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?
This is common in my LTC facility. I have a lady who gets 2 shots of vodka and some OJ at 1600. She is a vietnam vet, bilateral leg amputee, and alert and oriented. QUALITY OF LIFE is vital.
If I ever end up in SNF, I may just have to ask for an order "Medicate until hammered"
This is nothing new more like old way of dealing with alcoholics that are medically unstable for detox.. The kitchen of hospitals have a locked coolers with alcohol. I've been house supervisor and part of my job was having the key to booze.
also the hospital keep booze for the doctors get together and cooperate party stuff. I know the first time I got sent to the kitchen for booze was my first year of nursing back in 92. I was so naïve LOL I was so surprised to see a locker full of booze at a hospital
I don't know these days how its done cause I mainly work ER and we don't do maintenance anything. Its hopefully fast in/fast out to home or floor.
My mother was used to having 2 old-fashioned every evening. We posted the recipe on the cabinet in the kitchen, and her caregivers all got "inserviced" on how she liked it mixed. Whether or not it interacted w/her meds was moot. She was 85+; my sisters and I could see no good reason to with hold her drinks. When she went to the hospital, we mixed it @ home, and brought it to her. No one @ the hospital said one word.
If a provider orders ETOH, you might just ask why, or the purpose of the order. Are they preventing DTs? Are they just to keep the pt happy? jmo
I worked in a SNF and had plenty of residence with similar orders. We kept their alcohol locked in the med room and gave it as directed whether it was prn or routine. You have an order for it I don't see a problem but ifyou are still concerned talk it over with the Dr.
As other posters have said, this is nothing new. Back in the day we used to give our little old ladies 60cc's of sherry 30 mins before dinner to help their appetites. I have encountered resistance from staff when I worked with DD adults in the community. They enjoyed a beer or two as well and many were quick to label this as 'alcohol dependence.' Sometimes we have to get over ourselves.
When my time comes I hope my family ensures I have orders for PRN Prosecco and/or Moscato please and thank you.
Yep, I have given whiskey and beer per order, usually to those at risk for DTs but occasionally for a hospice patient who just wanted a beer with dinner.
The beer was kept in our med fridge which I found amusing. The whiskey came from pharmacy in a little red med syrup bottle with the label "Whiskey elixir" and smelled like it was the cheapest of the cheap, but the patient had no complaints.
I don't think it's any worse than loading them up with benzos to hold off the DTs, really, especially if they're someone you know perfectly well is headed back to drinking a fifth a day after discharge. It's one thing to be trying to transition them off the liquor if there's some hope they'll go to rehab, but when there isn't, a controlled dose to keep their withdrawals in check is a simple and humane way to keep them stable while you treat their other problems.
There is a can of beer in my unit's med fridge right now for a patient. I work on a busy inpatient surgical unit so it's not just in LTC or Assisted Living.
Not hijacking just background info on why this occurs: I worry if my dad ever needs to go inpatient as he's a chronic alcoholic and I don't trust nurses to do CIWA as ordered (some of ours don't) and would like him to have beer (his beverage of choice) so as not to go into DTs or have a seizure or a stroke. He drinks so much that I have no idea how much he would need to stay in a safe range but not enough to get drunk or even buzzed but maybe that isn't even possible at this point after about 50+ years of heavy drinking. I should check with an Addictionologist to see if there is a way to figure it out.
CapeCodMermaid, RN
6,092 Posts
I've been able to drink legally since I was 18. Why should I have to stop if my last days are going to be spent in a nursing facility?