what is the legal term of this matter?

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the patient is lack of mental capacity and unable to verbally express his medical needs; for instance asking for pain medication or anxiety; patient is showing sign of escalating agitation and screaming for 7.5 hours, patient has warrants of PRN; the charged nurse refused to give his prn medication. what is the legal term of this matter?

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Specializes in Psych, Corrections, Med-Surg, Ambulatory.

Legally, the nurse with the license makes that call and is responsible for the consequences of that call. She will use her knowledge of the patient's history, her general knowledge of pharmacology and pathophysiology to determine the best intervention for the patient. Sometimes the prescribed medication just doesn't work. Sometimes it's contraindicated for other reasons.

It's not the nurse's job to shut the patient up for everyone else's convenience. Maybe she isn't a very good nurse, or maybe she knows more about the situation than you do. Please ask her if there's anything you can do to enhance the patient's comfort level.

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Specializes in PACU.

There is no legal term for this, it's nursing judgement when to give PRN medications.

I've never seen an order give PRN for screaming. Giving medication to "stop someone from screaming" can actually be considered a chemical restraint. Restraints (physical or chemical) are very regulated with very specific criteria having to be met and signed off on before they can be given/applied.

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Specializes in Critical Care.
There is no legal term for this, it's nursing judgement when to give PRN medications.

I've never seen an order give PRN for screaming. Giving medication to "stop someone from screaming" can actually be considered a chemical restraint. Restraints (physical or chemical) are very regulated with very specific criteria having to be met and signed off on before they can be given/applied.

Just to clarify because this term often misunderstood, treating behaviors that result from a medical or psychiatric condition is not chemical restraint. If for instance someone is screaming for 7 hours straight simply because it's how they enjoy spending their free time then sedating them to stop their normal behaviors would be a chemical restraint. If instead it is due to any sort of medical or psychiatric condition, then treating the underlying condition that is contributing to the behavior is not a chemical restraint.

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Esolmayor are you in the United States or another country?

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Specializes in PACU.
Just to clarify because this term often misunderstood, treating behaviors that result from a medical or psychiatric condition is not chemical restraint. If for instance someone is screaming for 7 hours straight simply because it's how they enjoy spending their free time then sedating them to stop their normal behaviors would be a chemical restraint. If instead it is due to any sort of medical or psychiatric condition, then treating the underlying condition that is contributing to the behavior is not a chemical restraint.

Agreed!! If they are truly having anxiety that can not be controlled in another way, then the use of medication would be treating a symptom.

Unfortunately I don't know why this person is screaming... they maybe agitated from being in a locked unit.... and showing the frustration, which would mean using the medication is a chemical restraint.

Either way there is no legal term for not administering a PRN medication. I feel like the poster want us to label this as abuse or neglect. But I cannot, based on the information given, call it anything but nursing judgement, which is not a legal term.

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Specializes in PACU.
the patient is lack of mental capacity and unable to verbally express his medical needs; for instance asking for pain medication or anxiety; patient is showing sign of escalating agitation and screaming for 7.5 hours, patient has warrants of PRN; the charged nurse refused to give his prn medication. what is the legal term of this matter?

I also have had patients screaming in pain (post-op) that were not able to verbalize and because of anesthesia not yet in their "right state of mind". I have had orders for PRN pain meds and not given them... because if I did the patient would have stopped breathing. Everyday I make the decision, based on my nursing judgement, whether or not to give opioid IV meds to patients that are hurting. I was in tears myself once, because the patient hurt so bad, but with BP 50/30's and sleep apnea, I could do nothing. I felt helpless watching my patient hurt and kept rousing him, even though it woke him to the pain... because it also woke him up enough to breath. (Eventually he went to the floor and stabilized enough to get pain relief with oral analgesics, but it was a rough couple of hours).

There is so much more to know before an opinion could be attempted, and it would still be one-sided based only on information provided.

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Specializes in retired LTC.

I think there might be more to this post than we have been made privy to.

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Specializes in Med/Surg, Ortho, ASC.
I think there might be more to this post than we have been made privy to.

Exactly. And it may even just be a homework question.

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Specializes in Med/Surg, LTACH, LTC, Home Health.
the patient is lack of mental capacity and unable to verbally express his medical needs; for instance asking for pain medication or anxiety; patient is showing sign of escalating agitation and screaming for 7.5 hours, patient has warrants of PRN; the charged nurse refused to give his prn medication. what is the legal term of this matter?

I'm unsure of what it is you're asking. Are you referring to the matter with the patient, the nurse, or both? A few things come to mind:

The patient: mental retardation/challenge, expressive asphagia, deaf/mute, deemed-incompetent.

The nurse: failure to treat, negligent, incompetent.

Without knowing the 'whys' or the physical/emotional history, any of these or none of these could/would apply. The nurse may have a clinical reason for withholding treatment. Was the physician made aware of this? Is this a baseline behavior of the patient? Is the patient having a procedure soon that would conflict with the patient's medication therapy?

So many blanks....how about we fill in some of 'em?;)

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Specializes in tele, ICU, CVICU.

The nurse who wouldn't give PRN meds - negligent, lacking sympathy (not really a legal term), Is there a reason that nurse wouldn't give these PRN meds? As another poster stated above, there is a plethora of situations when certain medications should be held. I would think most electronic MAR systems ask for patients vitals prior to giving the med. And if that is left blank, that med cannot be charted as given.

I'm sure there are many different terms used for such a situation: Mentally incompetent, Power of Attorney, patient is 302 patient (unsuccessful suicide attempt, being involuntarily held against their will for 72 hours)

If we had more information about the particular incident you're referring to mite help clarify some details and yield more accurate answers...

Hope you're able to find an accurate answer for your question.

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Failure to treat, I think. Go up the chain of command and report her.

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