I get so frusturated....

Oh, so they wanted to medicate him when he wasn't having an episode? Is Haldol a common drug used with patients who have a problem related to alcohol? Sorry for the question, this is supposed to be a vent. I can tell you this many people today in many profession and jobs don't want to do their jobs. Sorry you had to deal with that.

You were in the right. Chemically restraining a patient for the staff's convenience is illegal. Sounds like you were supervising appropriately and providing adequately for the patient's safety.

The nurses in your facility who choose to overmedicate for their convenience need to be educated.

Stick to your guns, and rant on! :)

Sorry you had a rough shift

I had a lovely conversation with a CNA the other night after returning from a really bad shift myself. She was upset because none of the nurses (myself included) had helped her with weights and chems the morning before (we were swamped) so she "got out late" and was letting us know right off that wouldn't be happening again the following morning. I was like, WTH??? You left at 7:10 and the first nurse didn't get out till almost 8:30!!! Your shift doesn't even end till 7:30 so you actually left 20 minutes early. Gah!

I can't believe another nurse would take it upon themselves to chemically restrain your patient in a non-emergency situation! I don't even like to give pain meds to someone's patient without asking first.

Thank you for that vent, I loved reading about it. It was educational (being a new grad) in terms of what to look out for and i'm sorry you had a tough day:D

Amen, sista!

I mean, was he even climbing out of bed? Was he yelling and screaming? Was he past his withdrawal phase? And even if he wasn't, you'd give Ativan, not Haldol. That is so not cool.

I've been a nurse for a year now and I end most of my work days feeling frustrated. Often VERY frustrated. Sometimes very, VERY frustrated.

I've been using my blog as a way to vent about my job and as way to try to process all the frustration and difficulty we encounter and have to deal with every day.

I understand how you feel. I think we all have shifts like that. unfortunantly probablky way too often.

He did have Haldol ordered. He's way beyond just the DT phase, he's basically fried his brain. At the time she medicated him, he was starting to act up, so I don't have an issue with her giving him the meds. I would have done it when I got off the phone. What my issue was, was the attitude she gave me for him not having been medicated all day. He's my patient, and just because you have cared for him a few times, does not give you a right to dictate the care he recieves today.

At the end of the shift, they kept yelling at him to lay down. Just because he was sitting up in the bed. The bed alarm was on. They basically expected him to lay down 24/7. He's by the desk for a reason. I have no problem medicating when they really need it. The end of the shift... YES he did need it. Throughout the day.. NO he didn't.

The other nurse was busy with her patients, so the times she happened to be standing in the nurses station, and saw him rolling or sitting up, does not justify her telling me I was wrong for not keeping him sedated all day.

PATMAC, no haldol isn't common. Usually a patient going through DT's will get ativan. But his is a bit different. He's been in the hospital a couple weeks now. He was in our ICU. (Where I work), but was then transferred.

At the beginning of the shift, they were all talking to the aid who was on, and had worked a few days before. She apparently didn't do 4 pm vitals, and one of the nurses didn't realize until end of ****. She was complaining (the aid) that she was by herself and didn't have time. They had 7 patients on the floor. There is no way you couldn't get vitals done. The problem is, you have nurses who will go out of their way to find the aid and tell her to do something, when they can easily do it themselves. Drives me crazy, and screws the ones who actually try and help. Because they end up having to do everything, instead of just pitching in.

Amen, sista!

I mean, was he even climbing out of bed? Was he yelling and screaming? Was he past his withdrawal phase? And even if he wasn't, you'd give Ativan, not Haldol. That is so not cool.

I've been a nurse for a year now and I end most of my work days feeling frustrated. Often VERY frustrated. Sometimes very, VERY frustrated.

I've been using my blog as a way to vent about my job and as way to try to process all the frustration and difficulty we encounter and have to deal with every day.

I bookmarked your blog, I'm going to check it out later when I have some time!!

First, I am sorry your shift ws "one of those". Second- about the other nurses medicating your patient-- I would be looking for their assessment charting. I would want to see what other interventions they did/tried before administering the chemical restraint medication. I also would like to see the follow up documentation on how the medication affected the behavior of the patient.

Since you did not ask for the assistance from these other nurses, nor did you deem it necessary to request your Charge Nurse to intervene for you on behalf of this patient, I do feel that the nurse patient relationship between you and your patient was compromised. Since you had not asked for help, nor asked to be relieved from duty for a mandated work break, then this was plain interferrence with your plan of care for this patient. I would be extra careful to have done charting reflecting this dose and use of Haldol. I am sure that your other charting would reflect the behaviors you wrote about above, ie: being lethargic, ect.. I also would have informed the physician about the medication being given by another nurse, without that nurse consulting you about needing assistance with this patient. I would have asked if said physician had any further orders for following this prn use of medication.

Thank you for sharing your work story. It reminded me to keep careful documentation and question the use of prn haldol when ordered.

Sorry you had a rough shift

I had a lovely conversation with a CNA the other night after returning from a really bad shift myself. She was upset because none of the nurses (myself included) had helped her with weights and chems the morning before (we were swamped) so she "got out late" and was letting us know right off that wouldn't be happening again the following morning. I was like, WTH??? You left at 7:10 and the first nurse didn't get out till almost 8:30!!! Your shift doesn't even end till 7:30 so you actually left 20 minutes early. Gah!

I can't believe another nurse would take it upon themselves to chemically restrain your patient in a non-emergency situation! I don't even like to give pain meds to someone's patient without asking first.

People never fail to amaze me. My hospital, you have to get permission from the supervisor to leave more than 7 minutes before the shift ends. Then you have to write it in the exception log. Which makes no sense to me though. So they end up paying people to sit on their bum and watch the clock so they can clock out.

Bit of a vent here, but I need to get it out, with people who understand. Anyways, I get so frusturated sometimes, with feeling like I bust my butt, but at the end of the day I am left responsible for the things other staff failed to do, or the one or two things I was unable to get to are what is focused on.

I know the aids are just as over worked and stressed as the nurses. I try so hard to help them as much as I can. I do baths, put people on bedpans, etc. But then at the end of the day, I find they didn't chart any intakes for the whole day. I wasn't the one who cleaned up their tray, I don't know what the intake was. Or I go to do something for the patient, and even though they say they bathed the patient, you sure can't tell.

Today, I cared for an alcholic who now has encephalopathy, and is out of his mind. In 4 point restraints. They D/C'd the restraints today to try and work on getting him out. He did pretty well. Sat up in the bed a few times, would roll around, and at one point was up on his hands and knees. But for the most part he was lethargic, wouldn't eat, etc. The other nurses were giving me **** at the end of the shift because they went and medicated him with haldol while I was on a phone call. (I was floating) Telling me it's messed up, no one has given him any medication all day long, and look at him. I told her, he hasn't been doing that. She responds well then you must not have been seeing the same thing we saw. I'm sorry, but when it takes me 5 minutes to wake the man up to take a pill, I'm not giving him a med to calm him. The few times he sat up, he was easily calmed. He's right by the desk. Sorry to inconenience you, I don't care to medicate my patients for my convenience.

Gah, sometimes I just leave so aggravated. I don't really care for where I work right now, and things like this just make it worse.

Thanks for listening:rolleyes:

I know what you mean! When I went for my panel interview, I explained my strengths and my weaknesses. I we4aknes is getting frustrated when I see others not carrying thier load.

First, I am sorry your shift ws "one of those". Second- about the other nurses medicating your patient-- I would be looking for their assessment charting. I would want to see what other interventions they did/tried before administering the chemical restraint medication. I also would like to see the follow up documentation on how the medication affected the behavior of the patient.

Since you did not ask for the assistance from these other nurses, nor did you deem it necessary to request your Charge Nurse to intervene for you on behalf of this patient, I do feel that the nurse patient relationship between you and your patient was compromised. Since you had not asked for help, nor asked to be relieved from duty for a mandated work break, then this was plain interferrence with your plan of care for this patient. I would be extra careful to have done charting reflecting this dose and use of Haldol. I am sure that your other charting would reflect the behaviors you wrote about above, ie: being lethargic, ect.. I also would have informed the physician about the medication being given by another nurse, without that nurse consulting you about needing assistance with this patient. I would have asked if said physician had any further orders for following this prn use of medication.

Thank you for sharing your work story. It reminded me to keep careful documentation and question the use of prn haldol when ordered.

You are correct, my charting did show he was lethargic, I also charted that he was easily calmed and would lay back down with verbal correction. I didn't notify the doctor, only because I know he wouldn't have said anything. They are at their wits end with this patient, and are desperately trying to get him out of our hospital. As far as the other nurses, it's their a$$ to be honest. This happened 15 minutes before I would be giving report, we have computer medication passes, with the scanning system. So my name will be no where associated with this administration. They nver documented a thing as far as giving him the meds. My restraint charting stopped at 1500 when the restraints were discontinued, which my charting and prog note show. Although because he is considered the "trouble" patient, I'm sure nothing will ever be done about it.

You are right, it is a great reminder of how important our charting really is!