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?
I worked at a facility that would regularly have beer/wine nights or margaritas. The patients had a choice between their opiate sleeping meds or the drinks.
99% of the time they chose the drinks and guess what, they slept far better with a couple of drinks in them than they did with the meds.
I have had several patients who on an individual basis could substitute their meds for shots of liquor. They always did better with the drinks.
I seriously think that alcohol is a severely underutilized intervention.
I had a post-op shoulder in and we were giving vodka prn, I have to admit it was weird seeing a vodka bottle with a name sticker in the med room. Unusual? Yes, uncomfortable?, no. Post op with a new shoulder was not the time to be dealing with detox.
If you have an order then give it. If I am stuck in a nursing home I want whiskey and dilaudid please. A little peace is a good thing. Seriously though, if that is their normal thing it is best to not make them endure DT's which is very dangerous.
If we're putting in orders for end of life care, can I have some good port with my fentanyl? Now that's the way to spend the last few weeks before I go out.
Actually, that is not true. I work in a neuro/trauma ICU so we always get the really bad DT's. A woman in her 30's came in for back surgery and stayed longer than anticipated. As a result, she ended up going into DT's. she admitted to drinking wine and beer daily. I talked with her husband and mother who confirmed that she only drank wine and beer 2-3 glasses on average, but never liquor. They all where so shocked to hear that a little beer and wine could cause this response. Someone does not need to be an alcoholic to go through DT's.
Um, yes, somebody who is habituated enough to alcohol as to have withdrawal symptoms is, by definition, an alcoholic. Not all alcoholics are unshaven guys in shabby clothes or blowsy old broads.
There's as much alcohol in a 12-oz can of beer or a 5oz glass of wine (and really, who only pours 5oz in a wine glass?) as there is in a shot of hard liquor. So if she's having, say, three drinks a day, that counts. Recalibrate your expectations.
Um, yes, somebody who is habituated enough to alcohol as to have withdrawal symptoms is, by definition, an alcoholic. Not all alcoholics are unshaven guys in shabby clothes or blowsy old broads.
There's as much alcohol in a 12-oz can of beer or a 5oz glass of wine (and really, who only pours 5oz in a wine glass?) as there is in a shot of hard liquor. So if she's having, say, three drinks a day, that counts. Recalibrate your expectations.
Yeah, I'd have to agree that MOST people who end up in DT's after having their alcohol intake cut off suddenly have a dependence that can be accurately described as alcoholism. You can be a wine alcoholic just as you can be a vodka or hard liquor alcoholic.
Years ago we gave "Eldertonic" to patients at bedtime. This was vitamins, but you could get it with 13.5% alcohol. And yes, once upon a time we gave alcohol drips!
I worked in an STR and a Dr did order a glass of wine with dinner for a patient who normally did this at home but not because he didnt want her to go into withdrawal.
If this patient is in a hospital setting how about giving Librium to ward off DT's thats our protocol...just a thought.
Specializes in OR, Nursing Professional Development.
If this patient is in a hospital setting how about giving Librium to ward off DT's thats our protocol...just a thought.
Because drugs aren't free of adverse effects. If someone is in the hospital for a few days, that's not going to be enough time to change a behavior that is likely a long term thing. The patient is going to go right back to their same beverage choices once discharged.
This was more common back in more sensible times. The patient is obviously a daily drinker and needs his maintenance dose.
My late husband got wine with meals in the hospital to help his appetite thanks to a very caring dietitian to whom I'm forever grateful.
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.
Now hospitals use Marinal as an appetite stimulant, it works wonders.
There is a reason that alcohol is not allowed in hospitals..because thats where most of the alcoholics and addicts end up after a life threatening run.
Also, if a person HAS to have even one drink every day...there is a problem. I have seen too many people come to the hospital and tell me how it began for them and it is usually very casually and developes into a very serious disease.
People need to be educated on alcoholism...so, yes I do get nervous about people NEEDING a glass or two of wine every day!!!
Because drugs aren't free of adverse effects. If someone is in the hospital for a few days, that's not going to be enough time to change a behavior that is likely a long term thing. The patient is going to go right back to their same beverage choices once discharged.
So your saying that giving them wine in the hospital is better than librium?
KRN90
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Maybe we start our own chain of LTC facilities centered around daily happy hour and free flowing taps. Bet there'll be a waiting list to get in.