MVI tablet

[NurseAgatha]

Why can't the basic OTC multivitamin tablets be crushed? Does it have to do with release timing? There is nothing on the bottle that says it cannot be crushed, however I was informed by other staff recently that it cannot be crushed.

But my co-worker called the 1-800 number on the bottle and the representatives said that it could be crushed.

What is the verdict on this, especially in regard to state surveyors? There are many different opinions!

[ktwlpn, LPN]

Clear it up with your pharmacy or get the order changed to the vitamin elixir.

[caliotter3]

Sounds like there is a policy in place that deals with a previous supply of slow release tabs or that there was a blanket policy that no one looked at for this particular supplement. Agree, you should take it up with the pharmacy.

[CapeCodMermaid, RN]

No one living in a nursing home even needs a multivitamin. The solution is ---get it dc'd.

[ktwlpn, LPN]

Our new pharmacy consultant agrees-however the dietitian,residents and many family members do not. When you are talking about a terminal disease if a supplement gives the family some sense of doing "something" as long as they pay for it what 's the harm? I draw the line at refusals...None of the crap tastes good-no matter what you put it in -and when you can't get the resident to drink more then a few sips of liquid it's a loosing game.

[casi, ASN, RN]

As long as the pharmacy says it's crushable, crush away!

[CapeCodMermaid, RN]

Our new pharmacy consultant agrees-however the dietitian,residents and many family members do not. When you are talking about a terminal disease if a supplement gives the family some sense of doing "something" as long as they pay for it what 's the harm? I draw the line at refusals...None of the crap tastes good-no matter what you put it in -and when you can't get the resident to drink more then a few sips of liquid it's a loosing game.

Doing "something" can be harmful and annoying to the resident. If a family really wants to do something, they should come in and spend time with their loved one. Giving a multivitamin thinking it will help is just foolish.

[ktwlpn, LPN]

Doing "something" can be harmful and annoying to the resident. If a family really wants to do something, they should come in and spend time with their loved one. Giving a multivitamin thinking it will help is just foolish.

I don't believe you would say something like that to a resident's family....As I said,if frequent refusals are occurring we ask the doc to review and possibly d/c the med. We are not going to make an OTC med a battle when the family is going through adjusting to placement and facing the loss of their loved one.Our two consulting hospice agencies don't even do that.....

[KelRN215, BSN, RN]

I don't believe you would say something like that to a resident's family....As I said,if frequent refusals are occurring we ask the doc to review and possibly d/c the med. We are not going to make an OTC med a battle when the family is going through adjusting to placement and facing the loss of their loved one.Our two consulting hospice agencies don't even do that.....

Why not say that? It's not worth the battle with the resident and a multivitamin serves no purpose at the end of life. We say no to parents of dying children when they ask for absurd things at the end of life all the time- like if we could drop an NG tube on a daily basis to administer oral chemotherapy that the child could no longer swallow. No, we will not do that. And though you're used to knowing your child's lab values every day, we will no longer be checking them either.

Also, there are chewable multivitamins and liquid suspensions.

[amoLucia]

Most of the MVIs I've used are enteric-coated. Rule of thumb - enteric-coated meds should NOT be crushed.

Don't know if that means anything to this conversation.

[casi, ASN, RN]

I don't believe you would say something like that to a resident's family....As I said,if frequent refusals are occurring we ask the doc to review and possibly d/c the med. We are not going to make an OTC med a battle when the family is going through adjusting to placement and facing the loss of their loved one.Our two consulting hospice agencies don't even do that.....

I actually might suggest something like this. I may not say it so bluntly, but I'd point out that the use of MVI and other various vitamins frequently leads to GI upset and nausea. If they are worried about their loved ones intake or nutrition maybe they can bring in food from home or spend meal times with their loved ones.