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Discussion

Ethical question:

I am a nurse in CA at a SNF. One of my patients has C. diff and will not take her antibiotics. Someone suggested putting it in her juice. She is not her own responsible party because of dementia. Her responsible party is her son, who is ok with this. I'm not sure how I feel. What do you think?

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If she is not her own guradian and the son is and he is ok with it and given permission....then it is the same as the patient giving permission.

Give her the medicine...before you have more than one person with c-diff.

Her son wants her to have it he is the POA you have to respect his wishes on decisions. Her dementia has robbed her of making decisions. Working as a med pass nurse in LTC you will have to get creative to give meds at times...

Last I knew... the medicine to treat it (dificid) was running about $3, 600 per run. The last place I worked had to pay for it because the patient kept getting it and insurance wouldn't cover it.

Good Luck!

Why are you concerned? Do you believe you are going against her wishes or tricking her? She is obviously unable to make her own medical decisions and is there for a reason..to receive nursing and medical care! She needs the medication and it is perfectly acceptable to disguise or or hide it in her food to get it in her. Just make sure it is OK to put it in juice as sometimes that is contraindicated especially with acidic juices such as OJ. You can also check with pharmacy and see if other forms are available that will be easier to administer.

Also remember that there are other patents and residents (and staff members) that you need to protect as C-diff can spread rapidly especially if Healthcare workers are not consistently using standard precautions and/or housekeeping tasks are not done well.

Left untreated this can progress to toxic megacolon, sepsis and death. Not to mention it would be most likely be a miserable death!

Eh, this is what we do with kids all the time. Her son is her guardian and it's equivalent to the parents giving permission to do it with a kid, IMO.

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