Passing Medications/PRN's

[nursing gal 1964]

I have a question as a nurse, when working in a facility and a cna asks that the nurse give a prn medication due to behavior, well...let me explain....if a patient is up/down 5 times or 6 in a period, lets say 8-11 the cna asks the nurse to give the patient for sleep...but the nurse goes in and sees the patient before handing out meds and finds the patient asleep, should the nurse give a prn then? I did not but thought maybe I was in the wrong, my cna's can't handle the patients being up/down in our dementia unit and so to get the patients to sleep they ask for prn's. I am not giving anything unless I see reason, so does anyone else have this problem with their cna's asking for stuff?

[caliotter3]

When a CNA made a suggestion to me I would do my own assessment and act accordingly. However, what one CNA told me would have a different result than another. In other words, I trusted the judgment of some CNAs over others. If you walk into the room and the resident is now asleep, no more need for the PRN, as I see it. Now, if they wake up and start the up and down routine again during the night, I would give the PRN, partly based upon the CNA's report of behavior earlier in the shift.

[Mommyinschool]

I am just entering Nursing school, But worked in a group home under a RN and worked the over night shift. I was aloud to pass out meds myself if the patient was up and out of bed more then 3 times over a 2 hour period. But definatly not if they were already sleeping just to make sure they would stay asleep. I think that you did the right thing. If the patient is asleep then there is no need for the PRN. It is unfortunate for the CNAs to have to deal with them getting up all night, But is there a RN there to pass out meds if the patient wakes up? Or can they pass the meds out themselves?

[itsmejuli]

Do your own assessments and decide what is best for the resident.

When I was working in an LTC my direct supervisor who was a senior LPN asked me to give a PRN ativan shot to calm a dementia resident. I assessed the resident and told the supervisor that I refuse to give the PRN ativan since I could use other interventions to calm the resident. Yeah, my supervisor wasn't happy with me and I didn't care.

[annlewis]

You need the whole picture...it is a 24 hr facility..better nurse reporting on behaviors is what is needed...always listen to other nurses and your aides, ESP. If you have not worked in the past couple of days.o