PRNs day of discharge

[sassyann85]

Wondering everyone's thoughts on this. We have some nurses that won't give a PRN Ativan for anxiety the day of discharge even if the patient currently has it ordered if they aren't going to be prescribed it as a discharge medication. But what if they are anxious because they are getting discharged, the change of environment, etc?It's still an active med on their inpatient profile, right? Or would you be hesitant to administer it?

We also get patients who come in for a suboxone taper for opiate addiction, then decide to leave AMA, but request a dose of suboxone (PRN or sometimes they are actually do for a scheduled dose from the taper) the day they are leaving.... Is this ok? In my mind, if they leave not feeling crummy and sick, maybe they wont go run to find some heroin. And if they do go and try to use, the suboxone will block the effect of the heroin anyway. But some of the nurses won't give the suboxone the day they are getting discharged AMA.

[ocean.baby]

The prescription is still good the day of discharge, the med has already been given so no worry about a reaction, and the patient has the right to leave the facility in the best mental and physical condition possible.

[Meriwhen, ASN, BSN, MSN, RN]

Until a patient is discharged (either regular or AMA) and has left the premises, I will continue to give PRNs as ordered. The only instance I will not give it is if the patient is driving themselves home because of the risk of impairment. I'll notify the MD about this and they'll either d/c the PRN that morning, or withhold administration after a certain timepoint.

[tyvin, BSN, RN]

Kind of silly if you think about it. The patient is being discharged and most likely has a PRN Ativan because they need to relax/calm down/etc... I've never heard of a nurse that does that, we always go according to the orders right up to the time of discharge. You might want to look up to see if your facility has any p/p on it and of course if they're driving as Meriwhen has posted.

:)

[MrChicagoRN, RN]

Everyone above is absolutely right.

I came onboard to a place with some silly rules.

One was that you shouldn't give a PRN before leaving because that means they aren't ready to go.

Makes no sense. Discharge anxiety is real. Anxiety escalates as they wait for their discharge to process, their ride to come, etc

sometimes the EMT or medicare driver engages them in a conversation that the patient justly finds irritating.

Why on earth would I ever want my patient to arrive at his next destination in a less than optimal state?