Giving residents non-prescribed meds?

[prinsessa]

Has anyone else heard of other nurses doing this? Several nurses have told me (or hinted without really saying) that they will give some of the residents medications that aren't prescribed to them or increase a dose (without a MDs order). When I first heard this I was shocked. I have told them that I don't agree with it and they better be careful doing it. Mainly it is done to help residents sleep. I'm just wondering if this is done at other facilities. Does anyone else think this is crazy?

[realnursealso/LPN, LPN]

No, I've never heard of that, and would never consider giving unordered medications to patients. We are nurses we cannot prescribe medications, or increase dosages on our own. Sounds like a disaster waiting to happen.

[netglow, ASN, RN]

Ooh, bad, bad. If the reason is to snow them especially.

I have heard scuttlebutt that nurses in LTCs that do not have prompt med delivery will borrow identical prescribed pain meds so the resident does not go through a period of pain prior to the arrival of patient's own meds to the facility if really needed. This is out of compassion. Those type faciities without prompt delivery, and no "go-to" box have got to be horrible places to work. I am sure there are many of them tho.

[prinsessa]

Sounds like a disaster waiting to happen.

That is what I said. I don't understand why anyone would do this. If they think a resident needs a certain medication they should call the doctor. There may be a reason why they aren't getting it. Drug interactions....disease process

[TheCommuter, BSN, RN]

I've seen this practice before.

One of my former coworkers admitted to giving her sundowning residents IM injections of Phenergan to make them drowsy and "more quiet."

[CoffeeRTC, BSN, RN]

WTHeck???? Injections, meds without a doc order for sleep. Keep up that practice and see how far it gets them.

Okay...I might have done this with a Tums or Mylanta before and then gotten an order from the doc. (actually a lot of our younger pts have meds of their own like this and I then need to explain the need for orders for these types of things)

[bsyrn, ASN, RN]

Bad practice, illegal and yes it is crazy and a good way to lose your nursing license...run the other way if someone suggets you do this.

[aileenve, ASN, RN]

this is illegal and also considered abuse

[Schmoo1022]

I have seen people give Mylanta/Tums....But never something for sleep and certainly not an IM med! That is crazy!! I am not sure why someone wouldn't call the DR if something was so desperately needed. Isn't that what they are there for? At our LTC facility, we do have several standing orders. They are great to have in place. But, now that I think of it...there isn't any standing order for anything like Tums or Mylanta....Hmmm

[kymaw]

I used to work at a place where many of the nurses did this. They would give anything from Tylenol and Pepto Bismol to Haldol without an order. I never saw this happen, so I never reported it. Also, when I refused to do it, I was talked down to and because I was a young nurse, I was considering "naive".

Never did it. Would never do it.

[classicdame, MSN, EdD]

phenergan in the elderly is really dangerous. What if the resident coded? Anyway, this practice is called "presecribing" and is outside the scope of practice for all but advanced degree nurses. I would not risk my license on it.

[NurseLoveJoy88, ASN, RN]

I do give meds that aren't prescribed like mylanta, tums, immodium, however I do write out a T. O. and make sure the pcp signs it. I'm not waking up the doctor at 1030pm for an order for tums.

Also, one resident was unresponsive due to hypoglycemia. I gave her glucagon which was NOT ordered at the time. MY don gave the ok and we got the order later. So I guess it depends on the situation.