want a non-judgemental, competent nurse caring for her or him; someone who understood the physicians plan of car and could do their job appropriately.

[Skippingtowork]

America is still puritanical regarding alcoholic beverages. But with 5% of the world's population we consume 70% of the world's prescribed pharmaceuticals. We are one of 2 nations allowing direct to consumer advertising of drugs. Yet we get nervous at a daily glass of wine or 2.

This may be because it is well known that alcohol is the most dangerous drug and causes more problems in our society than the other drugs. It also causes more problems for the unborn than sexy cocaine. The problems do not come from having a daily glass of wine with dinner. Maybe, just maybe, practitioners may be concerned about causing additional problems or being sued.

Prescribing any alcohol should be done only after discussing the reasons and parameters with staff. Obviously, in certain circumstances the benefits of this order would outweigh the risks.

[dana.dee.lpn]

I had a patient a few years ago that had an order for whiskey PRN - it was the equivalent of 2 shots - I never saw any adverse effects from it, he was a self admitted life long "functioning alcoholic" and MD was aware...more often than not he'd also invite the staff to join him! It was weird to have a bottle of booze in the med room though lol

[Skippingtowork]

I am wondering if these same courtesies are extended to heroin and cocaine addicts and the newer additive medications. Just look at how pregnant women are judged when they have an addiction and present to the hospital. So sad.

[Asystole RN]

I am wondering if these same courtesies are extended to heroin and cocaine addicts and the newer additive medications. Just look at how pregnant women are judged when they have an addiction and present to the hospital. So sad.

Are opiates given to opiate addicts?

We should strive to not judge any patient but there is a strong negative social stigma with pregnant addicts. Destroying yourself is one thing but destroying the innocent is generally considered a bad thing.

[midgeypoo, LPN]

Are opiates given to opiate addicts?

We should strive to not judge any patient but there is a strong negative social stigma with pregnant addicts. Destroying yourself is one thing but destroying the innocent is generally considered a bad thing.

Many years ago (like 55 to be exact) when my father was hospitalized for major heart surgery, the Doctor ordered him whiskey shots. He was an alcoholic and I'm sure it was ordered to keep him from going into the DT's.

My only concern would be in giving the shot along with his medications. Guess I'd run it by pharmacy and get their opinion. Then give what is ordered.

Happy Holidays!

[Skippingtowork]

Are opiates given to opiate addicts?

We should strive to not judge any patient but there is a strong negative social stigma with pregnant addicts. Destroying yourself is one thing but destroying the innocent is generally considered a bad thing.

Unfortunately, our knowledge of addiction tells us that pregnancy is not a cure for addiction. We need a less judgemental approach to the pregnant woman and an evidence-based program which could save both her and her child.

[midgeypoo, LPN]

I'm sorry you're unable to process the posts that disagree with your opinion without being frightened.

I'm not sure any of the nurses posting here think that giving a patient alcohol in the hospital is the BEST idea; but it IS a way to prevent DTs, and for years it was the standard order for doing so. There are still some older physicians out there who order this as a matter or course.

DTs are no laughing matter, and i'd rather give alcohol to prevent them than not prevent them and end up with a patient in full blown DTs. In addition to the very real possibility that they weill seize and stroke, I've seen many a patient have to go back to surgery because with their thrashing about in DTs, they had a wound dehiscence.

Alcoholics are going to annoy us all night no matter what -- the alcoholic personality exists even if the person has not been drinking for years. So it's not to avoid being annoyed. As far as them going out and drinking again -- it's very possible. And they're not in my ICU with that enormous incision for a course of alcohol detox.

If this were my mother, son, daughter or husband, I would want a non-judgemental, competent nurse caring for her or him; someone who understood the physicians plan of car and could do their job appropriately.

Ruby Vee: I have to agree with you. Bad enough my father was an alcoholic back in his day but my older sister became one too. She was then and here 25+ years sober is still annoying and has all the alcoholic traits and behaviors even though she is sober.

I've learned to see her on a limited basis so I don't get too upset about it. That's just her personality and I have to accept it.

Some people are just closed minded and fearful. Life has it's way of teaching us to keep an open mind.

[workinmomRN2012, BSN]

She was then and here 25+ years sober is still annoying and has all the alcoholic traits and behaviors even though she is sober.

That's just her personality and I have to accept it.

Again, people should really educate themselves. I bet your sister does not go to AA on a daily or weekly basis... because if she did, she would not be the same person 25 years later. It is so much more than putting down the bottle! Her "traits and behaviors" would be diminished. If she is not going to meetings, she is what is called a "dry drunk"

A famous doctor once wrote about this, an alcoholic needs his/her medicine (meetings) the alcoholic will relapse and the same goes for a cardiac patient. If a person is on cardiac meds and they dont take there meds what happens??? same thing!!!

[midgeypoo, LPN]

Workinmom: Actually, my sister was a sponsor for many years and attended many AA meetings. I know this because I recall going with her to a few of them. She's no longer active at age 80 in AA to my knowledge. Interesting information though.