Published Jul 14, 2009
A couple of years ago, there was a doctor new to our facility who ordered for a ETOH dependent pt to receive 1 can of beer TID w/each meal. The nursing staff got a good laugh about it, but another nurse told us that some facilities give their patients beer to prevent withdrawal symptoms. Is this common in other hospitals? Or used to be common, but resorted to ativan instead? Some nurses say we might as well give them beer since when they leave the hospital, they'll be drinking anyway. But others think that it's going to make it worse for the pt since most alcohol dependent individuals drink more than 3 beers a day and it would cause more agitation by "teasing" them. I'm just very curious as to know how other hospitals handle their ETOH dependent patients.
I've seen both sides of this. Some docs (and I) prefer to give ETOH pts beer or vodka, if that reduces their length of stay and prevents DTs. If the pt is a known alcoholic with no intentions of stopping, what right do we have to put them at risk by withholding the substance their body has become so reliant upon? After seeing pts have seizures, become extremely combative / confused, or intibated, I don't see the point in holding a treatment that could prevent all of this.
We had that same order about six months ago, I believe the patient was in his 80s or 90s and the doc knew he wasn't going to quit drinking now so just give him a couple beers. Our pharmacy actually stocks it (some horrible brand that would make me quit :beercuphe). The doc thought it would be best not to put the guy in DTs when he will go home and continue to drink anyway. We did get a laugh at it though.
VivaLasViejas, ASN, RN
In the small country hospital where I worked years ago, we had a frequent flyer for whom the admitting doc wrote orders for "1 40-ounce beer PO Q 6 hrs. PRN". I'm not joking. The man had been drinking roughly half a case of beer a day since his teens and was not about to stop; the MD simply figured it was the lesser of two evils to just treat him for whatever brought him into the hospital, rather than have him go into DTs.
I agree with giving pts beer or alcohol if they are chronic, long term alcoholics. There is no point putting a patient through the horrible-ness of DT's if it can be prevented. I mean, if you have a trauma, a patient who's body is already stressed, why make everything worse by withholding a substance that the body has become reliant upon? If this keeps the pt from becoming combative, confused, and intibated, I'm happy to mix a drink up for them!
Elvish, BSN, DNP, RN, NP
Done it many times. I'd much rather give a patient a beer a few times a day than have them go into DTs, esp if they do not want to quit drinking.
Remember one lol, around 90yo, every night at hs she shot 30mls Brandy. The family had to supply it.
I work in an ALF, and a few residents get wine or whiskey with their 4:00 or 8:00 meds.
Wow! I need to get out more! I feel sorry for our poor pts going through DTs. Ativan don't help too much, so the pt's are on 1:1 observation, agitated, combative, beating up the poor staff, incont of urine and stool. It's a shame to see them going through that and a few pts had to go to ICU to be intubated-all because of the DTs!
DolceVita, ADN, BSN, RN
I had an instructor who discussed this with us. I have to say I that I wouldn't be thrilled about having to give this.
My question to you all is what happens when they are on meds and alcohol is contraindicated? Doesn't that leave the doc, RN and facility open to some kind of lawsuit or worse?
I worked in more than a few nursing homes where the patient had orders for 1 beer for supper, or 1 shot of whiskey at bedtime. And the family/patient bought it, we kept it in the med room, and the patients would roll up to the desk and ask for their booze!!! The most recent was just a couple of years ago.
I've never seen it in any hospital I worked in. Just the usual DT protocol, Ativan, Valium, sitters, restraints, etc.
This isn't uncommon.
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